Friday 31 March 2023

Minister Salas: Covid-19 will displace heart attacks as the first cause of death this year

The Minister of Health considers that the country has already overcome 50% of the pandemic, but does not rule out a second wave if we become careless; assures schools will reopen for 2021

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31 March 2023 - At The Banks - BCCR

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QCOSTARICA – Dr. Daniel Salas, the Minister of Health, would like to have a crystal ball to answer how 2020 will end, marked by COVID-19.

As an epidemiologist, Dr. Salas estimates that the country has already advanced the pandemic by more than 50%, but assures that it is still far from over, which is why he insists that we must respect the recommended measures to reduce the risk of contagion. Photo: Julieth Méndz

“It is still very uncertain,” he says. “What is almost certain is that COVID deaths will displace those caused by heart attacks by the end of the year”.

Up to Tuesday, November 3, Costa Rica has registered 1,419 deaths associated with the coronavirus.

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In 2019, deaths from acute myocardial infarction totaled 1,322, according to the preliminary report of the National Institute of Statistics and Censuses (INEC).

“It is logical that there is a lot of pressure, but I am calm with the decisions (of the sanitary measures)because they are to protect health,” said the good doctor.

Eight months after the declaration of national emergency due to the pandemic, and with 112,120 confirmed cases (November 3), Salas considers that the country has already advanced 50% of the pandemic, but there is more to come.

“It was our turn for this generation to live such an unpleasant time as this pandemic, but this must evoke that each interaction and leaving the house carries a responsibility. The virus will not go away in 2020,” Salas told La Nacion in a telephone interview on November 3.

Q: How do you rate the behavior of the population at this stage of the national emergency due to covid-19?

A: There is still a very important percentage of the population, difficult to estimate in quantitative data, which continues to take care. They are people who, when they go out, think about their mask, about not going out if they have symptoms, about not breaking social bubbles. Clearly there is also mental and physical fatigue. This also brings challenges. But there is a significant percentage of the population that is still attentive by proactively complying with the protocols.

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Q: In what phase are we, according to information from the data analysis center, taking into account variables such as the R rate (less than 1 in recent weeks), mortality and hospitalizations?

A: I believe that we are already advanced in the first wave, possibly starting to come out of i, we are just over 50%. That will depend a lot on the vaccine and how quickly herd immunization can be achieved. We expect vaccination to occur sometime in the first half of 2021.

It is not feasible to say that this is the case because it depends on the number of vaccines and the logistical deployment. The faster we can vaccinate risk groups, we can say that the pandemic can begin to pass faster.

Q: The Government is currently betting on the strategy of shared responsibility, Costa Rica works and takes care of itself. Within the framework of this strategy, how should people understand the management of social bubbles and coexistence with others?

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A: There are people who understood the issue of bubbles clearly. Others not so much. What we have wanted to convey is that the group of people who are related by usual situations of their life normally, that is their bubble and that interactions outside that bubble are with all extremes. If I have to see someone, I hope it is in an open place, without removing my mask or eating with that person. That I wash my hands beforehand. That is the challenge.

Many people want to forget and think that December 31, 2020, is the expiration date of SARS-CoV-2, and it is not. Many of us would like to forget much of this 2020, and for the virus to understand that 2021 is coming and the pandemic is over, but it is not like that. Really, we are risking the lives of many people. Many groups, especially young people, tend not to behave in the right way. And it is not fair that they decide the lives of older adults. Nor for the lives of others.

Q: Can I go out and have fun with my friends? How should I do it? Where?

A: It’s not that I’m going to go party with my friends. For example, my mom. She is not part of my social bubble, but in the midst of mourning my father, it is not possible that I only contact her by video call.  I have had to see her several times.

But we sought out a ventilated place, we wear a mask all the time, if we eat something, she goes to a separate room and so we can have that kind of interaction. I am not going to break (social) bubbles left and right under any excuse, because that is how can provoke a second strong wave that will break the stability that we have had in the health system so far.

Q: Are you afraid that people will break bubbles for year-end parties?

A: Partying is not something we should be doing. If we want to do an activity, hopefully, it will be within the bubble. If for a mental health issue we want to see such a person, hopefully we can in an open place. I know that sometimes we say “I have not seen so and so for eight months.” Suddenly they saw each other, they shared five hours in a poorly ventilated place, and they forget that the virus exists. That’s the problem. They shared five hours together, they took off their masks.

If we start to do that in a sustained way, there will be a very, very strong wave. And I’m sure that when we see scores of deaths and the collapse of the healthcare system, we are going to be sorry.

Q: Could we see in Costa Rica what is happening in Europe right now, with massive confinements?

A: Confinements as severe as those in Europe are no longer feasible in Costa Rica because the economic situation is already declining and let us remember that health is not only the absence of disease, there is mental health, employment, and education. Other determinants that can cause more complex sequelae than the covid itself.

Many diseases are being triggered by a lack of physical activity. Many people do not have a salary for adequate nutrition, people in moments of anxiety crisis (…). All of this leads to disorder in other areas. It is actually quite complex. We have to see the human in an integral way. Our goal remains to have the lowest mortality possible.

We have 1,419 deaths, but it could be 3,000 or 5,000 or more! That is still our goal: keep it as low as possible. No one ever said this was a piece of cake. We are all living it firsthand. Recognizing this historical moment leads us to bring out that patriotism and civic duty to protect others. People must understand: that in these chains of contacts there are people with risk factors who will die because I deliberately burst the bubble. We have to have these balances and understand that we do not have a license to resume precovid life. No. We are in the covid and this means we have to behave differently.

Q: Do you believe face-to-face classes will return next year?

A: Yes, they will return, but that will be gradual. Not 100% will go back to school. We will have to understand that it will be shared between face-to-face and virtual, more virtual at first. But also understanding that there will be some schools where face-to-face classes cannot be retaken due to their infrastructure. We have to go back to normality as much as possible.

Q: What do the epidemiological projections say about the end of 2020? Or is this still a lottery?

A: The projections help, they give an idea of ​​what is happening. At this point, saying how we are going to close 2020 is quite uncertain. The data we have right now tells us that, possibly, we started to have a bit of a decline from the first wave. A second wave is likely.

I wish I could have that crystal ball.

Q: In hindsight, everyone has 20/20 vision. To date, what is your assessment of the COVID-19 approach to this emergency?

A: We could have advanced the development of some protocols, and have had stronger supervision mechanisms from the beginning. I would have liked a stronger culture of handwashing. Information system, I would have loved to have interoperability between the different information systems. When the COVID-19 arrived, the interoperability of the systems was not specified.

We only have one life. I know that because of that feeling of readiness we want to live it now, without sanitary measures, but this may mean that life is cut short. There are many who have a life expectancy of much more, but this can be cut short because they want to live. immediacy as if there were no pandemic.

There are people who have infected people very close to them, relatives who have died …

It was our generation’s turn to live such an unpleasant time as this pandemic, but this must evoke that each interaction and leaving the house carries a responsibility.

The virus will not go away in 2020. Possibly, the virus will become endemic, with less mortality and lethality (…). But at this moment it is still a virus that is destroying the health systems of very powerful countries.

Read the entire interview (in Spanish) at La Nacion.



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"Rico" is the crazy mind behind the Q media websites, a series of online magazines where everything is Q! In these times of new normal, stay at home. Stay safe. Stay healthy.

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