Covid-19 underreporting maintained by Nicaragua’s Ministry of Health (MINSA) intends to artificially keep the fatality rate low, at the same time that it seeks to project a normal environment that serves to try to convince supporters of the Sandinista Front that it is safe to go to the plaza on July 19, to celebrate the 41st Anniversary of the Revolution, says epidemiologist Alvaro Ramirez.
The truth is that, while the Ministry of Health states that the number of infections and deaths is decreasing, each week, more than a hundred people die in hospitals due to Covid-19, while different medical associations begin to report the death of their members.
“On the fatality rate—which is now 4%—it was something that worried them and they quickly corrected it. On May 19 they released a report that jumped to 254 cases, in order to lower the case fatality rate, which was 32%. The highest in the world!”, said epidemiologist Alvaro Ramirez, when interviewed in the program “Esta Semana,” which is only broadcast online, due to the censorship of the Government of Daniel Ortega and Rosario Murillo.
“They became aware of the mathematical error they were making and decided to start correcting it, inflating the number of cases and reducing the number of deaths,” he amplified.
According to the weekly reports from MINSA, the number of new confirmed cases decreased from the 480 it was three weeks ago, to 359 a fortnight ago, to leave it at 346 last Tuesday.
The number of new deaths also falls week by week. If 21 days ago, 18 more deaths were officially reported than in the previous one, fifteen days ago only eleven deaths were added to the count, and last Tuesday only nine.
“What we can expect from the report on Tuesday is that they are going to continue lowering it, because they need to appear to have little circulation of coronavirus for the celebrations and crowds on July 19,” Dr. Ramirez predicted.
The expert estimated that the handling of numbers can be linked to their desire to be able to say during the July 19th celebration, that the country is in normality, that everything is under control, and even “be able to claim victory over Covid-19, on top of all the cadavers and all the Nicaraguans that are getting sick.”
Instead of that, the expert predicted exactly the contrary to happen. “The high circulation of the virus in the country will generate a flare up, a very strong outbreak, above all on those families that participate in agglomerations.
He recalled that, more than a theory, this is a thesis that Ortega supporters are already confirming. “Their own militants, their own paramilitaries, their own deputies, are the same people who participate in these activities, and some have been among the first to die. There is simply no respect for the right to life of Nicaraguans,” he lamented.
Virus has no political preferences
Although the intention of projecting an artificial case fatality rate of only 4% to the world is to be able to compare it with the international community (data from the Covid-19 Citizens Observatory places the rate at 28.1%), Ramirez assures that there is no way to compare the numbers of the MINSA with those of any responsible country.
“These are all mathematical processes that the Ministry of Health does so that the average fatality rate of Nicaragua is normal. The international rate for coronavirus is less than 2%,” so that 4% would make Nicaragua be within the average, Ramirez said.
However, there is no way to compare Nicaragua’s approach with that of the rest of the world, because “those countries are facing a health problem that affects all citizens, regardless of their political color, race, or religious creed, and that is what is happening here: There have been dead from all sectors, including people from the government, deputies, ministers,” he explained.
The vision that his was a real international health problem “did not apply in Nicaragua. The thesis was applied that Covid was something invented by a few right-wing coup mongers, and nothing was going to be done, so that those people would die. They did not realize that this virus does not even respect them. The difference is in the epidemiological principle of how to deal with it,” said Ramirez.
By defining it as a political problem that would only affect the right wingers, “with the view that the right must be treated as subhuman and be left to die… it was decided to do nothing and not take the risk of assessment requested by PAHO, nor the epidemiological health plan, or the public health policies… because it was defined as a political problem of coup plotters,” he repeated.
Epidemiological Bulletin Suspended
Ramirez offered another proof of the prevailing mentality in the government ranks, remembering that, when the epidemic began there had been free access to epidemiological bulletins, which allowed to see the behavior of diseases such as malaria and dengue. That existed until the government discovered that such public information could be used as a weapon against them.
“The easiest way was to suspend it, and since they are not obliged to give that information to the people, and they have no health communication strategy to guide and benefit the Nicaraguan people, they simply suspended the epidemiological bulletin,” he noted.
The result is that “we will continue in the dark, without knowing where we are as a country, with the epidemic spreading throughout the national territory,” he predicted.
The government operates entirely outside the framework of international health regulations and does what it wants with the numbers. It is very difficult to try to understand their logic,” so Nicaragua lives “a reality at three-levels: what the Government reports, what the Citizen’s Observatory reports and the reality of the suffering of the people in their homes,” he explained.
A decrease (of patients) in hospitals
The epidemiologist also explained that the decrease in the numbers of hospitalized patients and dead from Covid-19 in the hospitals does not mean that the epidemic is receding, a conclusion that cannot be reached until there is “at least three to four weeks of continuous decrease.”
“It is absolutely normal,” that there are less intense weeks than others, he explained.
“There are weeks when it goes down a little, and it lets the staff rest, but then it goes back up. Epidemiologically speaking, this is the normal behavior of the Covid, but we must be prepared, because this epidemic has not gone away, and we have not yet reached its peak, but we are approaching it,” he warned.
An additional reason to understand why there are fewer Covid-19 patients in hospitals, is that citizens have already given up on the belief that they will find the care they need in those places.
“At the beginning, the population believed that hospitals and health centers would solve the problem and that there they would receive appropriate care, but over time they realized the quality of the service, in addition to the fact that in each hospital there are political commissars who decide who receives services and who doesn’t,” he described.
Ramirez explained that people began to understand that it was useless to take their patient to the hospital, where they would give them the prescription to look for medicines and the rest of the health material. Besides that, many of the them did not see their relative alive again, with the aggravating factor that they do not even have the certainty of having buried their relative—and not a stranger—because they are handed over in a sealed black bag, without knowing if the person in the coffin is their relative or not.
“People are changing the dynamics: instead of sacrificing themselves in front of the hospital gates, of being in a room with a bunch of people getting more infected with Covid, they have decided to stay at home to attend mild and moderate cases,” he clarified.
The problem is that “while many of these cases are going to recover, but those that get complicated will already arrive late to the hospital,” which will make their recovery more difficult.