Coronavirus – Civic sense, home swabs and family doctors: the success of Uruguay and Costa Rica against Covid-19

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Although the new outbreak of the pandemic of COVID-19 in the world is now theLatin America, there are two countries on this continent that have successfully managed to contain the virus, without imposing a mandatory quarantine: Uruguay is Costa Rica. Both focused on the civic sense of their own citizens, who spontaneously reduced their outputs and adopted the social distancing, and have benefited from having built one in recent years local medicine, with the family doctors sent to the home of the sick to give him the buffer and to assist them, avoiding to make them go en masse in the hospitals. A strategy that has allowedUruguay, for several weeks, to reopen some activities and allow the return to school of the students.

In Uruguay no mandatory quarantine – Here, since the declaration was declaredsanitary emergency March 13 (less than two weeks after the inauguration of the new president Luis Lacalle Pou) As of May 28, 811 cases and 22 deaths have been recorded. Considering that the population of the country is 3.5 million inhabitants, the rate of mortality was 0.6 deaths per 100 thousand inhabitants, against 12.2 in the Brazil, 4.5 of Chile, 1.1 from Argentina and 0.2 from paraguay, which however resorted to mandatory quarantine. Now the country is basically in the Phase 2, in which protocols are being prepared and applied for a progressive return to the ‘new normal’. ” Reopen the schools in rural areas and lessons are being resumed voluntarily and progressively across the country, with the capital Montevideo and universities last. To April the sector is back to work building, in May the trade and public offices. The families and friends already gather, but the use of masks, the social distance and working in the presence of people with is not recommended risk factors for health.

Like other neighboring countries, theUruguay has closed the borders, suspended flights, lessons, masses and mass events, but never decree the quarantine mandatory. “Anyone who proposes general social isolation must be willing to apply the penalties for the crime. Is anyone really willing to bring a person out to earn money for the day before a judge? “He said at the beginning of the epidemic Lacalle Pou. His government’s strategy was to appeal to citizens’ sense of responsibility, which in over 90 percent of cases accepted the recommendation to stay at home, although not mandatory.

One of the first measures taken by government, and supported by the opposition, was the creation of the Coronavirus background, funded primarily by the 20 percent cut in wages premier, ministers, deputies and other published employees who earn more than $ 1,800 a month, in addition to the request for funds from the Inter-American Development Bank and the Andean Guild for progress. Relying on these credit lines with rapid approval and favorable conditions, theUruguay it did not have to depend on the more fluctuating government bonds. Another factor that helped, according to the health minister Daniel Salinas, was the universal health system, where public and private are integrated: “We have a strong presence of family doctors, who provide home care, and a pre-hospital emergency system across the country. We did i do swabs for suspected cases directly at home, so much so that compared to Argentine, Brazil and paraguay the amount of tests per million inhabitant in Uruguay it’s triple. ”

Costa Rica: doctors on WhatsApp with patients – Even the Costa Rica, where the first case of COVID-19 it was discovered on March 6, and proved ‘virtuous’ in managing the epidemic. So far 1,084 people have been infected, and 10 have died coronavirus he was treated at home, and people never felt abandoned, because doctors went to visit patients every other day, keeping in touch with them through Whatsapp. One of the strengths of the Costa Rican public health system are the 1000 clinics of thechais (Equipo Basico de Atencion Integral en Salud), which recall a little the project, never fully taken off in Italy, of the Health Houses. Doctors, nurses, technical and pharmaceutical assistants work there, and thanks to them structures the cases of COVID-19. So much so that in the first two months only 16 people, out of 400 sick, were hospitalized.

When a possible case is identified, the active vigilance on symptoms until confirmed. If the patient gets worse, he is hospitalized. After the first dozen cases, they have been suspended meetings, school lessons, tourist activities and social and have been closed borders, promoting work from home, hand washing and distancing social. Rules respected by the majority of Costa Ricans, although, as the Minister of Health pointed out, Daniel Salas, the return to the former life will not be short. “Most of the population has not been exposed to the virus and has not taken it – he concludes – and in a short time we could have an increase in cases and cases contagions also intense. Let’s walk on the eggs ”.

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