Precautionary Measures: Pre-COVID-19 Outbreak
A task force co-chaired by the Prime Minister and the Leader of the Opposition Party was assembled to implement precautionary measures including the closure of schools, day-care centers and universities. These measures were adopted with bipartisan endorsement, which may have combatted any unwillingness to cooperate by the general public due to political biases.[5][6] Persons who were travelling from countries where COVID-19 was endemic were prohibited entry into Belize. Belizean nationals returning to the country from areas of native spread were urged to self-quarantine for 14 days. Social gatherings were limited to 100 people. Ports of entry on the ground, except the northern border with Mexico, were also closed.[5] Campaigns were conducted countrywide to educate the public on the importance of proper hand-washing hygiene and cough and sneeze etiquette. Recommendations were issued to the general public that rely on public transportation to avoid overcrowded buses, and employers were instructed by the government to be accommodating to their employees with working hours, as the situation evolved. All forms of public transportation were mandated to disinfect all vessels following each run.[7] As cases began to appear throughout Central America, social gatherings were further reduced from 100 to 25 people, including supermarkets, grocery stores, restaurants and bars.[2] These mandates were heavily upheld by law enforcement.
COVID-19 Outbreak Phase
Following the first confirmed case of COVID-19 on Ambergris Caye, the country’s most populated island, a state of emergency was declared on the island which grounded all vessels entering or leaving Ambergris Caye for 72 hours. During this time the Ministry of Health conducted a mapping and tracing exercise of contacts.[8][3] Residents on the island were encouraged to stay at home and not leave except in the case of unavoidable circumstances. All bars, restaurants, casinos, clubs, and lounges were ordered to close within two days countrywide.[8] These measures were set in place to contain the first identified cluster of COVID-19.
In preparation for a potential health crisis, a brigade of Cuban medical professionals specialized to assist in times of disaster and pandemics was received two days after the first case of COVID-19 was confirmed.[9] The Judiciary of Belize closed all criminal cases being tried by the Supreme Court and excused all jurors. Civil and family court cases were addressed by written submissions and over the telephone. Where persons had to attend court in person, the guidelines with regards to gatherings and social distancing were enforced.[10]
On March 29th 2020, the third confirmed case was identified on mainland Belize. The patient was placed into self -isolation and a mapping exercise of the patient’s contacts was conducted.[11] This led to the declaration of a national state of emergency which included a curfew from 5:00 a.m. to 8:00 p.m. that restricted movement, except for health emergencies.[12] A heavy monetary penalty or two years imprisonment was enforced for anyone who did not adhere to the curfew. Social gatherings were limited to 10 persons along with the closure of all services deemed non-essential. Measurements were set in place on the basis of evidence gathered from other countries and the advice from local experts. The agreed upon conclusion was that the best way to at least slow, and hopefully stop, the spread of the virus, was by strictly enforcing physical distancing, restricting movement of non-essential workers across district lines, quarantining, and self-isolation of COVID-19 patients.[12][13]
Services deemed essential were allowed to operate during the business hours of 5:00 a.m. to 7:00 p.m. Public social distancing of three feet was enforced. Working from home was strongly encouraged wherever possible and social gatherings were prohibited with the exception of funerals capped at a maximum of 10 persons. Movement across district boundaries was restricted except for essential workers and it was announced that even Belizean nationals were not allowed entry into the country.[14],[15]
On April 7th, additional measures were implemented to quarantine the Cayo district where a potential second cluster of infections had been identified.[16] This included restricted movement in and out of the district and reduced working hours for essential services from 8:00 a.m to 4:00 p.m.[17] Additional legislation prohibited movement across district lines.[18] On April 17th, movement on Sundays was completely restricted for a period of 14 days, except for essential workers and emergencies.[19]
Plateau and Recovery Phase: Returning to a New Normal
On April 18, 2020 Belize plateaued at 18 confirmed cases (see Fig. 1.1). Daily public briefings were made on social media, the Government’s platform of choice, and other news outlets. As regulations subsequently became slowly lifted, movement of people was allowed on Sunday, curfew hours were reduced, and non-essential businesses such as hotels and hair salons were allowed to operate within specified protocols to limit social contact.[20] Despite no new cases, on April 30th, it was made mandatory for all citizens to wear face masks in public. Businesses that were allowed to reopen were instructed to ensure a distance of at least six feet between employees and all employees were required to wear masks. Certain establishments remained closed including casinos, gaming establishments, gymnasiums, sporting complexes, discotheques, bars and nightclubs. Movement during non-curfew hours had to be purposeful and all citizens were subject to questioning by law enforcement officers when outside. Social distancing and sanitization continued to be enforced and encouraged.
On May 4th 2020, new legislation was signed into effect to allow almost all businesses to reopen with the exception of schools and daycare centers.[21] Belize’s largest industry, the tourism sector, took the hardest economic hit when all borders were closed. The indefinite closing of the tourism industry by COVID-19 made reopening the local economy a priority. Social distancing protocols were to remain enforced with an emphasis on wearing face masks, regularly sanitizing hands, and maintaining a six-foot distance in between patrons. A strict curfew and restriction on movement across district lines remained in place to minimize unnecessary movement.[22]