Director of Nicoya’s Hospital says “we could have a spike in January”

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Translator: Arianna Hernández

Almost the entire Guanacaste coast is on orange alert: Hojancha, Nicoya, Santa Cruz, Carrillo and Liberia, according to the update of COVID-19 alerts from the National Emergency Commission (CNE- Comisión Nacional de Emergencias).

This means that in these cantons, the index of risk by canton (IRC) is high (between 2 and 3). This index analyzes the trend of cases and the attack rate, in other words, how much the virus is infecting the population of a canton. This was explained by the Minister of Health, Daniel Salas, during a press conference in July.

The increase along the coasts is a national trend. The president of the CNE, Alexander Solis, specified that three out of four cantons on orange alert are from the coastal provinces (Limon, Puntarenas and Guanacaste).

“That puts us on alert in terms of what is coming in the next few days. They are coastal cantons, in remote areas and many people could be traveling there,” said Solis. He added that during visits they have made to Limon, they’ve observed that “people visiting are the ones who normally don’t comply with the measures.”

The increase in cases is impacting the COVID services of hospitals in the province.

The previous week, the Costa Rican Social Security Fund (CCSS) transferred 12 COVID-19 patients hospitalized at the Enrique Baltodano Hospital in Liberia to medical centers in the Greater Metropolitan Area (GMA).

In Nicoya, the COVID patients care service at La Anexión Hospital has noticed the increase in positive cases, especially in residents of Santa Cruz and Nicoya, said director Anner Angulo.

“In recent weeks, we’ve had an increase in cases and most of the tests that have been done have come back positive,” Angulo told The Voice of Guanacaste.

To tell you something, out of 20 that we process, 17 can be positive. So we have between 60 and 70 percent of the lab tests performed that come out positive,” he added.

Angulo indicated that infections may increase if communities don’t change their behaviors. “Right now going into summer (dry season), when there are Christmas festivities, if society travels more, we could have a spike in the month of January, starting in the second week,” he estimated.

Angulo insisted on the urgency of putting four measures into practice: distancing, maintaining social bubbles, wearing a mask and washing hands frequently. “If those four little things were put into practice, the transmission would be much lower,” he said.

Room for How Many More?

Despite having a COVID-19 unit, the hospital in Nicoya continues to transfer patients who require hospitalization to medical centers in San Jose (San Juan de Dios, Ceaco, Mexico and Calderon Guardia), Angulo explained.

COVID patients only remain hospitalized in La Anexión while they undergo tests to determine the level of inflammation and infection. Once they have the results, they decide which medical center in San Jose to send them to. According to Angulo, five to six patients are transferred weekly.

“To date,  the COVID unit hasn’t been saturated,” Angulo said.

We’ve had good capacity and good case handling, so much so that we’ve been coordinating with the Enrique Baltodano Hospital, because in some cases they’ve transferred [patients] here, and in others, we’ve supported them in transferring patients to San Jose.”

On Wednesday, December 16, for example, the hospital had 15 COVID-19 patients admitted undergoing exams. The unit’s maximum capacity is 32.

Enrique Baltodano Hospita’s situation is more critical. The Costa Rican government reported that COVID-19 spaces in Liberia have exceeded 90% occupancy in recent weeks. That medical center has the capacity to admit 22 patients in the group room and 14 in the intensive care unit (ICU). The Voice of Guanacaste tried repeatedly to talk with the director, Marvin Palma, but he didn’t respond to requests for this article.

The saturation of capacity in the GMA has the CCSS staff in suspense. On Tuesday, December 15, for example, the San Juan de Dios Hospital had 97 of the 102 spaces they have for COVID-19 patients occupied, so people who required hospitalization had to be transferred to other medical centers.

“We are reaching maximum capacity when one wouldn’t expect to reach the point of deciding that a patient can’t be in an intensive care unit and having to place them in other places that don’t meet all the conditions,” said Angulo, worried.

If the COVID-19 spaces in the Greater Metropolitan Area become overwhelmed, the CCSS plan for the Chorotega Region is for the Liberia hospital to treat critical cases (because it does have an intensive care doctor) and the Nicoya hospital to handle mild and moderate ones. Dr. Marvin Palma explained this in a previous interview with The Voice of Guanacaste.