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Costa Rica will consider some as COVID-positive without requiring test

The Health Ministry on Friday updated its coronavirus guidelines and will begin treating some people as having COVID-19 if they live with someone who has tested positive for the coronavirus and themselves begin exhibiting symptoms.

Daniel Salas, the Health Minister, said these patients won’t “formally” be positive cases but will be otherwise treated as such. This means they will receive isolation orders and regular follow-ups from medical professionals.

“They are not positive formally, but will be handled as a confirmed case,” Salas said Friday.

The updated norms for a confirmed case in Costa Rica read as follows:

  1. Laboratory confirmed case: Refers to a person who has been detected with the virus that causes the COVID-19 disease regardless of clinical signs and symptoms. This confirmation will be made by public and private laboratories that have PCR-RT capable of identifying SARS-CoV-2 and have an authorization from an external regulatory entity such as FDA or its equivalent duly authorized by the Health Ministry as well as the National Center for Virology.
  2. By epidemiological link: People residing in the home of a laboratory-confirmed case and who develop respiratory symptoms during the 21 days after the first day of isolation. For these people, it will not be necessary to carry out a PCR-RT test. 

Based on the published norms, we believe these presumptive cases are included in the daily total; we have contacted the Health Ministry for confirmation on this topic.

Salas said the new guidelines will help Costa Rica improve testing throughput, which has begun suffering from delays as the country has entered a phase of community transmission.

“In previous months we could process 2,000 tests in a week, but today we are processing the same amount in a single day,” said Angie Cervantes, a microbiologist for the Costa Rica Social Security System, who estimated a 700% increase in testing demand.

Reducing the backlog in testing is one of the main drivers for the change in guidelines, Salas said.

“I insist there must be symptoms,” he said, indicating that the Health Ministry won’t automatically consider someone as a coronavirus case if they are asymptomatic and haven’t tested positive.

“If another person within the same family circle starts showing symptoms, it’s almost 100% certain that they have COVID. It’s a matter of practicality.”

For the past several weeks, Costa Rica has also considered some patients as recovered without necessitating a negative test.

The Health Ministry guidelines define a patient as recovered as follows:

  1. 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. 

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

As of Friday, Costa Rica has announced 87 coronavirus deaths. Two-hundred and ninety-eight people were hospitalized, with 49 in intensive care.

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