Monday 27 March 2023

What is the effective formula in Costa Rica where fewer covid-19 patients die?

Costa Rica's robust health system has been key to fighting the coronavirus pandemic in the country.

HealthWhat is the effective formula in Costa Rica where...

Costa Rica's robust health system has been key to fighting the coronavirus pandemic in the country.

After spending a terrible night, with fever and severe headaches and shoulders, Henry* did not hesitate to go to the local EBAIS (clinic) in San José the next morning.

It was March 9, three days after the first case of the new SARS-CoV-2 coronavirus was detected in the country, which to date has left just 742 infections but only 6 deaths

Local health worker making a house call to deliver medicines and verify patient’s treatments.

At the government health center, he and his mother, who also had symptoms, were given some basic tests and sent back home.

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“They told me that I had a very large throat infection,” he tells his story.

The 50-year-old Venezuelan, residing in Costa Rica, suspected that he had caught covid-19 in his office, as another employee tested positive a few days earlier, after returning from a trip to Europe.

By March 17, Henry went back to the clinic to have samples taken. And four days later he received an email: he and his mother tested positive for covid-19.

Despite having some discomfort, and that his mother is at greater risk as she is over 70, his treatment was to be carried out at home. His wife and daughter were also infected.

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Henry assures that they never felt abandoned, but quite the opposite.

“From March 21 and until about 10 days ago, doctors came here for every other day,” to closely follow the treatment, explains Henry.

They were visited by health workers from the EBAIS, and their doctor was in contact with the family through WhatsApp messages.

The Equipos Básicos de Atención Integral de la Salud (Basic Teams for Comprehensive Health Care) – EBAIS – system has been the first line of response to the pandemic in Costa Rica and represents one of the keys that have allowed the country to have the lowest covid-19 case fatality rate in Latin America, experts say.

As the country today is 60 days in from the first detected case, on Monday, more than half of the infected (399) have recovered and 17 are hospitalized, of which only 5 are in Intensive Care.

Our best vaccine against covid-19 is to have a disciplined and educated population and a fairly consolidated health system. We do not spend on the army, but we do spend a lot on health, social security and education, and that has been very important,” says Dr. Luis Villalobos, a former dean of the Faculty of Medicine at the University of Costa Rica.

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A solid health system. Through more than 1,000 EBAIS clinics, administered by the Caja Costarricense de Seguro Social (CCSS), staffed by doctors, nurses, technical assistants and pharmacists, clinicians are treating covid-19 cases at the detection stage, which is crucial for containing infections.

The mortality rate in Latin America. Source Johns Hopkins Coronavirus Resource Center

As in Henry’s case, as a possible case is identified, active monitoring of symptoms is maintained until confirmation. If a patient worsens, then they go to the hospitalization level.

The most complicated moments in these last two months occurred between March 18 and April 13, when 496 new infections were confirmed. The worst day was April 9 with 37 infections reported in a single day. See our Covid-19 timeline here.

However, since then the progression of the disease has decreased markedly: less than 10 new cases have been detected every day, with the exception of April 16 and 22 (16 and 12 new cases respectively).

Artificial respirators, which many countries are struggling to obtain, are about 400 in the health system, and the government announced the acquisition of 300 more.

And having only 6 deaths from covid-19 in almost two months has made Costa Rica one of the countries with the lowest mortality rate from the disease in Latin America, and even in other regions of the world.

The operation of the system is largely due to the fact that Costa Rica is one of the few countries in the Americas (along with the US, Canada, Cuba and Uruguay) that invests more than 6% of the Gross Domestic Product (GDP) in health.

“Most of the population, due to the short time of the presence of the virus in our country, has not been exposed to the virus, has not been infected with the virus. We can have an increase in cases, transmission chains, intensely, in no time. The country is walking on a very fragile eggshell floor,” he warns.

Although on May 1, the government relaxed some measures in place since the beginning of pandemic, Health Minister Daniel Salas, who is cautious about the near future, warns Costa Ricans that the return to what was normal cannot be accelerated nor will it come in the medium term.

On May 11, the government of President Alvarado is expected to let the population know what restrictions will or will not continue past May 15.

* Henry is not the real name of the patient, his identity is reserved so as not to cause concern to his relatives in Venezuela.

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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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