Up through August 31, 2020, Nicaragua had the third highest percentage jump in excess deaths of any country in the world. That excess mortality is almost certainly attributable to COVID-19.
The British daily “Financial Times” recently published a worldwide comparison of excess deaths in 2020. They graphed the percent increase in countries’ excess deaths when compared with the country’s historical averages. That data, as well as national studies, point to a 90% under-registration of Coronavirus deaths in Nicaragua. In other words, the 179 COVID-19 deaths officially recognized by Nicaragua’s Ministry of Health (Minsa) are barely a tiny fraction.
Carlos Hernandez is a a public health specialist and member of the Multidisciplinary Scientific Committee. Speaking on the internet television news program Esta Noche, he explained the implications. “With the data published, we can measure under-reporting. Obviously, Nicaragua is the country with the greatest under-registration. Based on Minsa’s monthly data, up through August 31st there were 7700 deaths. That indicates that the 176 (COVID-19 deaths according to Minsa) is 2.6% of what’s reported. That is, there’s an under-registration of 90-plus percent”.
The Financial Times study just published April 6th, indicates that Peru occupies first place, with the greatest excess mortality. Ecuador and Nicaragua follow, in second and third place respectively. Both show a percentage of excess mortality higher than 60%.
Both Peru and Ecuador update their statistics on excess mortality every two or three months, Hernandez indicated. In the case of Nicaragua, however, there’s still no data from August 2020 to the present. It’s fairly certain that the mortality statistics “have grown a lot” since then.
Hernandez recently updated his statistics using the official Minsa data. Based on this, he believes that the numbers of COVID-19 deaths in 2020 may have reached 9,000. Between 2005 and 2019, Nicaragua had a monthly average of 25.5 to 29.8 deaths for every 100,000 inhabitants. The year that COVID-19 struck, the average rose to 44.5 deaths per 100,000.
The expert lamented that Nicaragua doesn’t provide the public information needed to know how the pandemic is behaving. On the one hand, Minsa has frozen its data on infections and deaths. Every week, they report some 50 new cases and one death. “It’s unheard-of and unprecedented on the planet.”
The latest graphs from the independent monitoring group Citizen’s Observatory “still show irregularly rising peaks” in infections.
Slow pace of vaccination with no sense of urgency
Nicaragua received its first supplies of the COVID-19 vaccine in February. At that time, the government announced the donation of 6,000 doses of the Sputnik V vaccine. On March 16, they received a supply of donated vaccines through the Covax mechanism. Despite this, the vaccination of people with chronic diseases didn’t begin until April 6th.
Epidemiologist Leonel Arguello, also participated on the Esta Noche program. He questioned the lack of urgency in the vaccination process. According to vice president and government spokesperson Rosario Murillo, the goal is to immunize 167,500 people a month.
Arguello believes that the country has the experience, the capacity and the human resources to work more quickly. However, it’s not being done that way. The vaccination plan isn’t even known yet.
The country’s supplies include 335,000 doses donated by India, and the Covax supplies of the Oxford-AstraZeneca vaccine. With these, they should be able to vaccinate 11,500 people a day. Health personnel could apply the first dose, while awaiting the next delivery, confirmed by the Pan American Health Organization. Then they could complete the doses, Arguello suggested.
“They still haven’t understood the urgency of vaccinating as quickly as possible. If we don’t, the more contagious variants of the virus are going to reach us. (…) A vaccine can’t be put in storage. Once it arrives at the storage site, it needs to reach people’s arms with a sense of urgency. Deaths must be avoided,” Arguello emphasized.
The first day of COVID-19 vaccinations for chronic patients, recipients waited in long, crowded lines for hours. Arguello criticized the poor organization of the program. The country had plenty of time, he noted, to be prepared for this stage of the pandemic.
He recalled that this vaccine isn’t like the others. The sites must be well ventilated, and the population spaced apart. Those waiting should wear masks. What was observed, though, was just the opposite. “With one hand, they’re bringing people together to spread the infection, while with the other they administer the vaccine. The vaccine isn’t going to stop that spread, if you’re already promoting it at the vaccination site,” he highlighted.
Like Arguello, health expert Hernandez feels that Nicaragua “could multiply greatly the number of daily doses offered.” He noted that one of the problems faced by the world’s countries is the scarcity of vaccine doses. But in Nicaragua, there are vaccine doses available, and the challenge is organizing the vaccination process.
“The more we prolong this, the greater the possibility that two things could happen to us. First, the more transmissible and serious virus variants may enter. Second, with each day that passes, there are more avoidable deaths,” declared Hernandez.
Up until now, Nicaragua has been using donated doses to vaccinate. However, at the beginning of the year, Murillo reported that they were working to acquire three different types of vaccines. Their plan at that time was to immunize 55% of the population. Among other negotiations, the country was working to purchase 3.8 million doses of the Sputnik vaccine. Four months after this announcement, the progress of these negotiations is still unknown.
A “misleading” normality
According to preliminary data from the Nicaraguan Tourism Institute, 2.4 million Nicaraguans travelled during Easter Week. Many of them were part of crowds and relaxed the preventive measures against Covid-19.
Hernandez indicated that there’s a “misleading pseudo-normality” in the country. In 2020, specialists began noting the upward curve of infections two weeks after Easter Week. Similarly, this year, “we know that a multiplication of infections could be in the wings following Easter Week. I hope it’s not true,” he warned.
Arguello recommended that those possibly exposed to COVID contagion over Easter Week stay six-feet away from family members. If they begin to feel any symptoms, they should go to a health clinic. In other cases, the person themselves may not have symptoms, but someone in their group of friends does. They, too, should keep six feet away from everyone, and wait ten days before resuming their routine. Even those who don’t get sick at all should still maintain the regular preventive measures.