(TODAY NICARAGUA) Gregorio could not say goodbye to his father. When he found out that he was dead, men uniformed from head to toe in a white waterproof jumpsuit and face masks were already burying him in the northern cemetery of the city of Masaya, on the morning of Monday, May 11.
No one from the family was present at the funeral.
Doctors from the local hospital Dr. Humberto Alvarado only informed them that he died of “atypical pneumonia” and that the directive of the Ministry of Health (Minsa) was to bury him “immediately”.
The last time this 30-year-old man saw his father was on Friday, May 8, when he entered the emergency room with severe chest pain and a dry cough, the best-known symptoms of covid-19, caused by SARS-CoV-2 coronavirus. However, in the hospital they were hardly told: “Apparently, he has pneumonia.”
The case of Gregorio’s father, which could be unusual, is not unique in Nicaragua. Since the first week of May, dozens of anonymous videos and testimonies report semi-clandestine burials or those without relatives, some in the evening or early morning hours. All coffins are hermetically sealed. The cities of Masaya (in Suroriente) and Chinandega (in the West), are where more burials of this type have been seen.
Dozens of relatives have pointed out that the epicrisis of their relatives showed death due to “atypical pneumonia” or “severe pneumonia”, which would not be an impediment to keeping them awake at home, as is the tradition in Nicaragua.
For this reason, the government order to “immediately” bury the dead due to “pneumonia” and other chronic conditions, sets off alarms among Nicaraguan doctors, who consider that the Government of Daniel Ortega and Rosario Murillo is trying to minimize the severity of the covid pandemic. -19.
Government silence on the covid-19
On Tuesday, May 5, the Minsa stopped providing its daily report on the situation of covid-19 in Nicaragua. That day – more than a month and a half after the confirmation of the first positive case of coronavirus -, the Secretary-General for Health, Carlos Sáenz, said that Nicaragua maintained four active cases and five died, accumulating 16 confirmed cases since March 18. The rest of the week there was no other official report.
Saenz reappeared seven days later before the cameras of the official media, the only ones who have access to the Minsa press conference on a subject of national interest. The official reported nine new cases of covid-19 and admitted three other deaths from the pandemic.
“There were other deaths of people who have been followed up, caused by pulmonary thromboembolism, diabetes mellitus, acute myocardial infarction, hypertensive crisis and bacterial pneumonia,” said Sáenz, without specifying the exact number of deaths, who have been buried immediately. , like Gregorio’s father.
The silence on the state of the pandemic is holy and sign of the Government of Nicaragua. President Daniel Ortega spent 34 days – between March 12 and April 15 – without appearing in public, sheltered in his home and office in the El Carmen neighborhood, a kind of walled citadel and guarded by dozens of police, who control a multi-block circuit, including a park and surrounding streets.
On the 34th day, Ortega reappeared on a national television channel to speak from his bunker about the covid-19. “Here (in Nicaragua) if you stop working, the country dies, and if the country dies, the people die, it dies out,” said Ortega to attack the # QuédateEnCasa civic campaign and defend the role of his Administration against to the pandemic. The response has been criticized by national and international organizations and experts. The unanimous balance is that the regime puts the health of the population at risk.
Nicaragua is the only country in Latin America that has not officially closed its borders, maintains in-person classes for primary and secondary public education, and promotes mass activities, such as a free entry boxing evening that was held in the capital, the Saturday, April 25, while the sports world is on hiatus due to the coronavirus.
Nicaragua, the country of the unusual
“Nicaragua makes a global milestone a reality: we are the only country with a live sports event!” Repeated the official entertainer of the evening: a boxing card broadcast by the ESPN KnockOut program on the ESPN Latin America network. Activity in the midst of a pandemic once again placed Nicaragua on the radar of the international press.
The news that transcends from this country of six million inhabitants are the unusual acts against the covid-19: the absence of the president in the midst of a pandemic; a walk of “Love in the times of the covid-19” with the participation of “brigadistas” who then went home to home, visiting “more than 350,000 homes”; and the call for all kinds of sports, tourism and cultural activities, which on the second weekend of May totaled 2,500, as confirmed by Vice President Rosario Murillo, Ortega’s wife and official spokesperson.
Appointed by her husband since the Sandinista National Liberation Front (FSLN) returned to the Presidency in 2007, Murillo has imposed an “uncontaminated information strategy”: everything the Government does and says goes through her soliloquy of at least one hour a day. The guideline has not changed in the face of the pandemic and rather the information has been centralized to the extreme.
The Government has also been deaf to calls from the Pan American Health Organization (PAHO). “We are concerned about the lack of social distancing, the call for agglomerations. We are concerned with testing (from covid-19), contact tracking, and case reporting. We are also concerned about what we see as inadequate in terms of infection control and prevention, ”said Carissa Etienne, director of the agency, in early April, despite the fact that the official has been identified as close to the regime.
In the days that followed, nothing has stopped Murillo from continuing to call for mass activities. “This is how we are and this is how we go, invoking God our Lord every day, and working hard to advance. Peasant markets throughout the country; Corn House, Concert; Yard Production and Technologies, in Plaza 22 de Agosto is presented this Weekend, and there are a number of Food Fairs and Festivals throughout the country (sic.), ”Said the spokeswoman on May 14, after reciting, during his monologue, verses by the poet Manolo Cuadra.
The reality hit of covid-19 in Nicaragua
A Protocol for the Preparation and Response to the Risk of Introduction of the Coronavirus in Nicaragua, prepared by the Minsa, calculated in February that the country would have 32,500 affected by covid-19, and of these 8125 would be seriously ill. “If we take as reference the lethality of 2.5% of those infected, we could have 813 deaths. The deceased are 80% of the patients that require an Intensive Care Unit, ”admitted the Minsa in the protocol revealed in early March by Confidencial.
Two months later, the Government recognized 25 positive cases and eight died, placing Nicaragua in the queue of infections in Central America, but at the top in the percentage of deaths. Thus, still limited to these official data: more than 30% of covid-19 patients died in Nicaragua, being the country with the highest case fatality rate.
A week later, in the weekly Minsa report, cases increased by 1016%, going from 25 to 279 positive cases. The dead, despite reports of “express burials”, such as that of Gregorio’s father, rose from eight to 17.
Official information is scarce. On April 27, the secretary general of Minsa read a statement on television in less than a minute. Active cases: three. People / contacts in follow-up: anyone who deserves it. We do not have local community transmission. We continue to work with respect, patience, prudence and infinite thanks to God our Lord, ”he said briefly.
Government figures are also widely questioned. The Nicaraguan Medical Association, which brings together hundreds of health professionals, has criticized “the unclear way in which statistical reports in relation to the incidence and progression of the pandemic have been handled in Nicaragua.” The country does not know either the number of covid-19 tests carried out, nor the results thereof, which are centralized by the Minsa.
The same PAHO admitted in late April that it does not have “data to make an evaluation” on the situation of covid-19 in the country, according to the deputy director, Jarbas Barbosa da Silva. “They are not reporting the truth, nor the true results of the tests carried out in the laboratory of the National Center for Diagnosis and Reference (CNDR),” a source linked to the Government, who has learned of the results of the tests of the government, told Confidencial. “Conchita” Palacios National Health Complex, headquarters of the Minsa, where the test is centralized.
Three sources linked to the Ministry of Health with partial or total access to the CNDR tests agreed in an investigation of this medium that “the official reports are made up by political criteria”. “Some 5,900 tests have been processed, of which 4300 were negative, and 1600 positive,” for a contagion rate of 27%. “With this trend, thousands of daily tests should be carried out throughout the national territory, to know the true dimension of the pandemic and, above all, the circulation of asymptomatic cases,” added a source from the Minsa.
The Government, however, ignores PAHO’s requirements and the call to make the data from the covid-19 tests transparent, and so far continues without explicitly admitting that the country has entered the community transmission phase, which the exponential increase in cases precedes and the eventual collapse of the precarious hospital system. Nicaragua has less than 6,000 hospital beds and only 160 ventilators, which as of March this year, according to medical sources, were 80% used by patients with other pathologies.
In the absence of official information, a self-convened multidisciplinary group created the COVID-19 Citizen Observatory in early April, which reports the progress of the pandemic, based on complaints from the population.
Until May 22 – the date of its most recent report – the Citizen Observatory registered eight times more cases than those recognized by the Government, with a cumulative of 2323 suspected infections. This figure includes 465 deaths, presumably from covid-19 (404), according to the doctors who collaborate with the Observatory, or from some type of pneumonia (61), such as the one that the Minsa affirms that it killed Gregorio’s father, in Masaya.
The figure also includes no less than 180 doctors and Health personnel who have presented symptoms associated with covid-19. Despite being on the “front line” against the pandemic, until mid-April the government prohibited the use of masks, gloves or gel alcohol among hospital staff “so as not to alarm” the population.
“They said that everything was fine, that there were few cases, and that if we used face masks we were going to alarm people,” said Graciela, a doctor who has been working for Minsa for more than a decade.
“They are exposing all medical personnel,” claimed Dr. José Antonio Vásquez, a member of the Nicaraguan Medical Unit (UMN), a union organization of doctors from the public and private sectors. “This,” he added, “happens at the level of health centers, where the population with suspicious symptoms of coronavirus is also cared for, and in large city hospitals. It is something that is being repeated in all health units. ”
Despite the fact that the Ortega Government has made its own reality about the pandemic, and is going in the opposite direction to the international recommendations to prevent contagions, the alarms continue to go off.
The independent Nicaraguan Foundation for Economic and Social Development (Funides) warned in an April report that, if the government does not establish prevention measures, in mid-June there will be 119,703 infected and at least 650 deaths from covid-19 in this Central American country.
“Ortega’s speech is criminal,” said the former Minister of Health, Dora María Téllez. “It is no longer simply negligence, but a deliberate action that puts the health of the population at risk. When Ortega, who has a voice of authority, says that nothing is going to happen, there are people who simply, within their humility, believe him.
A “family” health model
The Ortega y Murillo government has based its strategy to fight coronavirus on its “family and community health model” that, according to state officials, has been effective in facing global epidemics, such as H1N1, and local ones, such as leptospirosis. or malaria.
This model is made up of departmental and municipal Health units. The municipalities have been divided into sectors, which are constantly monitored and visited by Health officials.
The Nicaraguan opposition represented in the Civic Alliance for Justice and Democracy, and the Blue and White National Unit, which emerged after the protests in April 2018, have proposed actions to prevent contagion, including promoting physical distancing, carrying out and decentralizing the massive tests of covid-19 and make its results transparent, in addition to access to resources to face the pandemic and assist the economically vulnerable population, in a country where seven out of ten Nicaraguans work in the informal economy.
The proposal includes a reform of the General Budget of the Republic, the creation of an emergency fund, the release of political prisoners, the restoration of constitutional rights, as well as a three-month moratorium on the payment of basic services, of the Property Tax. Real Estate (IBI), Value Added Tax (VAT), Fixed Fee and other taxes.
The official response to the proposal came from the National Assembly, dominated by the FSLN. The pro-government deputy, José Antonio Zepeda, claimed: “Why don’t they take (the money) out of their bags? I think that demagogues, speeches do not convince us workers who daily know what it is to develop economic, political and social activities ”. The FSLN member of parliament is a teacher, but he has years of not teaching, dedicated to his political career first as a union leader and later as a legislator.
The Orteguismo prefers to continue betting on house-to-house visits throughout the country, despite the disapproval of experts, who warn about exposure to contagion from the population and officials.
Gregorio does not remember that his home in Masaya has been visited by any government medical unit. The last time he saw a Health worker was when he was told that his father had died, without openly telling him that it was from covid-19. You will always have the doubt. But, for now, he will take preventive measures to avoid another case of “atypical pneumonia” in his family. And end up buried without a candle, in a country where the rulers insist on denying the impact of the pandemic.