The Strategy of Isolation with Solidarity
By Eduardo Ulibarri
In my home office, the engraving “El solitario”—“The Solitary One”— by famed Costa Rican artist Francisco Amighetti has accompanied me for many years. The image is divided into two planes. At the bottom, a quite lively group is festively socializing with glasses of wine and rum in hand. At the top, a listless figure, caught up in his own loneliness, looks out at a balcony practically suspended in the sky.
I used to identify with the solitary figure intimately; all of us, at one moment or other, need to take refuge within ourselves. But Covid-19 has made me appreciate the engraving in another dimension: that of an imposed isolation as a necessity of collective protection; the renunciation of personal interaction as an imperative safeguard for health, the return to our inner selves that has been activated as an inevitable daily obligation.
It is no longer an individual option, but a call for human survival; both solitude and distance become strategies of solidarity.
As in so many other countries, to isolate and distance ourselves have been a key part of facing the pandemic in Costa Rica. Unil now, although uncertainty reigns and the economic effects of the crisis portend to be devastating, the results in terms of health and mortality are cause for hope.
At midday on April 19, there were 660 confirmed cases of covid-19 in 59 of the country’s 82 municipalities; 7,142 potential cases eliminated as a result of testing, 112people recovered, 15 hospitalized (10in intensive care) and four dead (Costa Rica has slightly more than five million inhabitants.) Thanks to a reduction in daily cases since the April 9th, the epidemiological curve is moderate, and the saturation of health services has been avoided.
The preventive restrictions have not been imposed with an air of arbitrary authoritarianism, as in some other countries such as, at distant extremes, China and El Salvador. Instead, the government has applied incremental measures as the pandemic evolves. These measures have been based, essentially, on the General Laws of Health and of Transportation. The first gives the authorities the power to make a wide range of decisions in the face of health emergencies, including closing establishments; the second permits restrictions on the circulation of vehicles.
These capabilities, together with an intensive public relations campaign in favor of physical distancing, have permitted individual rights to continue in effect, without direct limitations.
Since March 6, when the first case (that of a U.S. tourist) was confirmed, that authorities have opted for a gradual strategy. As a matter of fact, the strategy had begun a few days before the first case was confirmed, insisting that people was their hands; not kiss, hug or give handshakes in greetings; giving instructions on how to cover coughs; activating early warning protocols, and providing for the import of necessary supplies for coronavirus test kits, tests which inititially could only be performed in a state laboratory, but now have extended to some private ones).
On March 9, the government launched the campaign #quedateEnCasa (#Stay at Home). It also banned gatherings of crowds and encouraged working from home. On the 12th, school was suspended—from kindergarten to university—and no reopening date has been scheduled. Three days later, the government ordered all discotheques, bars and casinos closed, and greatly restricted the seating capacity of restaurants. Later, all religious denominations complied with the government request to suspend in-person religious services.
With the declaration of a national emergency on the 16th, non-resident foreigners could not enter the country, and foreigners who left the country without a justified reason after that date would lose their migratory status.
Two days after the death of an esteemed 87-year-old pediatrician, on March 18th, the first death attributed to the virus, two other senior citizens and a 45-year-old man have died.
The next step was to close down the access to beaches and national parks, followed by a curfew that prohibited the circulation of private cars (with a few specific exceptions) between 10 p.m. and 5 a.m. During Holy Week from April 6-12—a traditional vacation period—the curfew was imposed all day long, but the Monday after, the curfew was imposed from 7 p.m. to 5 a.m.
On March 31, after a marathon two-week conversion, a rehabilitation hospital began to operate exclusively as one exclusively for coronavirus patients to reduce the pressure on the rest of the system and the possibility of contagion in other hospitals.
A nationwide universal system of health care with different degrees of oversight and attention has been the fundamental bedrock of the strategy. Its organization, taking into account differences in resources, is similar to that of the National Health Service (NHS) in the United Kingdom, and the Costa Rican Social Security Institute (la Caja Costarricense de Seguro Social), which collects benefits and directly provides services, is generally as well-regarded by the public as the NHS.
From the very beginning, the Institue has been the mainstay for the detection of suspicious cases and administered the appropriate tests. This has permitted it, at least up until now, to maintain control and have ability to do contact tracing that minimizes the need for a massive use of the tests, difficult to afford.
The most recent step in the chain of preventive actions has been the use of a voluntary digital app in which each person transmits his or her symptoms, receives a risk classification and keeps up to date any perceived changes.
At the same time, a group of measures aim to improve hospital supplies, elaborate contingency plans and redistribute equipment.
The greatest Achilles’ heel of this strategy revolves around those who live in marginal neighborhoods, as well as the homeless and prison inmates. In spite of the existing socio-economic, educational and health support network that attends this marginal population, physical distancing is almost impossible because of overcrowding in cramped spaces; among the homeless who live on the streets and prison populations who are confined to shared pavilions, the situation is even worse.
Another great concern for Costa Rica is the contempt with which the government of Daniel Ortega has faced the epidemic in the neighboring country of Nicaragua. The possibility of a runaway contagion in Nicaragua, aggravated by its collapsed health system, could increase migratory pressures and challenge the capacities of Costa Rica. Although strict border controls exist between the two countries, there has always been a flow of migrants without documents who elude official crossing points.
The epidemiological dynamics can be contained, but not controlled, above all, if the approach depends on others. At any moment, the impact could multiply and overwhelm the capacity to confront the pandemic. For now, even though this has not been the case, the risk is still there. And to this risk is added a second challenge: a rapid and alarming economic deterioration.
When the emergency arose, the Costa Rican economy had only barely started to give signs of reactivation, after almost a year of slowing down, The fiscal crisis, manifested in a deficit close to 6% of Gross National Product (GNP) and an accumulated debt equivalent to a little more than 57% of the GNP, was slowly being controlled, thanks to a reform approved last December.
Only the financial system was very solid, with robust liquidity, solvency and money reserves in the Central Bank, in addition to an accumulated inflation the previous year of less than 2%.
With the Covid-19 crisis, the international export of products and services swiftly contracted, although some export sectors such as manufacturers of medical supplies or microprocessors have maintained flourishing activity, they are the exception, rather then the rule. Tourism, Costa Rica’s main source of foreign exchange and a great generator of employment, has plummeted. Local trade is experiencing its worst crisis in decades, and several domestic manufacturers, as well as agriculture exporters, have suffered huge blows. As a consequence, and although no official statistics are yet available, unemployment has increased dramatically.
To deal with a shock of such magnitude from the vantage point of economic weakness is particulary difficult. It demands a financial, technical and legal instrument difficult to formulate and also limited in scope. Moreover, in contrast with the consensus over issues of public health, the debate over the correct mix of compensatory measures or consumer stimulus is marked by differences in political ideologies.
In spite of this, the politically weak executive power and the Congress, the most fragmented in the modern history of Costa Rica, have managed to draw up a series of agreements with unusual speed and without many hitches.
Essentially the focus has been on reallocating budget funds from their original destinations to the health and economic emergency. The measures have also called for a “solidarity tax” on the highest salaries. They seek to make the standards for layoffs or reductions in labor contracts more flexible and to permit a proportional withdrawal of unemployment insurance for those receiving a lower percentage of their income. Another issue agreed upon was to quickly seek approval with international financial institutions to partially divert funds to deal with the effects of the pandemic.
These decisions, in addition to providing relief to the productive sector, are also directed at granting direct subsidies to the unemployed, to strengthen the network that already attends disadvantaged families and to stimulate overall consumer spending.
The regulatory authorities of the financial system, for their part, have loosened the requirements on reserve levels to maintain their operations for the commercial banks (the two largest belong to the state) and have created conditions so that possible payment arrangements with debtors do not have repercussions for their balances. The Central Bank has lowered the El Banco Central has lowered the benchmark interest rate and obtained congressional authorization to acquire, if necessary, government-issued debt.
The horizon established for this package of measures is three months. Much is still not known: Will these measures be sufficient to prevent a possible economic collapse (a recession is something else); how will the public coffers resist, already decimated by the fiscal crisis and increased spending; what will be the future cost for the overall economy and the taxpayers, and how profound will the impact be on Costa Rica’s credit in the international markets.
In the midst of some dissident voices, up until now, a consensus exists that in the face of health and economic challenges, the balance of public policy has been adequate. Given the relative success in the pillar of health, one of the great tasks for the authorities in the coming days will be to maintain the social discipline to avoid accelerating the spread of the virus and not to act hastily and prematurely in lifting the restrictive measures, while, at the same time carefully and gradually advancing toward the difficult return to normality.
The principal bet is still on distancing. The listless figure of “El solitario” becomes a symbol, at least for me. Many lives depend on keeping apart. But we ought to complement that distance with the closeness of collective solidarity. Together, we seek to be able to leave our balconies—real or virtual—and to join, fully, the society of which we are a part.
Eduardo Ulibarri, Harvard Nieman Fellow (class of 1988), was the editor of the newspaper La Nación, of Costa Rica and later Costa Rican ambassador to the United Nations. He is currently an academic, analyst and consultant.