SETTING THE WAY TO GO FOR ALL GLOBAL INSTITUTIONS COMBATING THE PANDEMIC
The United Nations (UN) representative in Costa Rica has recognized the “exceptional and innovative” way in which the country has responded to the Covid-19 Pandemic. “Under the leadership of the President of the Republic (Carlos Alvarado), the Minister of Health (Daniel Salas), the Emergency Operation Center (COE) and all related institutions are truly developing an inter-institutional response and an exemplary articulated response,” was said by Alice Shackelford, UN coordinator in the country.
Shackelford highlighted, for example, the fact that the National Liquor Factory (Final) is producing gel alcohol, instead of Guaro Cacique, to supply demand and that “Correos de Costa Rica” is providing facilities to distribute this product to the population. “There is a coordinated, articulated response, also thinking about an innovative system that can help us against Covid-19,” said the representative.
She states that “on behalf of the United Nations System we want the citizens to know that the country is being accompanied to develop this response by the different implementation plans to ensure that no one is left behind.”
Hackelford indicated that they are supporting the communication and development of the country’s official’s message to the population about the novel Coronavirus, with a more specific focus on more vulnerable groups such as indigenous peoples, children and adolescents, senior adults and people with disabilities to ensure that no one is left behind.
On Thursday morning the country had registered 69 people infected with the virus, one of whom died last Wednesday and five others continued hospitalized. The first fatality is a retired doctor (pediatrician), 87 years old, who was hospitalized in the Intensive Care Unit of the San Rafael de Alajuela Hospital.
Daily, the health authorities offer a press conference to inform the population about the new cases, the measures to be taken and insist that citizens do not leave their homes unless for urgent needs. Among the provisions that have been taken as a result of the pandemic, there is the suspension of classes until April 13th, the cancellation of large public gatherings, the suspension of sports activities and the closure of discos, bars, and casinos.
Also, as of this Thursday, all borders are closed for the arrival of foreigners, while nationals and residents entering the country will be placed in mandatory quarantine. For its part, the bank system will prioritize the adjustment of debts for those affected by the virus, and the National Rehabilitation Center (Cenare) was designated as the exclusive hospital to attend patients with Covid-19.
Friday I went to Alajuela early for my appointment at the government hospital to get an appointment scheduled with my Cardiologist in Nov-Dec for my annual checkup (yeah, its weird to have an appointment to get an appointment), plus I had a package to pick up at Aeropost and a couple of items to get at PriceSmart.
Wow! I had not been to Alajuela since the Coronavirus scare hit and it has nearly as many cases as San Jose as the second largest city (and my provincial capital by the way). EVERYTHING WAS DIFFERENT!
1st, to get to the hospital early enough for shorter lines, I took the 6:30 AM bus, which is usually packed with people going to work, shopping, appointments, visits, etc. There were just 5 of us passengers on the bus – scattered out one to a seat. And at the entrance to bus was a bottle of hand sanitizer.
Empty streets!
2nd, as the bus arrived in Alajuela I could immediately see a difference with fewer cars and people – some streets like a ghost town!
3rd, no wait for a taxi with few people there to use them.
4th, when I got to the hospital, there were few people out front as I was expecting by now, but I wasn’t expecting to be turned away! When I got to the door a guard was stopping everyone and I showed him my cita(appointment paper) and he rattled off several things rapidly that I did not fully understand but I think he was basically telling me “no” that “all appointments not emergencies are canceled.” Bottom line, he would not let me in! 🙂
I got there early on purpose to avoid a long wait, yet I still expected to spend an hour or more. But I spent only 5 minutes there and it was now about 7:20 AM, with Aeropost not opening until 9 and PriceSmart at 9:30. Ugh! Oh well, I drank no coffee at home that morning and had only a bowl of cold cereal, so I took my time walking about 8 blocks to the nearest McDonald’s for breakfast.
5th, I entered the biggest MacDonald’s in Central Alajuela with only one other customer inside! Like the bus, they had hand sanitizer at the counters. I took my time with ham & eggs and lots of coffee while reading the Washington Post. At about 8:30 I began the 6 block walk to Aeropost, getting there 10 minutes before they opened officially.
6th, at Aeropost I only waited a few minutes before one of the clerks, who recognized me through the glass (I’m a regular), came out with my little package, so I did not even have to be one of their limit of 3 customers inside the store – see sign below. And the bright red & green sign reflected backwards in their window is a MegaSuperMercado, a downtown chain-supermarket across the street! The English translation of their home-made sign: “Maximum 3 customers within the branch.” In what they call a “branch office.” That is also the feature photo and the recommended “Social Distancing” to help stop the spread of the virus. Costa Rica is doing its part one little business at a time! 🙂
“Social distancing!” inside banks and businesses.
7th, Because of the time I saved from the hospital rejection, I had about 30 minutes before PriceSmart even opened, so I just walked the 12 or so blocks to PriceSmart which opens at 9:30. This is one way I get my exercise! 🙂 And in so doing, I walked by Alajuela Central Park which, like the one in Atenas, is closed with yellow tape wrapped all around the whole block:
“No large public gatherings” thus all parks are closed in Costa Rica!
8th, at the entrance to PriceSmart (our store like Costco or Sam’s Club) they not only had a bottle of hand sanitizer, but specifically asked me to please use it while the lady wiped off the handle of my push cart. But unlike everywhere else I had been that morning, they were full of people and at opening time! Full with long check-out lines! And still some crazy bulk-buying by the panicked!
I actually don’t like this store which is too expensive, too large a quantity of things, and not consistent in their stocking; BUT they usually have about 5 or so items I cannot get anywhere else – things I really like. (Another option might be at AutoMercado, an American-styled supermarket specializing in American brands, but their location is not as handy for me as PriceSmart, as a bus rider.)
When I got out of PriceSmart it was a little after 10, meaning I had just missed the 10 o’clock bus! In the mornings the return buses only run on the hour (tho every 30 minutes in the afternoon), so I just slowly walked the 6 blocks to the bus stop for Atenas and still had time to read a little of my new mystery book before it left at 11. Oh well, another morning is gone! But hey! I’m Retired in Costa Ricaand this kind of virus-influenced inconvenience is simply part of my daily adventure! Its what you do when you are retired in Costa Rica! 🙂
“An adventure is only an inconvenience rightly considered. An inconvenience is only an adventure wrongly considered.”
― G.K. Chesterton
I went to the dentist this morning (report below) and afterwards the bank to pay my rent (my only monthly bill not on auto-debit which is a long story) then by the park to my pharmacy for two prescriptions from Dr. Ureña. I noticed two or three new precautions for Coronavirus. Here’s two pictured.
Bank Line with 6 ft. Distances
Bank lines here (and many others) have always used chairs so people can wait in line seated, just getting up and moving every time another person is called. Before now, many chairs were crammed in side by side with people elbow to elbow. Now we are separated! 🙂 And I did not ask my teller to let me photograph his hands, but all tellers are wearing rubber gloves now.
It seems even more stark when no one is in line! But I don’t like to photograph people in public without their permission anyway! 🙂
Central Park Closed
While I was walking by the park this morning, city employees were stringing up the yellow hazard tape to essentially close the city park where usually it is the center of social activity and close contact between people. Not now! Such social distancing is necessary if we (the whole world) are to defeat this pandemic!
And I am avoiding my 2 or 3 times a week coffee or breakfast with friends at Crema y Nata. The World Health Organization recommendation. I may still eat out once or twice a week, but at odd hours at a table solo!
Stay Healthy! Avoid People! 🙂
Dental Update
This morning was my time to go back to the dental specialist for my root canal, assuming the infection was gone. Well, it hurt all week which was an indicator that I still have an infection. Plus the root canal specialist couldn’t make it because she had to rush her husband to the hospital with some kind of kidney problem, but Dr. Ureña is very good and I trust him. In fact, he did two things I wish she had done: He removed the temporary cap and will leave it off with only a wad of cotton in the hole, allowing the infection to drain (she did say that might have to be done). In addition to an antibiotic in the hole, he gave me a prescription for an oral antibiotic to take for a week. Together they should clean up the problem caused by a North American dentist not completing his root canal properly. He also gave me his personal cell phone number if I have any problems or severe pain. It is hard to find soft food that I like to eat beyond oatmeal and pudding! 😉 And even then I can only chew on my left side.
Whew! I go back Monday to see if infection is gone so the root canal can be completed or decide when, but surely sometime next week. But Dr. Ureña assures me I will be fine for my trip the 30th. And since tourism is at a standstill here, I may be at the lodge nearly alone or with an easy job of “social distancing.” 🙂 From the land of rainforests & happiness . . .
Yesterday one case of Coronavirus was confirmed in Atenas. Many of our local people commute to both Alajuela and San Jose for jobs, a natural way for it to spread from the two cities with the most cases. Country-wide Costa Rica has 75 cases now and one death. This is a real pandemic!
Costa Rica is a very health conscious country with one of the best healthcare systems in the world. Thus you can expect great care when a pandemic comes.
I just checked the WHO Website and it showed only 23 cases in Costa Rica as of Friday but see article below for now 26 cases on Saturday, but we have had no deaths. I am still planning my in-country trip 30 March through 4 April to the Talamanca Mountains south of here at San Gerardo de Dota. The fresh mountain air should be healthy as long as no Chinese or Italians are visiting when I do – 🙂 – Just kidding you Chinese & Italians! 🙂 I expect there will not be big crowds from anywhere there and I keep a good “social distance” usually anyway, so think I will be fine as long as none of the hotel staff are infected. People here have already quit shaking hand and cheek kissing for greetings with the elbow bump looking kind of funny to me, but a fun and healthy substitute!
Over this last weekend an upper right jaw tooth was hurting when I chewed on that side. So, first thing Monday after Spanish class I go to my dentist, Doctora Karina Valerio, who speaks only Spanish, which is good for me! 🙂
Office of Dra. Karina
She checked it out and said she really needed a digital image to make an assessment and sent me to Doctor Ureña Bogantes Rodrigo, one block away, who is also a dentist along with being the only dental radiologist in Atenas with all the expensive equipment for that. And he speaks English! 🙂
Office of Dr. Ureña
He x-rayed my teeth from different angles and gave me the printout from his computer to take back to Dra. Karina, saying he believes I need a root canal. His charge was 15 mil or $26.35.
Digital Image of my Upper Right Jaw – Root Canal is needed on the right side of the bridge.
So I took the image back down the street and Dra. Karina says, “Necessita la endodoncia.” which of course is a root canal! 🙂 And she does not do those, but Dr. Ureña has someone he can bring in to do it. So I pay her only 5 mil or $8.78 for two visits and consultations.
Then I walk back down the street to Dr. Ureña again where he calls and schedules a root canal specialist to come to his office 3 days later, this Thursday. The woman Endodontista (root canal specialist) will have to drill through the right side of a bridge for the needed root canal. Of course it will cost only a tiny fraction of what one costs in the states! 🙂 AND it is soon (3 days) AND ¡No más dolor! (No more pain!)
And yes, I could have gone to the public clinic for free social security dental work, but it would have taken much longer and they would send me to their specialist in either Alajuela or San Jose for a root canal at who knows how long a wait, so I chose private care that is local (I walked to both dentist offices), and so reasonably priced, quick and with excellent service for which I’m willing to pay. While the very poor here can get similar treatment for free, just a longer wait and bus ride to Alajuela or San Jose.
You are possibly aware that dental tourism is one of the big businesses in Costa Rica! You can buy a plane ticket to Costa Rica, stay in a hotel, have the dental work done and do a little tourist activity all for less than what a dentist would charge you in the states for the same work. Dental work prices here are about 20% of the U.S. prices. And remember that doctors and medical care here is ranked higher than that in the USA by the UN World Health Organization, but you guys do rank number 1 as the most expensive in the world on all medical care and services. 🙂 ¡Pura vida!
El urólogo
OK, I won’t go into as much detail about the urologist here. I’m an old man you know. 🙂 At 80 everything starts malfunctioning! 🙂
But the interesting thing I wanted to reportis that our quiet, peaceful little farm town does not have a urologist (or many other medical specialists), either in the public clinic or in private practice. Thus, as I do for my dermatologist, I expected to go to Alajuela for this specialist.
But now we have two new private clinics (competing of course) in Atenas who bring in various specialists based on need. In my case, Dr. Rodriquez, urólogo, comes here to Clinica Santa Sofia (photo below) once a month. While young doctors like him probably stay a lot busier by sharing their time between a big city office and probably several small town offices, it is also very helpful to us in the small towns! We can avoid a trip to the big city! I like my dermatologist in Alajuela very much, so I probably won’t change him, but I expect all other future “specialists” to be found in one of these two new clinics here in Atenas. 🙂
Centro Médico Santa Sofía El Coyol – For specialists and the only complete radiology facility in Atenas including sonar which is especially good for our pregnant women!
Coronavirus
Yes, the dreaded pandemic is even here in paradise! The last I read there are 13 confirmed cases in Costa Rica. (The first 3 were Italians who flew over for a “holiday.”) CR just cancelled 2 cruises to here and suspends mass gatherings but has no airline travel restrictions here yet and I imagine the tourism industry will discourage such but may be necessary. And yes, this virus hurts the tourism business maybe more than any other, just like in the states!
But to indicate the virus panic we already have here, I thought I would be well prepared “just in case,” far in advance and I tried to buy some surgical masksyesterday. After visiting 3 Farmacias (drug stores) here in Atenas I learned that there are none available anywhere in the whole country of Costa Rica – all “Out of Stock” they say. 🙂 Ours probably come from China and I imagine China is using all they can make there now! 🙂
This morning I walked to my favorite supermarket for a regular shopping trip and found that they are “Out of Stock” of all hand sanitizer and Liquid Hand Soap in dispensers but had some “refill” liquid soap in plastic bags that I got 2 of. They were also nearly out of alcohol. Hmmmm. Ticos are very health conscious and most are very healthy. So I am optimistic about avoiding the virus here. And generally I prefer avoiding crowds or many people anyway, which we must do now! So stay healthy! 🙂
“The great benefit of slowing down is reclaiming the time and tranquility to make meaningful connections–with people, with culture, with work, with nature, with our own bodies and minds”
~Carl Honoré
Photo by Charlie in the Caribbean
— As vegetarians who eat slow and move slow, Sloths conserve their energy and live happy lives. So maybe we humans can learn something from them at this often busiest time of the year! 🙂 Or just “Retire in Costa Rica!” like me! 🙂
See my collection of sloth photos in two galleries:
The featured photo at top is one I took at Banana Azul Hotel in the Caribe Sur. There are sloths all over Costa Rica but more at lower elevations and especially along the Caribbean (Atlantic) Coast.
Wow! Another great trip to one of my top 5 or 6 favorite places in Costa Rica, Arenal Observatory Lodge, with photos of 49 bird species , including the two new lifers for me! Plus 7 other animal species, a new birding trail (Bogarín), the waterfall, wonderful hiking trails and gardens to walk through, and the tallest birding tower in Costa Rica where this year I got lots of Honeycreepers in place of all the monkeys photographed last year, plus a repeat of my favorite room 29 and really good food! I have been so busy after the trip that it has been difficult to process all the photos, but finally done! Check them out at (or click image):
All medical appointments here are adventures, whether it is getting there or struggling with the language since everything is in español! Plus for my heart only right now, I am using the public healthcare system which here means all doctors and other staff work for the government, which always slows things down everywhere. 🙂 My October appointment had already been moved up to this November week because I was getting a new doctor.
This year they also decided to divide my appointment into two appointments, one for the EKG called electrocardiograma here with no initials used. Both appointments were last week (Tues & Thur), my first week back from a trip, already busy with the usual catch-up:
TUESDAY
I get a taxi to the 12 noon bus to Alajuela for my 2 pm appointment which in theory I should take the 1 pm bus (45 min ride), but there are too many possibilities like bus breaking down and long lines at hospital. — I arrive Alajuela before 1:00 and with a taxi to the big government hospital a little after 1 pm, show ID & cita (appointment) to guard and take elevator to the 4th floor for Cardiology and wait in this regular line (photo below):
Waiting line to check in for doctor.
It is to check in for my 2 pm appointment and then realize the adulto major (senior adult) line is a little shorter and I move to it and from a chair in it I took the above photo. Both lines move very slow and at nearly 2:00 I’m the second person in line for check-in when over the loudspeaker they call my name among several Hispanic names which is always funny (Gonzalez, Rodriquez, Doggett, Rojas). And of course my name is hard to pronounce. This means they see we haven’t checked in yet and so they call us to front of line and check us in. (So why wait an hour huh?)
She sends me to Puerta nueve (Door 9) where I wait with about eight other people for our EKGs. After about 20 minutes I am called in and of course an EKG only takes a few minutes and I’m off to the front door and a waiting taxi to get me to the Atenas Bus. Not bad for free medical service!
And oh yes, now they don’t worry about communicating with each other, the technician gives me a paper copy of my EKG folded into an envelope for me to take with me to my doctor appointment on Thursday. – Now the taxi ride to bus is easy with Oscar, a nice young taxista who handles the Alajuela traffic well and I include a good tip as always (it pays off in the long run as you will see).
It was not until I arrived in Atenas that I realized my cell phone was not in my front pocket. I walk back to our bus station and the nice folks there did not find my phone on the bus, but the Spanish-only young man grabbed a high school kid to translate and long story short he dialed my phone and Oscar in my Alajuela taxi answered and suggested two options of either him driving here to deliver it or me going back to Alajuela to meet him at a place of my choice.
Zipper in front right pocket.
I chose letting him drive to me, all the way to my house mind you! I paid the fare and a healthy tip thinking all the time about how much a new phone would have cost.
Now – Why did it slide out of my pocket in Alajuela? I was wearing some new hiking shorts (almost all I wear here) and I have not yet had my seamstress sew a zipper in my front pocket to prevent the phone from sliding out while sitting. I lost a phone in a San Jose taxi in 2017 for this same reason and all my old shorts got zippers in the front right pocket then. See my 2017 zipper post. Monday or Tuesday I will take my new shorts to the seamstress for zippers! 🙂 Might be Tuesday since I have to go back to Alajuela Monday after my Spanish class to get my prescriptions! 🙂
And that is not nearly all of my heart exam adventure which continues on
Thursday
Since my doctor appointment is at 12 noon and we have a 10:20 bus to Alajuela, I took it. (All other buses are on the hour and I have no idea why this one is at 10:20!) But anyway, same procedure – get off the bus in Alajuela and grab a taxi (in long pants today since phone doesn’t slide out of them). 🙂
Get to hospital only 45 minutes early this time and go straight to the old folks line and wait to be called to one of these windows to be checked in again:
Check-in windows to see 4th floor doctors. I’m sitting in row of chairs at right.
Same thing happens again today. I wait and wait and I’m second person in line and they call my funny name out among the normal names. I walk up to one of those windows and she checks me in, puts my EKG in my file folder and hands it to me, explaining that I must stop first at the vitals station for temp, blood pressure, etc. before wait at Puerta dieciséis (Door 16) for Dr. Garcia to call me in. I’m given a slip of paper with all my vitals (weight, height, temp, pulse, blood pressure and one more thing). I Carry that and my file folder to door 16 and wait about 20-25 minutes which is really not bad.
My new heart doctor is a kid, looks like right out of medical school (like one I had at my private doctor’s office in Atenas once) or maybe I am just old! 🙂 He was very nice and tried to explain simply to me in English (most of the younger ones speak English) why my current EKG did not show an arrhythmia this time but I still have the condition and he is going to keep me on the same medication, Atenolol and a baby aspirin every day. Last year the doctor wrote one prescription, signed it, then made 11 more copies on his copier and printed out official-looking 12 stickers from another machine with changing numbers and stuck one on each of my 12 months prescriptions. (They are not allowed to give out more than one month of any drug at anytime.) I take these prescriptions once a month to the Public Clinic Pharmacy here in Atenas to be filled for free! Last year he even included the baby aspirin.
Dr. Garcia said they have now consolidated that at the front desk and I had to take my folder back up front and wait in line again for the front desk to print out my prescriptions and make my appointments for next year. I waited about 15 minutes in the same line when one lady called out my name again and took my folder and typed a lot in her computer, then she said (all in Spanish with a nearby lady helping me where I did not understand) “We no longer make appointments a year ahead. You must come back to the “platforma” in main lobby in March to make your appointments – so it was moved from Doc to front desk and now to main lobby in a later month – hmm. I had almost forgot about prescriptions then turned around and asked about that and she told me through the nice lady translator that I had to wait until Monday and then go to the Farmacia in the lobby for the prescriptions. She pointed to which slip I took there and which one for next March. Bureaucracy in paradise! So now I get to go back Monday and again next March 20 (which is sort of an appointment to get an appointment which I now remembered happened once before.) Maybe they think I’ll give up and not return or just die before then! 🙂
BUT HEY! IT IS ALL FREE! The private doctors here (like my GP and Dermatologist) are more punctual and provide a whole lot more services and speak English but you pay for those services! I figure my once a year heart exam was a good way to experience the local “CAJA” medical services like the majority of Ticos. Plus the private Cardiologist in San Jose Dr. Candy sent me to the first time charged much more than fifteen hundred dollars for her heart exam and her prescriptions were going to cost more than $100 a month! So I’m saving around $3,000 or so a year by using the public doctors and getting something for the monthly payment I am required to pay into CAJA as a legal resident.
Below is the Hospital Lobby where I will make my appointment in March and Monday I will go to the Pharmacy off this lobby for my prescriptions with many other people both times.
I encourage you to watch this brief 1 minute video ad that will be appearing in larger city TV markets in the U.S. and Canada this year. Then plan your trip to Costa Rica for the “Essentials of Life!” in Costa Rica! – 🙂 – ¡Pura Vida!
And for the bird-lovers & nature-lovers up north, are you aware of the tragedy of our lifetime? Nearly 3 Billion Birds Gone from U.S. & Canada – staggering! Link is to article from The Cornell Lab of Ornithology. We are destroying the earth little by little. I’m thankful to live in a small haven of nature, Costa Rica!
TAKE IT SLOW![20190604_111253[1]-A-WEB](https://www.charliedoggett.net/wp-content/uploads/2019/11/20190604_1112531-A-WEB.jpg)
