In the early months of the pandemic, there was significant uncertainty about many of the fundamental metrics that epidemiologists use to assess the threat and determine the appropriate response to a novel virus. Fortunately, as better data emerged, it became clear that mortality risk was heavily weighted to the elderly and patients with a comorbidity. In fact, according to the Mayo Clinic, 80% of Covid deaths in the US have been in people aged 65 and older with those over 85 with the highest risk of serious symptoms. In an effort to provide context, according to the CDC, more Americans in the 15-24 age bracket have died from Pneumonia this year than Covid-19. Other causes of death for this age bracket including "unintentional injury", suicide, homicide, and malignant neoplasms (cancerous tumors), far outpace Covid-19. This Mayo Clinic Article offers a good summary of underlying health conditions that increase risk and, as always, we recommend getting advice from a medical professional.

While risks to healthy college age students are low, we understand the stress and uncertainty that students and parents may feel about the virus. In our decision to offer this program, we had to be confident that students would be as safe or safer than they are in the United States. Of course, individual behavior plays a significant role in the risk of contracting the virus but environment also plays a role in influencing behavior. Our campus environment will reduce the number of transmission vectors simply because students will not be interacting with nearly as many different people as they would on a college campus. Furthermore, the majority of your time in Costa Rica will be spent in open air environments around campus, hanging out at the beach, or hiking through the rain forest. With winter weather bringing cold temperatures to most US regions, it will be much more difficult to spend time in outdoor environments than it is in Costa Rica, which significantly reduces the risk of transmission.

In determining when it is possible to travel again, our organization has been simultaneously focused on both the risks the virus poses to student health as well as potential complications with international borders or other political uncertainty. While Covid-19 is a new consideration for us, we've accessed several other health related risks over the years including Zika Virus, Dengue Fever, and Ebola. Likewise, we've evaluated a wide variety of political risk in each of the countries where we operate. Costa Rica opened their borders to all US citizens on November, 1st after first opening, in stages, to certain states. There is no requirement for quarantine upon arrival. We are confident that Costa Rica will remain open to and accommodating of US citizens for the duration of the pandemic. In the extremely unlikely event of a border closure, we would have plenty of warning for students to finish out their program or return home. Another consideration during the pandemic is ensuring that our students would have easy access to high quality medical care for Covid or any other reasons. There is a private hospital located 10 minutes from campus that, in normal times, serves the large community of ex-pats in the Guanacaste region and is equipped to manage large influxes of tourists during the high season. With international tourism reduced during the pandemic and Costa Rica's Covid-19 infections per capita lower than the United States, we have no concerns that the local hospital will be overburdened. We will continue to monitor these factors closely throughout the spring. The US Embassy in Costa Rica provides frequent informative updates.

Several of our US staff members have traveled to Costa Rica this month and our staff who live in Costa Rica have been visited by family from the United States. Airport protocols are similar to those in the US, masks are mandated for all travelers as well as all security people and TSA agents are constantly disinfecting surfaces between travelers. Normally congested security lines are spaced out to allow 6-feet of social distancing. We recommend a surgical mask rather than a cloth mask which studies have shown to reduce risk of transmission. Studies also show that a face shield in addition to a mask further decreases risk. If you do not wear a face shield, even sunglasses can make a difference. We recognize that the flight to Costa Rica is probably our highest risk factor despite research showing that airplanes pose less risk than normal daily activities like visiting a grocery store or eating out. Accordingly, we will spend our first few days in Costa Rica with very strict Covid prevention policies on campus.

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