A multilayer network model of Covid-19: Implications in public health policy in Costa Rica.

Successful partnerships between researchers, experts, and public health authorities have been critical to navigate the challenges of the Covid-19 pandemic worldwide. In this collaboration, mathematical models have played a decisive role in informing public policy, with findings effectively translated into public health measures that have shaped the pandemic in Costa Rica. As a result of interdisciplinary and cross-institutional collaboration, we constructed a multilayer network model that incorporates a diverse contact structure for each individual. In July 2020, we used this model to test the effect of lifting restrictions on population mobility after a so-called "epidemiological fence" imposed to contain the country's first big wave of cases. Later, in August 2020, we used it to predict the effects of an open and close strategy (the Hammer and Dance). Scenarios constructed in July 2020 showed that lifting restrictions on population mobility after less than three weeks of epidemiological fence would produce a sharp increase in cases. Results from scenarios in August 2020 indicated that the Hammer and Dance strategy would only work with 50% of the population adhering to mobility restrictions. The development, evolution, and applications of a multilayer network model of Covid-19 in Costa Rica has guided decision-makers to anticipate implementing sanitary measures and contributed to gain valuable time to increase hospital capacity.

The Role of Mobility and Sanitary Measures on the Delay of Community Transmission of COVID-19 in Costa Rica.

The aim of this paper is to infer the effects that change on human mobility had on the transmission dynamics during the first four months of the SARS-CoV-2 pandemic in Costa Rica, which could have played a role in delaying community transmission in the country. First, by using parametric and non-parametric change-point detection techniques, we were able to identify two different periods when the trend of daily new cases significantly changed. Second, we explored the association of these changes with data on population mobility. This also allowed us to estimate the lag between changes in human mobility and rates of daily new cases. The information was then used to establish an association between changes in population mobility and the sanitary measures adopted during the study period. Results showed that during the initial two months of the pandemic in Costa Rica, the implementation of sanitary measures and their impact on reducing human mobility translated to a mean reduction of 54% in the number of daily cases from the projected number, delaying community transmission.

Actos de salud con niño/as y jóvenes: resistencias, desenclaves y reflexividad / Children and youth/youngsters in the health acts: persistences, unnailings and reflexivity

El Acto de Salud se constituye en un espacio de intersección e intervención entre productores de salud y usuarios, en el que ambas partes son capturadas por necesidades y modos de actuar. Allí se comparten carencias de recursos de distinta índole, inaccesibilidades, restricción de derechos y condiciones generales de deterioro del sistema de salud, pero también se comparten deseos y potencias de cambio en un contexto en que las situaciones epidemiológicas demandan una práctica más compleja y de alto compromiso. En este trabajo presentamos un avance del análisis cuali-cuantitativo mediante epi-info y Atlas ti del material recolectado a través de una Escala de Síndrome de Burnout, Entrevistas semidirigidas, Entrevistas en profundidad, Talleres y Observaciones etnográficas en distintos escenarios. En el marco de los condicionamientos que operan en el proceso de trabajo en salud, se analizan las problemáticas de la salud colectiva de la niñez y la adolescencia, y de los trabajadores de salud que asisten a esta población, según dimensiones identitarias, territoriales y topológicas e histórico-temporales.