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SAN JOSE, Costa Rica — “Pura vida” (pure life) is how Costa Ricans, affectionately called “ticos,” informally greet each other. They also use the term to encapsulate the country’s relaxed and free-spirited lifestyle, framed by beautiful beaches and storied volcanoes.
While the pandemic leaves me unexpectedly stuck in this visual paradise for three months, my experience has largely been pura vida, except for an emergency room visit in mid-April amid fears that I caught the virus — I didn’t.
Increasingly, more ticos aren’t hearing the same good news from the hospital staff; cases are on the rise after a largely praised light lockdown. The mini-wave of cases leaves some of the public wondering if the country’s low COVID-19 numbers relative to its neighbors and much of the globe has lulled officials into their own relaxed state. Others, and count me among them, wonder how severe any revived lockdown might be and what consequences will come with it.
As I write this in a high-rise apartment (I got a good Airbnb discount and San Jose’s glimmering skyline is an inspiration), Costa Rica is witnessing a sudden jump in coronavirus cases with 55 new illnesses reported Sunday — the highest daily number since this lush Central American nation recorded its first COVID-19 case on March 6.
I wonder (hope not) if Health Minister Daniel Salas (who some call Superman as he wears spectacles and looks like Clark Kent) will now re-tighten restrictions, something that neighboring Panama announced it would do over the weekend as daily cases spiked by 541 to over 16,000. (393 deaths have been recorded there to date, according to the Johns Hopkins University data dashboard.)
That number contrasts sharply with Costa Rica, however, where cases have barely ticked higher in the past three months, with the latest count at just over 1,300.
“ ‘We have the most modern and universal health-care system in Central America, which has been functioning for 80 years.’ ”
Indeed, this country of 5 million, nestled between the Pacific and Atlantic Oceans, has only reported 10 deaths from the pandemic (drawing international praise) compared with 386 for wealthier Panama, 230 for Guatemala and 53 for tiny El Salvador where an underfunded health system has been overburdened amid 3,000 cases.
“We have the most modern and universal health-care system in Central America, which has been functioning for 80 years,” Roman Macaya, the executive president of Costa Rica’s Social Security Fund, told me in March when I reported the beginning of the lockdowns.
Back then, Costa Rica was rushing to overhaul its health system to avoid disaster had the pandemic spread out of control. “We have 700 ventilators and we are opening a new hospital dedicated to COVID-19 [by converting a pre-existing facility] that will bring our number of ICU beds to 300,” Macaya said at the time, adding that the $60 billion tourism-based economy has 30 large hospitals, hundreds of midsize clinics and over 1,000 “ebais,” or small doctor offices, spread across its seven provinces. Given the virus’ low mortality rate here, it seems like all of these facilities were put to good use.
The lockdowns were hard to stomach but much easier than in other countries. At their height, they banned vehicle circulation from 7 p.m. to 5 a.m. and lasted over a month. Most retailers and restaurants were forced to shutter. Uber worked during the curbs, however, and people were allowed to stroll around the city, a sharp contrast from measures seen in Spain and Europe where citizens were caged for weeks, their rare shared experience clapping from balconies for a few minutes a day in support of health-care workers.
Costa Rica’s partial lockdowns, seen as the softest in Central America and most likely in Latin America (the pandemic’s new epicenter), were successful because rainforested Costa Rica is a peaceful country; the army was abolished in 1948 with spending diverted to education and ambitious civic programs, at least that’s what some of my new friends here have told me.
The result has been a nation that followed government orders and adhered to Salas’s daily admonitions for “Quedate en Casa” (Stay at Home). In fact, one of the things that impressed me about the government soon after I arrived in March was the rapid containment of sick people and the launch of a string of advertising campaigns to share health-care guidelines. These were later accompanied by similar spots from BAC Credomatic, the nation’s largest bank. Soft applause then for the bank whose ATM once charged me a whopping $27 for withdrawing $100; their ads were good, effective at encouraging customers to stay home and help quell the spread.
In mid-April, I got a first-hand view of this lauded health-care system. I had been unwell for a few days, with flu-like symptoms, fatigue and ultimately a high fever and had to seek emergency care. I have to differ with Macaya and say that on this particular occasion, the social security hospital I attended did not treat me all too well. Admittedly, doctors were stressed and I am not a Costa Rican citizen, so I forgave them for treating me like an alien.
After head-banging red tape (and a couple of whatsApp messages to Macaya), I was brought into the COVID-19 testing area. Unless you really think you have the virus, I don’t recommend this procedure. The nostril-prodding examination was incredibly uncomfortable and brought tears to my eyes. After the irritating experience, I was given hydroxychloroquine (the controversial treatment that has proponents and detractors) and asked to quarantine for two weeks. I panicked: a dual Spanish-American citizen, I was alone in San Jose and had no one to care for me.
Related:Hope dims for hydroxychloroquine even as medical study detailing the drug’s failure is retracted
The test results took much longer than the 48 hours nurses swore by. After three days of agonizing wait, I was told the test was negative. To ensure I wasn’t a false positive, I sought help at a private hospital in downtown San Jose. I was shocked to know the reason for my illness: chronic stress due to long confinement (I can’t fathom the consequences had the pandemic caught me in Spain).
“ Costa Rica further relaxed its restrictions in mid-May. Retail, dining and gyms are now open for a longer period of time. ”
Despite becoming ill, I am now fully recovered and enjoying Costa Rica. Helping along, the government further relaxed its restrictions on May 16, lifting them by three hours to start at 10 p.m. and run until 5 a.m. Retail, dining and other social venues such as gyms are now functioning for a greater period of time.
Costa Ricans have welcomed the move; they now appear to enjoy much greater freedom than their Central American peers, at least when compared to Panama and Guatemala, which also just extended its lockdown for another month.
Clearly, the government has done something right and will hopefully keep ticos from experiencing a second wave of cases.
Renato Gonzalez, director of regional health-care think tank the Inter-American Conference of Social Security (CISS) says the system is equipped to do so.
“Costa Rica’s public institutions have been reconfigured, including its social security fund,” he said. “This, coupled with the system’s larger [regional] coverage, will continue to lessen the crisis’ effect more than in other Central American countries.”
Costa Rica’s public health system can treat 98% of its patients, whereas Guatemala, El Salvador and even Mexico’s similar institutions cover 50% to 60%, according to Gonzalez.
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