Sunday 24 September 2023

‘It was not the time to change restrictions’ in the face of covid-19

Epidemiologist Juan José Romero warns of the lack of epidemiological intelligence in the country, or the use of quality data to make health decisions in critical situations, such as the pandemic

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QCOSTARICA – Juan José Romero Zúñiga is an epidemiologist at the Universidad Nacional (UNA) – National University (UNA) – and one of the most media specialists in this pandemic.

His reading of the data and the evolution of covid-19 in Costa Rica is frequent in the national media, where his criteria are requested to interpret what is happening and where the country is heading with the SARS-CoV-2.

Juan José Romero Zúñiga is an epidemiologist from the National University (UNA). (Courtesy UNA)

On August 19, Romero and Agustín Gómez Meléndez, a statistician at the Universidad de Costa Rica (UCR) – University of Costa Rica – published an article in the opinion section of La Nación where they warn of the lack of “epidemiological intelligence” in Costa Rica.

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They define it as the use of data (in sufficient quantity and quality) to detect outbreaks or changes in disease trends and, among others, to know their location, identify patterns in affected individuals, sources of contagion and means of transmission.

This is one of the bases for governments to make decisions with an impact on public health.

Romero and Gómez criticize the lack of quality data, systematized through the use of modern computer tools, and the lack of inter and intra-institutional cooperation to view the information in real time and facilitate decision-making in health.

Not just because of the pandemic. Also to control other events that impact health and economies, such as food-borne diseases and antimicrobial resistance.

The data to which the authors refer are managed, on different platforms, by the Ministry of Health and the Caja Costarricense de Seguro Social (CCSS).

The CCSS, for example, has the Expediente Digital Único en Salud (EDUS) – Unique Digital Health Record – which, for the control of vaccination, has the Sistema Integrado de Vacunas (SIVA) – Integrated Vaccine System.

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Other institutions that are part of the health sector have their own databases. Among them, Acueductos y Alcantarillados (AyA), the Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (Inciensa).

The article by Romero and Gómez appeared 24 hours before the Government announced adjustments in the sanitary restriction measures, this August 20, just when the number of new cases, hospitalizations and deaths from Covid-19 is growing.

The two most important changes announced Friday, starting on September 1,  is the elimination of the daytime vehicle restriction, on weekends, and a pilot plan to allow fans at major sports events, such as the men’s and women’s national soccer teams events at the national stadium in September.

On August 13, CCSS teams carried out the second mega transfer of patients from Nicoya, Guanacaste, to San José.

The conclusion

For Romero and Gómez, far from reducing infections and hospitalizations, the changes in sanitary measures announced for September and the accumulation of decisions that have to do with fewer restrictions will result in an increase.

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“I wish, with all my heart, that all my years of study and the hours that I dedicate to the study of this thing will be of no use to me and at this moment I am wrong.

“I say that we are going to have more internments, more people in the ICU and more deaths, not because of this decision of whether to release or not, but because of the accumulation of decisions that have to do with fewer restrictions. I think that we are going to go up and we are going to have more hospitalizations because we are already having them” said Romero.

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Reports by QCR staff

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