When I sailed down to the BVI just before COVID-19 I'd had an accident aboard and needed to go straight to the doctor upon arrival. I had a friend on island sort it out with the minister of Immigration before my arrival in the West End. Despite this, I was threatened with fines and jail time because the Customs minister hadn't given his permission and Customs and Immigration did not get along! So even if one thinks that permission has been granted for an exception it doesn't mean that they will adhere to it. The only time I got a break was trying to clear into Road Town. I had no dinghy (it had been stolen) and couldn't find anyone to bring me ashore. I called C&I on the VHF and when I finally reached someone and asked if I could take the boat to the dock at Nanny Cay and take a cab into town they gave me permission and things worked out.
But as others have said, the BVI have become very unwelcoming towards cruisers - both the C&I experiences and the addition of large fees and associated costs make it a less desirable location. After almost 15 years there I've relocated my boat elsewhere and don't have plans to cruise there anymore.