Costa Rica updates norms that define patients as recovered

Costa Rica on Friday updated its coronavirus norms, modifying its criteria for determining when a patient is considered as recovered.

Under the new guidelines, published here, some patients will no longer require consecutive negative tests in order to be classified as recovered from SARS-CoV-2. The updated definition reads as follows:

A patient will be considered recovered and home isolation precautions will be suspended, without the necessity of requiring a control test (PCR-RT) to those patients who meet the following criteria:
1. For patients with minor symptoms who have not required hospitalization: 13 days after symptoms began, after at least 3 asymptomatic days (no fever, nor respiratory symptoms).
2. For asymptomatic patients: 10 days after the date the PCR-RT sample was taken.

Patients who require hospitalization will continue necessitating two consecutive tests, from samples obtained at least 24 hours apart, before they are deemed as recovered.

Health Minister Daniel Salas said the changed criteria are based on guidance from the World Health Organization and based on studies indicating the SARS-CoV-2 virus stops replicating within 10 days after symptom onset in mild cases.

He didn’t provide more specifics on those recommendations, but a recent publication from the WHO says that while “comprehensive studies on transmission from asymptomatic individuals are difficult to conduct, … asymptomatically-infected individuals are much less likely to transmit the virus than those who develop symptoms.”

In the same publication, however, the WHO says “viable virus has been isolated from specimens of pre-symptomatic and asymptomatic individuals, suggesting, therefore, that people who do not have symptoms may be able transmit the virus to others.”

Salas emphasized that Costa Rica is not facing a shortage of PCR (polymerase chain reaction) tests for SARS-CoV-2, the virus that causes COVID-19.

Between the Costa Rican Social Security System (CCSS) and the Costa Rican Nutrition and Health Research Institute (INCIENSA), the country has some 38,000 available tests, Salas said.

Costa Rica has processed 31,308 tests for the coronavirus through June 12.

CCSS says it conducts daily check-ins with all patients who have tested positive for the coronavirus.