Nicaraguan Doctors and Health Professionals Urge Ortega to Take Covid-19 Seriously

Two hundred and thirty-six doctors and other health professionals signed a statement demanding that the government of Daniel Ortega responsibly face the health crisis caused by the covid-19 pandemic.

Nicaragua has stood out internationally, being one of the few countries that has not dictated suspension of classes, nor ordered quarantines at any level. Instead, the government encourages attendance at massive events such as pro-government rallies, contests, anniversaries, fairs, festivals, and even its own religious-type processions.

The signatories indicate in their text that the “educational campaign has been extraordinarily timid, with the aggravating circumstance of exposing health professionals to the risk of infection, with modalities that have not shown any efficacy, such as the so-called home-to-home visits.”

Here is the full text issued on April 30th:

Health Professionals’ Pronouncement on Covid-19 in Nicaragua

This past March 11, 2020, the World Health Organization (WHO) declared that the novel Coronavirus (SARS-CoV-2) outbreak which began in November 2019 in Wuhan, China, had become a global pandemic. As a consequence of said outbreak, the WHO recommended the implementation of national plans for contention and mitigation of the epidemic, with the objective of achieving control.

The lessons learned in China, the European countries, and North America showed us how late execution of these recommendations resulted in the collapse of the health systems of many countries, with a consequent elevation of the mortality rates and an enormous social and economic impact.

We, the health professionals, had the expectation that the Nicaraguan government would follow the WHO guidelines, like the rest of the Latin American countries, giving priority to the health and common well-being of the people, even at the cost of great economic sacrifices. We expected that the health authorities would develop and execute a national plan with basic preparative measures in the face of the imminent threat of SARS-CoV-2, including:

1.Contention measure, via:

• The localization, follow-up and isolation of COVID-19 cases and their contacts
• Appropriate testing of the population for the identification of suspected cases.
• The partial or complete closure of land and air borders.
• Training, preparation, and equipping all the health personnel with appropriate means for their self-protection and adequate attention in the health centers, private as well as state.
• Development of protocols for attention and management of cases diagnosed with COVID-19
• Recognition of the increased risk and need for education of the country’s most vulnerable populations, such as older adults, people with co-existing health conditions and patients with compromised immune systems.

2. Mitigation measures such as:

1. Physical distancing, travel restrictions, and restrictions on large gatherings, as well as the quarantine and isolation of infected populations.
2. Hygienic and sanitary measures such as the permanent washing of hands.
3. The use of face-masks for the general population in gathering places where there’s a risk of transmitting the infection.

3.Transparency in information and communication, with clear, brief and precise messages to the general population.

However, instead of complying with the recommended measures, the Nicaraguan government has promoted mass activities [like the “March of love in times of COVID-19”, Summer Plan, boxing matches, baseball games, the “Mayo Ya” Party].

Their educational campaign has been extremely timid, with the aggravating factor of exposing health professionals to the risk of infections with modalities that haven’t demonstrated any effectiveness, such as house to house visits.

They have also not adequately equipped the health units, and health personnel lack the basic protective measures to attend to the ill population with minimal risk. On the contrary, they’ve discouraged and restricted the use of face masks and in some cases have even forbidden their use, thus endangering the health of the workers.

In the same way, confusing information has been generated about the people affected by the infection. This kind of communication has created disinformation in the population, putting obstacles in the way of responsible management of the health crisis. It has become a factor that has facilitated the spread of the infection.

Further, testing of the suspected cases has been extremely insufficient for detecting the progression or development of the infection. This has been centralized, and its realization has been marked by arbitrary and capricious criteria, which seeks to obscure the status of the epidemic.

It’s important to note that the Central American Integration System (SICA), in its report from April 3, 2020 noted the following: “Nicaragua today receive a donation worth US $1 million dollars from the Republic of China (Taiwan) to face the COVID-19 pandemic, within the framework of the Central American Integration System’s Regional Contingency Plan. Thanks to this supportive solidarity, the supplies and medical equipment to attend to patients affected by the virus in Nicaragua will be increased.”

In the chart summarizing the measures implemented in each one of the SICA countries, it can be noted that Nicaragua – in contrast to the rest of the countries – didn’t suspend classes in the public and private schools; nor did it restrict the entrance of foreigners into the national territory; nor did it confirm whether any forms of telecommuting had been implemented as a means of preventing contagion.

For their part, the Central American Bank for Economic Integration delivered 26,000 rapid results test kits to Nicaragua for diagnosing Covid-19, but unlike the rest of the countries belonging to SICA, Nicaragua didn’t report on its plan to distribute and use these.

Jarbas Barbosa da Silva, the assistant director of the Pan-American Health Organization, affirmed this past April 24^th that they can’t “effect an evaluation of the pandemic situation in Nicaragua”, and reiterated that “in Nicaragua the situation is still indeterminate.” That is, there’s no data about “how it [the pandemic] is behaving” at this time.

As Nicaraguan citizens, we feel we have a right to receive quality integral health care without discrimination, and that it’s the inherent obligation of the state to guarantee this. In addition to being a Constitutional Right, health is a Human Right and it’s the non-delegable responsibility of the Nicaraguan State to guarantee this right.

Therefore, we as health professionals demand and insist that – given the scenario of a natural evolution of this pandemic – the Nicaraguan government:

1. Begin the massive realization of testing, at both a public and a private level. Carrying out a universal sampling is fundamental to mitigating the epidemic and reducing its impact on mortality and on the health services of the state and the nation.
2. Make transparent the pertinent data on the epidemic’s evolution in accordance with international epidemiologic standards, using clear technical language.
3. Establish publicly its contingency plan for this public health emergency and immediately implement the social distancing measures and the restrictions on large gatherings, as well as isolation and quarantine measures as needed.
4. Guarantee adequate protective measures for all the health personnel involved in the services of public attention.
5. Guarantee sufficient existence of diagnostic tests, medications and life-sustaining equipment (such as ventilators) to all patients with Covid-19 that need it.
6. 6. Guarantee – like the rest of the SICA countries – policies of socio-economic harm reduction or mitigation (a freeze on the rates for water, electricity, sales taxes, bank debts, aid funds, etc.) to allow some relief to the health workers and citizens in general in the face of the health crisis, as well as guaranteeing the human rights of the most vulnerable populations.

Despite the negligent management of the Covid-19 pandemic in our country, and the fact that economic stability has been prioritized over the health and welfare of the Nicaraguan people, right now the curve of serious cases has just begun to ascend and we feel it’s still possible to realize mitigation actions that reduce the catastrophic impact on mortality rates and on the health system.

We wish to offer our recognition to the health personnel that – in this public health crisis – continue offering attention to the population without the necessary means of protection.

WE URGE THE GENERAL POPULATION TO STAY HOME AND TO COMPLY WITH ALL THE MEASURES FOR PERSONAL PROTECTION!

Your truly,

Signed by: 236 doctors and other health personnel