Nicaraguan President Daniel Ortega has ignored the recommendations of national and foreign experts to confront COVID-19, making the country one of the weakest in the region to face the pandemic. Instead of promoting social distancing, authorities are organizing concerts, marches, and boxing matches, contrary to the recommendations of the Pan American Health Organization and the Multidisciplinary Scientific Committee, a Nicaraguan nongovernmental organization that monitors and reports on the virus.
“The COVID-19 situation is a double-sided coin. On the one hand, the state claims that it isn’t a problem; on the other hand, there’s a group of professionals that considers that the virus is a serious problem, and we are alerting the population that it will strike the country,” Leonel Argüello, a Nicaraguan epidemiologist who is part of the Committee, told Diálogo. “From an epidemiological viewpoint, there is no reason for the virus not to circulate; there were no restrictions, there was no quarantine, and recommended measures were not taken.”
“The situation is uncertain. Some reports state that a lot of people were in hospitals and were not included in official reports. These kind of games prevent us from grasping the real situation of the infection curve,” Álvaro Ramírez, a Nicaraguan epidemiologist based in Ireland, told Diálogo. “This is troubling. They create a false sense of security; they carry out mass mobilizations and political and social events without any oversight.”
A health system in decline
One of the specialists’ biggest concerns is that Ortega’s lack of response will lead to an outbreak of the virus, which will cause the Nicaraguan health system to quickly collapse.
“There are few specialists in the health system, which is largely managed by general physicians,” Ramírez said. “Nicaragua relies heavily on a [home] visitation system that should be for prevention, but in this case it poses a risk.”
Public health specialist Carlos Hernández, also a member of the Committee, projects that upon the outbreak of COVID-19 in Nicaragua, the health system would be overwhelmed in 23 days.
The March 26 report The Global Impact of COVID-19 and Strategies for Mitigation and Suppression, from the Imperial College London School of Medicine, estimates that if no mitigation or social distancing measures are applied in Nicaragua, 91 percent of the population would be affected by the coronavirus in one year, which would mean about 6 million people infected and 24,000 deaths.
According to the World Health Organization database, there are only 0.9 hospital beds per 1,000 inhabitants in Nicaragua. Another worrisome fact is that the official number of ventilators in the health system has not been made public, but local newspapers such as El Confidencial say that the total is likely around 160 ventilators, 130 of which are already being used to treat other illnesses.
Both Ramírez and Argüello believe that these combined conditions will lead COVID-19 cases to rise sharply in the coming weeks in Nicaragua.
“We believe that the curve will start to rise, and we won’t be able to stop it,” Argüello said. “The handling is reckless. We can expect rapid, exponential growth of the upward curve. Our weakened health system lacks the necessary capabilities,” Ramírez added.