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Costa Rica’s rising coronavirus numbers aren’t simply due to more testing

July 7, 2020

Costa Rica has averaged 251 new coronavirus cases daily over the last 10 days, by far its largest increase during the pandemic.

The country is indeed testing more people than before. So far in July, Costa Rica averages 1,084 daily tests (through July 6), up from 277 daily tests over the last half of April.

At the same time, Costa Rica’s test-positivity rate has increased dramatically (i.e., out of all people tested, how many came back positive). This is shown by the red line on the above graph, which represents a seven-day moving average.

Hospitalizations on the rise

Meanwhile, Costa Rica is experiencing a rise in COVID-19 hospitalizations. While many of those who test positive for the coronavirus are asymptomatic (or have mild symptoms), more people are currently hospitalized with COVID-19 than ever before:

Costa Rica coronavirus hospitalizations on July 7, 2020
Costa Rica coronavirus hospitalizations on July 7, 2020. Tico Times graph.

Why has Costa Rica’s test-positivity rate increased?

Costa Rica’s test-positivity rate has increased because there are many more people with the coronavirus today than there were in April, according to Mario Ruíz, medical manager of the Social Security System (CCSS).

“There is higher circulation of the virus, and higher chances of contagion,” Ruiz said of the positivity rate.

That’s likely due to various factors, including an easing of restrictions, people breaking physical-distancing guidelines, undocumented migration, and a strain of the coronavirus that is more contagious than the one that first appeared in China last year.

At the same time, Costa Rica has improved at targeting testing. For instance, health authorities conducted mass testing in Pavas after detecting traces of the SARS-CoV-2 virus in the district’s wastewater.

The CCSS is now testing at least 1,800 people in Alajuelita.

What does it mean to have high test positivity?

According to Johns Hopkins:

If a positivity rate is too high, that may indicate that the state is only testing the sickest patients who seek medical attention, and is not casting a wide enough net to know how much of the virus is spreading within its communities. A low rate of positivity in testing data can be seen as a sign that a state has sufficient testing capacity for the size of their outbreak and is testing enough of its population to make informed decisions about reopening. 

The World Health Organization (WHO) says that a test-positivity rate below 5% for two weeks is one indication a country has controlled the epidemic.

How did we calculate test-positivity rate?

We first calculated the daily number of people tested by adding a day’s new positive cases to new people who tested negative. (This is typically lower than the total number of new tests performed in a day, since one person can be tested several times.)

We then found the average percentage of tests that were positive over the prior seven days.

Here’s the raw data:

Date New people testing negative Daily positive tests Daily people tested Percentage positive tests (7-day moving average)
12-Mar 88 1 89
13-Mar 83 3 86
14-Mar 126 1 127
15-Mar 35 8 43
16-Mar 165 6 171
17-Mar 105 9 114
18-Mar 135 19 154 5.99%
19-Mar 96 18 114 7.91%
20-Mar 95 26 121 10.31%
21-Mar 144 4 148 10.40%
22-Mar 210 17 227 9.44%
23-Mar 133 24 157 11.30%
24-Mar 146 19 165 11.69%
25-Mar 5 24 29 13.74%
26-Mar 647 30 677 9.45%
27-Mar 455 32 487 7.94%
28-Mar 126 32 158 9.37%
29-Mar 203 19 222 9.50%
30-Mar 247 16 263 8.60%
31-Mar 136 17 153 8.55%
1-Apr 345 28 373 7.46%
2-Apr 111 21 132 9.23%
3-Apr 90 20 110 10.84%
4-Apr 175 19 194 9.68%
5-Apr 425 19 444 8.39%
6-Apr 252 13 265 8.20%
7-Apr 146 16 162 8.10%
8-Apr 491 19 510 6.99%
9-Apr 226 37 263 7.34%
10-Apr 135 19 154 7.13%
11-Apr 137 19 156 7.27%
12-Apr 136 18 154 8.47%
13-Apr 89 17 106 9.63%
14-Apr 70 6 76 9.51%
15-Apr 185 8 193 11.25%
16-Apr 198 16 214 9.78%
17-Apr 165 7 172 8.50%
18-Apr 221 6 227 6.83%
19-Apr 47 5 52 6.25%
20-Apr 94 2 96 4.85%
21-Apr 259 7 266 4.18%
22-Apr 289 12 301 4.14%
23-Apr 248 5 253 3.22%
24-Apr 101 1 102 2.93%
25-Apr 81 6 87 3.28%
26-Apr 35 2 37 3.06%
27-Apr 56 2 58 3.17%
28-Apr 51 8 59 4.01%
29-Apr 229 8 237 3.84%
30-Apr 103 6 109 4.79%
1-May 161 6 167 5.04%
2-May 83 8 91 5.28%
3-May 114 6 120 5.23%
4-May 103 3 106 5.06%
5-May 60 13 73 5.54%
6-May 203 6 209 5.49%
7-May 270 4 274 4.42%
8-May 444 8 452 3.62%
9-May 442 7 449 2.79%
10-May 580 12 592 2.46%
11-May 111 9 120 2.72%
12-May 70 3 73 2.26%
13-May 435 11 446 2.24%
14-May 300 15 315 2.66%
15-May 196 13 209 3.18%
16-May 655 10 665 3.02%
17-May 566 10 576 2.95%
18-May 203 3 206 2.61%
19-May 122 16 138 3.05%
20-May 419 15 434 3.22%
21-May 162 6 168 3.05%
22-May 478 8 486 2.54%
23-May 228 7 235 2.90%
24-May 398 12 410 3.23%
25-May 136 21 157 4.19%
26-May 120 5 125 3.67%
27-May 621 28 649 3.90%
28-May 358 16 374 3.98%
29-May 518 22 540 4.46%
30-May 442 25 467 4.74%
31-May 512 9 521 4.45%
1-Jun 233 28 261 4.53%
2-Jun 243 21 264 4.84%
3-Jun 363 52 415 6.09%
4-Jun 339 37 376 6.82%
5-Jun 409 34 443 7.50%
6-Jun 299 35 334 8.26%
7-Jun 213 55 268 11.10%
8-Jun 137 24 161 11.41%
9-Jun 196 33 229 12.13%
10-Jun 341 86 427 13.58%
11-Jun 304 77 381 15.34%
12-Jun 409 74 483 16.82%
13-Jun 460 50 510 16.23%
14-Jun 255 53 308 15.89%
15-Jun 208 29 237 15.61%
16-Jun 226 52 278 16.04%
17-Jun 376 75 451 15.48%
18-Jun 379 68 447 14.78%
19-Jun 510 119 629 15.59%
20-Jun 388 69 457 16.57%
21-Jun 305 86 391 17.23%
22-Jun 180 64 244 18.40%
23-Jun 352 91 443 18.68%
24-Jun 474 147 621 19.93%
25-Jun 534 169 703 21.36%
26-Jun 535 152 687 21.94%
27-Jun 747 143 890 21.41%
28-Jun 592 151 743 21.17%
29-Jun 552 139 691 20.76%
30-Jun 404 190 594 22.13%
1-Jul 559 294 853 23.99%
2-Jul 989 270 1259 23.42%
3-Jul 645 288 933 24.74%
4-Jul 688 310 998 27.05%
5-Jul 822 375 1197 28.60%
6-Jul 755 245 1000 28.86%

 

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