13 de marzo 2020
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The hermetic silence from the regime of Daniel Ortega and Rosario Murillo regarding the Coronavirus (Covid-19) pandemic, and the scant information being offered about how to prevent the illness has generated increased uncertainty in Nicaragua.
The Ministry of Health (Minsa) hasn’t yet explained to the public the measures they will implement in the face of the imminent arrival of the virus in Nicaragua. Such information is already being disseminated in other countries of Central America, but here they merely assure that “thanks to God” there are no confirmed cases of the virus in the country.
The inertia of the public health authorities could cause even more damage than the disease itself, reflects epidemiologist Leonel Arguello. Minsa does have “the tests and the training” necessary to diagnose the new virus, whose symptoms are similar to seasonal flu, but the silence around everything related to the pandemic could have negative repercussions in the health of the population.
Up through Thursday, the pandemic has registered 126,283 positive cases worldwide, has caused 4,724 deaths, and has now extended to over 120 countries around the world, twelve of them in Latin America, including Nicaragua’s neighbors Costa Rica, Honduras and Panama. The latter announced the region’s first confirmed death from the virus, a 64-year-old man who had additional health complications.
Lack of information fertile ground for panic
Covid-19 is a respiratory disease caused by a type of Coronavirus recently discovered in Wuhan, China. “Some 86% of the cases present as common flu,” affirms the epidemiologist, but he warns that “the remaining 14% lead to complications, and one part of these are going to be fatal,” since there’s no specific treatment in existence. The role of the health ministries is “to rapidly detect cases, so as to avoid transmission” of the disease.
Arguello said the state silence represents a “lack of prevention” of the pandemic, because the population isn’t being informed. As a result, “people get hysterical, enter into panic, begin to spend money, begin to create scarcity, and people in business take advantage of that.”
Although the presence of the Corona virus has still not been confirmed in Nicaragua, this week a supermarket chain restricted the sales of sanitizing products to avoid hoarding, and the supply of face masks is running out in some of the country’s pharmacies. Alcohol in liquid and gel form has also become scarce.
MINSA projects 32,500 cases of the virus over the next 6 months
A document obtained by Confidencial entitled “Preparation and Response before the risk of Corona virus”, elaborated by the Health Ministry in February, gives a projection of 32,500 people affected within 6 months after the virus enters the country. The calculation assumes a contagion rate of 0.5% in a 180 day period.
According to Minsa’s official projection: “It’s estimated that there could be 32,500 cases, with 75% of them (24,375) being mild or moderate, and 25% (8,125) serious. If we project a fatality rate of 2.5%, we could see 813 deaths. Those deaths would comprise 80% of the patients who need the Intensive Care Units, for which we calculate that some 1,016 will pass through the Intensive Care Units.”
Fascade of the Fernando Velez Pais Hospital in Managua. Photo: Ivette Munguía
In order to care for the serious patients, the Minsa document adds: 451 hospital beds will be needed for an average stay of 10 days, and of these, 79 of them in the intensive care units for a median stay of 14 days, with 79 ventilators, one per bed in the ICU.”
The World Health Organization indicates that those over 60 and those with preexisting medical conditions such as high blood pressure, heart disease, lung illness, cancer, or diabetes have the greatest risk of dying from Covid-19.
Dr. Arguello explains that each person infected with the virus could transmit it to an average of three more, so that the propagation of the virus will depend largely on the preventive actions that the Health Ministry and the population undertake.
The epidemiologist urged the government to wage a national prevention campaign, utilizing the media and the workplaces, since the virus is already in Nicaragua and the population hasn’t been sufficiently informed about the myths and truths of the Coronavirus.
“I don’t have any information about whether this is being done on a local level in the communities and neighborhoods, because that’s been their style of work, but this opportunity shouldn’t be disregarded,” to educate the population who right now are aware and demanding information, Arguello said.
Murillo centralizes communication
The Coronavirus has raised alarms in nearly all parts of the world. Italy and El Salvador have decreed a national quarantine. The international organizations have reduced their estimates of world economic growth; in Costa Rica all large gatherings have been suspended. In Nicaragua, the regime has sent messages of solidarity to the affected countries, while in the hospitals of the capital alerts about the epidemic have been posted in the form of picturesque murals.
Vice President Rosario Murillo reiterated in her daily noon monologue that “no type of quarantine” will be established for travelers. In addition, “the people with some tie to the epidemic that present symptoms can go to a unit of the health department for study and follow up.”
She explained that travelers that arrive from countries with confirmed cases of Covid-19 will have no restrictions for moving around in Nicaragua.
In addition to these measures, Minsa has stated that: “if there are cases that offer indications and test positive for the Corona virus, they will be admitted to the established Health Unit to receive medical attention.
How is Minsa preparing?
According to Minsa’s Preparation and Response Protocol, an Inter-institutional Commission – made up of Minsa, the Interior Ministry, the Customs office, Civil Aeronautics and the International Airport, National Port Services, the Institute of Agricultural Sanitation and Protection and the Ministry of the Environment and Natural Resources – is responsible for prevention, early detection and adequate management of the cases of Covid-19 that may present themselves in the country.
Mural on the Convid-19 virus at a Managua health center. Photo: Juan Carlos Bow
At the country’s points of entry such as the airport, border stations and maritime ports, a strict control has been established of those who enter the country. Airplane crews and workers for the Customs office must report to Minsa any case of suspected virus that should be transferred to the indicated hospital in an ambulance to be used exclusively for patients with this illness.
In some of the public hospitals they’ve already defined isolation wards for people with symptoms of Covid-19. All suspected patients will be tested, and if the diagnosis is confirmed, that person will remain isolated until they no longer have symptoms. Simultaneously, Minsa will monitor for 14 days those people who have had contact with an infected patient.
In other matters, the health workers assigned to attend to patients with the Coronavirus must comply with strict security and hygiene measures to avoid contagion.
In case of death from the Corona virus, the bodies will be turned over to family members in closed coffins, and must be buried immediately to avoid greater exposure to the virus, explains the official protocol.
Prevention of the disease is possible
Handwashing with soap and water, or with an alcohol-based disinfectant is, up until now, the best form of preventing Covid-19 and other respiratory illnesses, as well as diarrhea, conjunctivitis or parasites, Dr. Arguello explains.
Mural at the entrance of a health center in Managua. Photo: Juan Carlos Bow
Preventing the disease doesn’t cost the State anything. Habits like coughing or sneezing into your elbow and maintaining a meter of distance between people help avoid contact with the droplets of liquid from an infected person.
Another method of prevention, which the epidemiologist insists on, is to avoid touching the eyes, nose and mouth to avoid transmitting the virus from the hands to the face. At present, there is no specific treatment for this novel Coronavirus.
