Monday 28 November 2022

Drop in covid-19 cases is not only occurring in Costa Rica

The number of infections in the American continent and the world is on the decline; international experts do not have a clear answer, several factors could come into play

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QCOSTARICA – In recent weeks, Costa Rica has experienced a reduction both in the number of reported new cases of covid-19 and in its contagion rate, that is, the speed with which transmission occurs.

The use of masks has been a generalized measure in all countries. Photo: AFP

Only in the last week, the reduction was 20.6%. But the reduction has been since the beginning of January when the daily average of new cases went from 1,100 to less than 400.

The same has been happening with hospitalizations and deaths.

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On Wednesday, February 17, the Ministry of Health reported 326 people hospitalized with the coronavirus, of which 155 required intensive care (ICU). A month ago, on January 17, 533 people were hospitalized, of which 233 in ICU. The peaks were on December 21 when 658 people were hospitalized and on January 4 when 256 people required intensive care.

The same happens with the number of people deaths associated with covid-19. It’s been almost two weeks where the daily deaths have no surpassed single digits.

However, our country does not face an exceptional situation, this downward trend is also seen in the continent and in the world.

With certain exceptions, the vast majority of countries show a decline.

In the last seven days, in the Americas, there was a decrease of 16% in its cases, similar to the decrease was observed worldwide. The number of deaths fell 2% in the Americas and 10% in the world.

And, if we take into account more weeks, the reduction is even greater.

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“The number of reported cases of COVID-19 globally has declined for the fifth consecutive week. The number of cases reported per week has been reduced by almost half, from more than 5 million cases in the week of January 4 to 2.6 million cases in the week of February 8. Only in five weeks,” Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), stressed at a press conference on Monday.

“Simple public health measures work, even in the presence of variants,” stressed the head of the UN health agency.

In the Americas, almost all countries register a decline classified as “very important” by the Pan American Health Organization (PAHO), serving as the Regional Office for the Americas of the WHO and as the health organization of the Inter-American System.

“The daily case numbers that we are seeing in the region today are those that were seen 12 or 13 weeks ago. It’s a steady decline over the past few weeks. However, this decrease has only taken a week in the number of deaths,” said Dr. Sylvain Aldighieri, Deputy Director of the PAHO Health Emergencies Department, Wednesday morning.

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“However, a lot of this has to do with the reduction seen in the United States, the country with the highest numbers so far,” he added.

In the world, this decrease comes, in general terms, since last October, with certain exceptions in the United Kingdom and other countries, motivated, to some extent, by the appearance of potentially more transmissible variants of the virus.

What is the reason for this reduction? Epidemiology and Virology specialists do not have a clear answer and indicate that there is more than one factor.

However, all emphasize the importance of not claiming victory, because the virus is easily transmitted and carelessness can reverse the situation.

The ‘salad ingredients’

Dr. Mike Ryan, WHO chief of emergencies, indicates that there one reason only that motivates the decline in infections, rather it is a phenomenon similar to “ingredients that are combined, like in a salad.”

“For what is this? Is it the ‘seasonality’ of the virus? Is it that their patterns are always in the form of a wave and now almost all the countries coincide in a low moment? Is it the natural herd immunity of those already infected that slows the rate down? Are control measures having an impact?” Ryan reflected on Monday.

“I think all of these options are true to some degree, but together,” he added.

A woman waves a giant “All for Vaccines” flag in São Paulo’s Sambadrome, Brazil. Photo: WHO

Vaccines not part of the equation

However, vaccines still do not enter this equation, because their application began relatively recently, and still (with certain exceptions, such as Israel), too few people are vaccinated for them to have an impact on statistics.

On the other hand, the vaccine does not necessarily impact transmission.

“The objective of the vaccine is to prevent complications, hospitalizations and deaths, not to control transmission,” said Jarbas Barbosa, PAHO’s deputy director.

For Dr. Ryan, the decisions made about vaccines will be momentous.

“If we manage to distribute the vaccines equitably and the most vulnerable and most at-risk people are protected, the disease and our measures will change,” said the specialist.

“The consequences of the transmission will be different, we will continue to see cases, but fewer hospitalizations and deaths,” he added.

However, for Ryan, it is necessary to study all possible factors in the behavior of the disease.

“When things go wrong in an epidemic, not everything is our fault, and when things go well, not everything is related to what we do well; the virus and how it changes also play a role,” he said.

The director-general of the WHO concludes: “the fire is not over, it just lost intensity, we must work so that it continues like this and does not gain strength again.”


This general decline in cases is good news and gives hope, but there is a risk of being confident and that the disease will regain strength.

“We have to be very, very careful. We cannot do the same as we did a few months ago, that a decrease in cases in some countries allowed the disease to re-establish itself and its contagion to accelerate again,” Dr. Ryan emphasized.

He added that the virus still has control over us.

Maria Van Kerkhove, technical chief of covid-19 at the WHO, insisted that we cannot become complacent.

“There are many challenges: new variants and changes, the natural evolution of the virus puts us in uncertainty as to what the virus will do next. And then there is fatigue, the world is tired, we are all tired and we want this to end. And this can also work against us,” she warned.

The exceptions

While in Costa Rica we have seen first hand the downward trend, not all countries, however, are experiencing it.

For example, the Eastern Mediterranean region (Afghanistan, Pakistan, Egypt, Jordan, Kuwait and nearby countries), cases rose 7% in the last seven days.

The Caribbean, islands of Aruba, Barbados, Saint Lucia and Saint Vincent, and the Grenadines still report an increase in cases.

In the Central American region, in Honduras, there has been an increase in positivity (percentage of people whose test positive) and cases in some departments.

As of February 17, Honduras reported 162,584 accumulated cases and 3,933 deaths.

“It is important that we are observing a mosaic of transmissions in Central America. In Honduras, first, there are still a significant number of displaced families in the north of the country as a result of storms Iota and Eta in 2020. They were disasters of enormous magnitude and impacted the primary health care network. And second, the country is in a pre-electoral stage and this leads people to relax measures,” said Aldighieri.


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