Nicoya, COVID-19

Outbreak in Hospital Caused Four Deaths Due to COVID-19 in Nicoya

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Translator: Arianna Hernández

In the last two weeks, from Monday, September 7 to Sunday, September 20, Nicoya registered six of the seven deaths associated with COVID-19 that it has recorded since the pandemic began. In other words, on average one person died every two days, according to data from the Ministry of Health analyzed by The Voice of Guanacaste.

These deaths were added to the only death the canton had reported: a 78-year-old elderly woman on June 27.

At least four of the six deaths were people who were hospitalized for reasons other than COVID-19 but contracted the virus inside La Anexión Hospital and died right there. “Even though they were intubated, it wasn’t possible to save them,” the hospital director, Anner Angulo, told The Voice of Guanacaste.

Those who died had conditions considered high risk for COVID-19, such as cancer, chronic kidney disease, diabetes and hypertension. “They developed [COVID-19] very abruptly and there was no chance of transferring them [to a referral hospital in San José].”

The outbreak within the hospital originated when a person visited a relative hospitalized for a condition other than coronavirus. “That’s where the outbreak began. We have identified it,” the medical director affirmed.

Angulo also acknowledged that the outbreak happened despite the fact that the medical center trains visitors to comply with protocols, such as hand washing and the use of masks and face shields.

The hospitalized relative as well as the five men with whom he shared a room contracted the virus. Some hospital employees who were caring for these patients were also infected and the virus spread among patients and workers.

Sometimes the patient’s companion, with a very humanitarian gesture, helps other patients, but that shouldn’t be the case because they are only given permission to be with that patient,” Angulo reflected.

“But sometimes they forget. Then infections pass from bed to bed, from patient to patient and from there, they spread from one place to another,” he added.

Since the hospital identified the outbreak, it has again canceled visits to hospitalized patients, as it did at the beginning of the pandemic and when Santa Cruz reported a case after weeks without new cases in the lowlands.

Workers Come and Go

Between September 7 and 20, a total of 29 hospital employees tested positive for COVID-19 due to infections outside or inside the hospital. In addition, 105 (including the 29 positive cases) were sent home to isolate due to confirmed or suspected cases.

According to Angulo, some have already returned to work, others remain in isolation, and the hospital is sending others to quarantine due to suspicion or confirmation of the virus.

For the institution, this means investing financial resources and time. For each person sent home with a health care order, they must hire and train a professional to replace them “in everything that is involved in caring for a COVID and a non-COVID patient,” said Angulo.

As of Monday, September 21, La Anexión Hospital had 12 people hospitalized in the COVID area, four of whom were admitted that day. The doctors were evaluating whether their health statuses were evolving to a critical condition to transfer them to San José, since the hospital only keeps patients in mild or moderate conditions hospitalized there.

In March, when the coronavirus emergency began in Costa Rica, La Anexión Hospital set up a sink, towels and soap at the entrance. Two visitors were washing their hands outside the hospital on the afternoon of March 20. Photo: Cesar Arroyo Castro.Photo: César Arroyo Castro

Canton at Risk

During the two weeks in which Nicoya registered the six deaths, the canton also experienced an increase of almost half of all accumulated infections (46.6%) as of Sunday, September 20.

The hospital director attributes the increase in the numbers to people dropping their guard.

The social bubbles are bursting and we believe that is the way the majority of people are getting infected. They lose their fear, they lose the social bubbles and there come the infections,” he said.

Nicoya is one of the cantons with the highest risk of infection in the country, according to the baby shower index, analyzed by the UCR Central American Population Center.

The institution explained this indicator as the probability that  there is someone with an active COVID-19 case that transmits the virus to some of the participants during a meeting of 20 people, such as a baby shower or a party.

According to this index, there is more than a 10% probability in the canton of Nicoya that an infected person will spread the virus among those who attend an event of more than 20 people. It is ranked as having the 15th highest rate out of 82 cantons nationwide.

The study also pointed out that in recent weeks, communities in coastal areas are among the most vulnerable to getting sick with COVID-19.

As of Tuesday, September 22, Nicoya registered 380 people with the coronavirus, of which 170 are recovered and seven have died.

Due to the increase in deaths and cases, the director of La Anexión insisted that people should reinforce measures such as hand washing, use of face masks and not bursting social bubbles.

“Although it is true we have been working with the different institutions, the strength of all the personnel of each of the institutions is exhausted by the indifference of society to avoid infection from covid,” he stated.