PAHO: “Increased Deaths in Nicaragua Related to Covid-19”

The increase in mortality in Nicaragua “is directly and indirectly related to the Covid-19 pandemic,” said the Pan-American Health Organization (PAHO), in an interview conducted by Confidencial, through a questionnaire that the institution replied in writing.

The increase of mortality during the health crisis, according to the official death certificates list pneumonia, heart attacks, diabetes mellitus, and high-blood pressure as the leading causes.  Dr. Carlos Hernandez, public health expert, notes that the estimated 4,429 people who died between March 11 and July 30, concerns PAHO, because the Nicaraguan government only provides “very scant” information that does not allow us to analyze the progress of the pandemic in this country.

The regional body explained that in the case of Nicaragua, it is evaluating information from sources such as the Citizens Covid-19 Observatory, CEPREDENAC, medical societies, NGOs and the media, in accordance with the provisions of the International Health Regulations.

Likewise, in response to a question from Confidencial, about the migratory crisis on the border between Nicaragua and Costa Rica, where more than 500 Nicaraguans are stranded because the Ortega Government requires a negative test of Covid-19, PAHO indicates that the Nicaraguan State should provide access to free tests.

According to the regional organization, the State of Nicaragua has the duty to “provide the diagnostic service free of charge, to all those who need it, including the migrant population” and for this they have delivered to the country more than 250,000 reagents for PCR tests, since the first cases of coronavirus were reported in the region.

Until July 28, Nicaragua accumulated 116 deaths from Covid-19 and 3,672 sick people according to the Ministry, in contrast to the 9,044 suspected cases and 2,537 deaths reported by the independent monitoring of the Citizens Observatory, in its latest report issued on July 29.

What is PHO’s estimate of the number of Covid-19 infections and deaths in Nicaragua?

PAHO does not have a clear estimate of the number of infections and deaths in Nicaragua.

Public health expert Carlos Hernandez analyzed the excess mortality that occurred in Nicaragua, between March 11 and June 30, 2020, and according to data from death certificates in this country, 4,429 people have died from pneumonia, heart attacks, diabetes, hypertension, deaths that the health expert considers “suspected cases of Covid-19.” What is PAHO’s assessment of this increase in mortality in Nicaragua in the context of the health crisis?

PAHO considers that the increase in mortality in Nicaragua is directly and indirectly related to the Covid-19 pandemic. As mentioned before, PAHO remains concerned about the administration of tests and isolation of all suspected and confirmed cases, the tracing and quarantine of contacts, and the treatment of all cases of Covid-19 in Nicaragua. We receive a very scant weekly report from the Nicaraguan authorities, but unofficial sources indicate much higher figures that are related to the increase in mortality, the saturation of health services and the affectation of health personnel.

Two women wear masks as a preventive measure against the coronavirus on a street in Managua. Photo: EFE/ Confidencial

Since what date does PAHO considers that the phase of community contagion began in Nicaragua and what does this stage of the pandemic means?

PAHO relies on official data from governments provided in accordance with the IHR (International Health Regulations). Without this, we cannot accurately deduce when community transmission began in Nicaragua.

Which measures has PAHO recommended to the Government of Nicaragua to prevent new infections?

PAHO has reiterated its concern for the situation in Nicaragua during the pandemic and its repercussions in other countries in the region, especially during the press briefings by PAHO’s Director. It is vital that the country implement public health measures to stop community transmission and save lives and reliably report on the situation of Covid-19 in the country, particularly in border zones.

Does PAHO know how many Covid-19 tests the Nicaraguan government has administered and their results?

Nicaragua’s Ministry of Health should have information on the number, type of tests and their results. This information has not been shared with PAHO.

More than 500 Nicaraguans are stranded at the border between Costa Rica and Nicaragua. They want to enter Nicaragua, but the government requires a negative Covid-19 test, which only the MINSA does at a cost of US$ 150.00. If the government of Nicaragua has laboratories and Covid-19 rapid tests, can it provide this service to the migrant population?

Since the start of the pandemic, to date, PAHO has reiterated that the standard for the diagnosis of COVID-19 is CRP tests that identify the presence of the virus. For this reason, PAHO provided training to Nicaraguan laboratory personnel to carry out these tests and has so far donated more than 250,000 reagents for CRP (C-reactive Protein) tests to the country. PAHO does not recommend the use of rapid tests (antibody detection) to diagnose Covid-19. Countries should provide the diagnostic service at no cost to all those who need it, including the migrant population.

What type of assistance has PAHO provided to the Nicaraguan government during the pandemic?

PAHO has provided technical assistance since mid-January, by sending alerts and epidemiological updates, specific detection recommendations and treatment of cases, isolation of confirmed and suspected cases and quarantine of contacts. PAHO also sent experts to support the elaboration of preparedness and response plans, as well as to assess the capacities and needs of health services to deal with the pandemic.

It has donated hundreds of thousands of personal protective equipment and reactives for CRP testing. PAHO has supported the continuation of the expanded immunization program, which is essential to maintain Nicaragua’s vaccination achievements.

Can PAHO and other international organizations provide more assistance? On what factors does international aid towards to the Government on the pandemic depends?

PAHO and other agencies can provide greater assistance to countries that require it. The type of assistance (technical, operational, equipment, supplies, medicines, vaccines, etc.) depends on the evaluation and identification of the needs that the country cannot or has difficulties to cover. In all these cases, the country must request or accept the offers of aid.

PAHO has indicated that since official information is not reliable for Nicaragua, you are seeking information through “unofficial sources.” What are those sources?

In accordance with what has been established by the International Health Regulations, PAHO continually seeks and analyzes official and unofficial information on events that constitute or may constitute a public health emergency of international importance. In this sense, PAHO reviews and assess information from sources such as the Ministry of Health, the Citizens Observatory, CEPREDENAC, medical societies, NGOs, other public and private institutions, media outlets, individual reports, etc.