III. Impacts of covid-19 The structural precarity in which the migrant population and their descendants find themselves exposes them to multiple impacts of COVID-19. This section summarizes the research findings on the following topics: • • • • • • • • • • Prevalence of the disease and access to health services Knowledge about the virus and prevention measures Economic impact Access to education Social protection programs Voluntary and involuntary returns to Haiti Transnationalism Access to vaccination Documentation process Dialogue and search for solutions a) Prevalence of the disease and access to health services According to Public Health Bulletin # 397, as of April 19, 2021the Ministry of Public Health had registered 261,848 confirmed cases of COVID-19 and 3,426 deaths since the first case on March 1, 2020. Haiti had reported 12,918 cases and 251 deaths, as of April 18, 2021. On a global scale, the Dominican Republic (DR) has managed COVID-19 relatively well, given that the number of deaths is lower than many other countries. As of April 19, 2021 Worldometer reports the country as having 313 deaths per 1 million inhabitants. According to these same statistics, there have been fewer deaths in the DR than in Italy (1,948), the United Kingdom (1,867), the United States (1,749), Brazil (1,754), France (1,547), Colombia (1,340), Argentina (1,306), Germany (964), Russia (728) and Canada (624), which are all important markets for tourism in the DR and countries with more robust health systems. Nonetheless, by the end of April 2021, the US had classified the DR as level 4, advising against travel to the country due to the alleged high levels of COVID-19 (US consulate travel advisory, April 21, 2021). Furthermore, in the context of the insular Caribbean, the DR is the epicenter of the pandemic since it has more deaths per capita than other islands in the archipelago. This has important impacts on the national economy, given the Caribbean countries’ reliance on tourism. The Dominican Republic remains under a state of exception, decreed to extend until May 30, 2021 (Decree 319-21). The main urban centers around Santo Domingo and Santiago have the highest rates of COVID-19, while the border provinces, including the Enriquillo subregion, have a positivity rate below 5%. On April 19, 2021, cases in the four provinces that make up the subregion numbered: Barahona (2,727), Bahoruco (1,401), Independencia (1,022) and Pedernales (653). It should be noted that, similarly to Greater Santo Domingo, the Enriquillo subregion experienced another surge in cases of COVID-19 in May 2021. However, in the case of these southern border provinces there is lower access to health services than the capital area, due to the levels of poverty and relative underdevelopment. The public health measures with greatest impact in terms of epidemiological control have been implemented through a series of states of exception and limitations on mobility and gatherings. In addition, pandemic public health response has involved the creation of 20 Research Brief: COVID-19 Impacts on Haitian Migrants and their Descendants on the Southern Border of the D.R.