16 de marzo 2020
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A projected mortality rate of up to 80% among patients who present the most serious complications from the Covid-19 virus in Nicaragua, was the estimate of Minsa, the country’s Health Ministry. This estimate was contained in a document entitled “Preparation and Response Protocol for the Introduction of the Coronavirus.” According to public health experts, the projection amounts to an admission that the regime doesn’t have the capacity to respond to this pandemic, once a patient presents with complications.
The Minsa document which Confidencial obtained and revealed on Thursday, March 12, calculates that six months after confirming the first case of the novel virus, some 32,500 people in the country will have contracted the illness and, of these, some 8,125 would have complications. They further anticipate that 1016 would need the intensive care units, and 80% of them, some 800, would die. The Minsa calculation assumes an overall mortality rate of 2.5%, according to the world tendency, although, as of March 12, the estimate rose to 3.4%.
Dr. Alejandro Lagos, who holds a masters in public health and hospital management, feels that the Minsa estimates, in addition to “irresponsible”, constitute a cover-up; that is “they’re curing the health department” in the face of the possible deaths caused by the virus.
The statistic “was put out there because they know that they’re not gong to have 800 deaths, and later they can say that there were no more than 10 or 15 deaths from the coronavirus because our health services were strong, we were efficient, and prepared,” he believes.
With this projection, Minsa is practically saying that the most serious patients “are only going to come to the hospital to die”, as if it were a matter of helping them ‘die with dignity’, the doctor criticizes. That’s not the objective of a health system, he emphasizes.
National and international health experts have alerted that the first response to the virus must be to avoid the propagation of the illness. However, in Nicaragua, the government of Daniel Ortega has stated that it won’t declare a quarantine.
Lagos complains that the mitigation consists in avoiding “having the cases that aren’t serious get complications,” and maintains that diseases can be manageable. On the other hand, the epidemic could also diminish and become an endemic disease like dengue or malaria.
PanAmerican Health Organization studies Minsa measures
The protocol of the Health Ministry was presented this Thursday to a delegation of the Pan-American Health Organization (PAHO/WHO) that arrived in Nicaragua to review the prevention and response measures that the country is developing in the face of the coronavirus pandemic.
The principal recommendation of the PAHO was “preparation of the network of health services,” to respond to the disease. Covid-19 is now present in the neighboring countries of Costa Rica, Honduras and Panama. El Salvador, where no cases have yet been found, has closed the country’s borders.
Mural at the entrance to the “Socrates Flores” Health Center, in Managua. Photo: Juan Carlos Bow
Vice President Rosario Murillo declared at noon Thursday, March 12 that the representatives of the PAHO were informed that the Minsa brigades are continuing to fumigate against the mosquito that causes dengue. However, the functionaries of the regional health organization emphasize that Nicaragua should focus on the world emergency of the novel coronavirus to inform the population. Murillo and President Daniel Ortega, together with Minsa authorities, participated in an extraordinary on-line meeting of the heads of state and the government of the Central American Integration System regarding how to react to the virus.
Ortega hasn’t said anything, nor has he explained to the nation the official measures to be taken for the pandemic, as the rest of the region’s presidents have done.
Hygiene in a country where water is scarce
Handwashing constitutes the principal preventive measure for the pandemic, and the national authorities have a duty to guarantee minimum conditions so that the population can comply with the recommendations. However, in a large part of the country “there’s no water”, emphasizes Ana Quiros, a specialist in public health.
“Obviously, the topic of poverty and the lack of access (to water) are going to mark who will be most susceptible to acquiring the coronavirus,” she explains. Quiros also feels that this is just one of the multiple weaknesses of the Nicaraguan health system, where there is insufficient personnel and they may not be trained to face the new pandemic.
To former health minister Dora Maria Tellez, the moment for preventing the coronavirus “is now, and not tomorrow when there’s no remedy.” She insists that Minsa should be transparent in their communications, because currently in Nicaragua there are more doubts than answers.
“We don’t know how they’re preparing; we don’t know if there are enough reactive agents, no one has told us where you should go to be tested, there are no emergency lines for attending the population.”
In the former minister’s opinion, Minsa “isn’t acting as if it had an emergency situation,” and she warns that this situation is creating more distrust of the health system. “We don’t believe that there are no cases of Covid-19… There are cases in Honduras, in Costa Rica, in Panama, and it’s logical to think that the virus is already here,” she says.
Another, smaller mural about Covid-19 at the “Francisco Buitrago” Health Center in Managua. Photo: Juan Carlos Bow
Companies will take measures
The Superior Council of Private Enterprise (Cosep) and the Central American University are among the private entities that have warned about the coronavirus.
A communiqué issued by the association of large business owners urged the government to “facilitate the processes of importation and nationalization of all the products needed for the prevention,” given that the population has begun panic buying of hygiene products.
This week a supermarket chain restricted the sales of cleaning products, so as to avoid hoarding. The pharmacies are already out of face masks, and alcohol in liquid and gel form has also scarcened.
Cosep urged the government and private companies to adopt an educational campaign to create awareness among the population about the importance of handwashing and to take opportune measures to avoid the propagation of the Corona virus.
