COVID-19 pandemic in Nicaragua

The ongoing COVID-19 pandemic was shown to have spread to Nicaragua when the first case, a Nicaraguan citizen who had returned to the country from Panama, was confirmed on 18 March 2020.[2]

COVID-19 pandemic in Nicaragua
Disease	COVID-19
Virus strain	SARS-CoV-2
Location	Nicaragua
Arrival date	18 March 2020 (4 months, 4 weeks and 1 day)
Confirmed cases	4,115[1]
Recovered	3,072
Deaths	128

Ana Emilia Solís, the World Health Organization's representative in Nicaragua, has stated that since January, when the Nicaraguan Government declared a sanitary alert due to the threat of COVID-19: "Nicaragua has been working according to [WHO] guidelines. It has been working hard on the enlistment of health services, strengthening epidemiological surveillance and has been working with the Community Health Network to identify possible cases that may occur at the community level".[3]

A delegation from the Pan American Health Organisation, the regional branch of the WHO visited the country in the second week of March to coordinate measures to protect against the virus. Alexander Florencio, a representative of the delegation, stated that "the best conditions are being prepared". Florencio added that "provisions being made [by the government] have incorporated all PAHO recommendations."[4]

The government has particularly focused on an education program, with health professionals and volunteers visiting 1.2 million households in the last week of March, and additional information being distributed via TV and other media. Nicaragua is also preparing to mass-produce the antiviral drug Interferon alfa-2b for treating coronavirus patients.[5]

Some critics of Daniel Ortega's government have claimed the government is downplaying the severity of the virus.[6][7] An estimate by an organisation calling itself the Citizens' Observatory, claimed in May that the number of cases was 4 times and the number of deaths 20 times the official figure,[8] however the provenance of these figures is undocumented and the identity of the organisation unknown.[9] As of August 2020, the Citizens Observatory is claiming some 9,000 cases, which is around double the official count, but still massively lower than all other Central American countries except for sparsely populated Belize.[10]

Prior to the arrival of the virus in Nicaragua, a large public rally was organized by government supporters in solidarity with coronavirus victims in other countries; however, the event was criticized for lack of social distancing.[11] The opposition party grouping, the National Coalition, wrote a letter of complaint to the World Health Organisation, arguing that WHO representative Ana Emilia Solis should be promoting more extreme measures to fight the virus, despite Solis's advice being in line with WHO guidelines.[12]

On May 18, 2020, about 700 health workers signed a letter and sent it to the government urging them to take preventive measures suggested by WHO to control the spread of COVID-19 in the country. They raised concerns over the weak public health system and how people's life was at risk, as a result. In response to the letter, on 6 and 9 June 2020, several health workers were fired from their jobs by Nicaraguan Health Ministry without any legal procedures. Human Rights Watch urged the Nicaraguan authorities to give them back their job with compensation of the salary and to take required preventive measure to control the pandemic.[13]

Background

On 12 January 2020, the World Health Organization (WHO) confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster of people in Wuhan City, Hubei Province, China, which was reported to the WHO on 31 December 2019.[14][15]

The case fatality ratio for COVID-19 has been much lower than SARS of 2003,[16][17] but the transmission has been significantly greater, with a significant total death toll.[18][16]

Timeline

March

Vice President Rosario Murillo

COVID-19 cases in Nicaragua  ()      Deaths        Recoveries        Active cases Mar Mar Apr Apr May May Jun Jun Jul Jul Last 15 days Last 15 days
Date			# of cases	# of deaths
2020-03-18		​	1
⋮		​	1(=)
2020-03-20		​	2(+100%)
⋮		​	2(=)
2020-03-26		​ ​	4(+100%)	1
⋮		​ ​	4(=)	1(=)
2020-03-30		​ ​ ​	5(+25%)	1(=)
2020-04-05		​ ​ ​	6(+20%)	1(=)
⋮		​ ​ ​	6(=)	1(=)
2020-04-09		​ ​ ​	7(+16.7%)	1(=)
⋮		​ ​ ​	7(=)	1(=)
2020-04-11		​ ​ ​	9(+22.2%)	1(=)
2020-04-12		​ ​ ​	9(=)	1(=)
⋮		​ ​ ​	9(=)	1(=)
2020-04-15		​ ​ ​	9(=)	1(=)
⋮		​ ​ ​	9(=)	1(=)
2020-04-17		​ ​ ​	9(=)	1(=)
2020-04-18		​ ​ ​	9(=)	2(+100%)
⋮		​ ​ ​	9(=)	2(=)
2020-04-20		​ ​ ​	10(+11.1%)	2(=)
⋮		​ ​ ​	10(=)	2(=)
2020-04-23		​ ​ ​	11(+10%)	3(+50%)
⋮		​ ​ ​	11(=)	3(=)
2020-04-25		​ ​ ​	12(+9.1%)	3(=)
2020-04-26		​ ​ ​	13(+8.3%)	3(=)
⋮		​ ​ ​	13(=)	3(=)
2020-04-28		​ ​ ​	14(+7.7%)	4(+33.3%)
2020-04-29		​ ​ ​	14(=)	4(=)
⋮		​ ​ ​	14(=)	4(=)
2020-05-03		​ ​ ​	15(+7.1%)	5(+25%)
⋮		​ ​ ​	15(=)	5(=)
2020-05-05		​ ​ ​	16(+6.7%)	5(=)
⋮
2020-05-12		​ ​ ​	25(+56%)	8(+60%)
⋮
2020-05-19		​ ​ ​	279(+1016%)	17(+113%)
⋮
2020-05-26		​ ​ ​	759(+172%)	35(+106%)
⋮
2020-06-02		​ ​ ​	1118(+47%)	46(+31%)
⋮
2020-06-09		​ ​ ​	1464(+31%)	55(+20%)
⋮
2020-06-16		​ ​ ​	1823(+25%)	64(+16%)
⋮
2020-06-23		​ ​ ​	2170(+19%)	74(+16%)
⋮
2020-06-30		​ ​ ​	2519(+16%)	83(+12%)
⋮
2020-07-07		​ ​ ​	2846(+13%)	91(+9.6%)
⋮
2020-07-14		​ ​ ​	3147(+11%)	99(+8.8%)
⋮
2020-07-21		​ ​ ​	3439(+9.3%)	108(+9.1%)
⋮
2020-07-28		​ ​ ​	3672(+6.8%)	116(+7.4%)
⋮
2020-08-04		​ ​ ​	3902(+6.3%)	123(+6.0%)
⋮
2020-08-11		​ ​ ​	4115(+5.5%)	128(+4.1%)
Sources: various news sources and state health department websites. See Timeline Table and Timeline narrative for sources. Since May 5, the Ministry of Health (MINSA) has only issued reports once per week.

On 16 March, Rosario Murillo announced that the Nicaraguan Institute of Tourism was visiting the municipalities of the country and meeting with tourism entrepreneurs making preparations for Holy Week (which is an important holiday celebrated through all the country), an approach described by opposition newspaper La Prensa as "betting on tourism" and "keeping tourism alive during a pandemic". The Ministry of Government also stated that the border would operate "normally" but with medical teams operating "pertinent measures" such as checking body temperature.[19]

On 17 March, Vice President Rosario Murillo announced that Cuba was going to send doctors and pharmaceuticals to Nicaragua to help deal with coronavirus, despite there being no confirmed cases in the country at the time. Murillo also claimed that medical supplies were sent by Venezuela as well.[20]

On 18 March, Murillo announced Nicaragua's first confirmed case: a 40-year-old man who recently returned to Nicaragua from its neighboring country of Panama.[21] Regarding him Murillo commented stating he was in isolation and in stable condition, and that she hoped he wouldn't need a ventilator.[6]

On 20 March, the second case was confirmed, a Nicaraguan who came from Colombia.[22]

On 26 March, the first death linked to Coronavirus in Nicaragua was reported, the individual who died also suffered from other medical complications and also reportedly had HIV.[23]

April

On 1 April, Taiwan donated medical protective items, for use by medical professionals.[24]

On 2 April, the government was reporting a total of 5 cases, including the one death and a case categorized as recovered.[25] The 3 live cases are:[26]

• A 52-year-old woman, who arrived from the United States, who is in the process of improvement and undergoing treatment.
• A 70-year-old man, who also arrived from the United States, who is in poor health, but stable.
• A 76-year-old man also arrived from the United States, with multiple chronic conditions, who is in treatment and in a stable condition.

Of the 12 original suspected cases, two had been cleared, but two more were added to the list on March 31.[26]

On 5 April, a further case was reported.[27]

On 9 April, a further case was reported bringing the total to 7, but 2 were reported recovered, leaving 4 live cases, all of them imported.[27]

On 11 April, 2 further cases were reported.[27]

By 12 April, Worldometer reported a total of 4 cases as recovered,[27] including 2 who were reported recovered before by other sources, leaving 4 active cases. SICA (the Central American Integration System), however, reported 5 recoveries, with only 3 active cases.[28]

On 15 April, the Nicaraguan Ministry of Health is reporting 3 live cases, with 12 people who are being closely monitored and 5 people recovered:[29]

• A 64-year-old man, a contact of an imported case, who is stable.
• A 59-year-old man, who is stable.
• A 39-year-old woman, an imported case, who is stable.

On 17 April, there were 2 remaining live cases, the 64-year-old and 59-year-old mentioned above, with 6 recovered and no new cases. 12 people are being monitored.[30]

On 18 April, the second death was reported, the 64-year-old patient who also suffered from diabetes and many chronic conditions.[31]

On 20 April, the 59-year-old was reported recovered with a negative test for coronavirus, but a new case was added, a 58-year-old man who had contact with one of the imported cases.[32] 1.8 million children returned to school and 130,000 government employees returned to work in Nicaragua despite fears of COVID-19. President Daniel Ortega, who had not been seen for 34 days, said Nicaraguans "haven’t stopped working, because if this country stops working, it dies."[33]

On 23 April, it was reported that the 58-year-old man had died unexpectedly and a further case had been detected, a 68-year-old man who had contact with one of the imported cases. 15 people were being monitored as suspected cases.[34]

On 25 April, a further case was reported, a 64-year-old, who was described as "delicate".[35]

On 26 April, a 13th case was reported, increasing the number of active cases to 3. The cases at this point were the 68-year-old and 64-year-old mentioned above, plus the new case, a 57-year-old, all male. The 68-year-old was reported to be recovering.[36]

On 28 April, a 66-year-old man was brought to a hospital in an advanced state and died the same day, bringing the number of deaths to 4.[37]

May

On 3 May, a further case was identified, a man older than 65, who died the same day.[38] The newspaper La Prensa also reported two "unofficial" deaths, one a 58-year-old employee of Managua airport, who they say was diagnosed on 25 April and died on 29 April, and a 70-year-old resident of Esteli, who supposedly died on the same day. These cases were not included in the official tally.[39]

On 5 May, the Ministry of Health announced a further case, bringing the total to 16, including 4 active cases.[40][41]

On 12 May, the Ministry of Health announced that there were a further 9 cases identified, bringing the total to 25, and that this included a further 3 deaths. It was also reported that other deaths had occurred amongst people who were being monitored but who died from other severe illnesses.[42]

On 19 May, the Ministry of Health made a further announcement on the status of the disease, making it clear that the bulletins were now taking place on a weekly basis. This reported 254 cases, with 17 deaths, but with 199 of the total being reported as recovered.[43] There was some confusion as to whether the 254 figure was the total or the number of new cases for the past week. However, SICA correctly reported that the 254 were in addition to the existing 25 for a total of 279.[44]

On 25 May, the government published a "White Book", explaining its approach to controlling the outbreak.[45][46] In the document Nicaragua's approach is likened to that of Sweden: "With the increasing abandon of the “lockdowns”, all the countries of the world will have to combine defense against the Coronavirus with the functioning of society, just as Nicaragua and Sweden have done from the beginning."[47]

On 26 May, the weekly bulletin showed 480 new cases, bringing the total number of cases to 759, including a total of 35 deaths and 370 recovered.[48]

June

On 2 June, the weekly bulletin showed 359 new cases, bringing the total to 1118, with the number of deaths rising to 46 and 691 recoveries.[49]

On 9 June, the weekly bulletin showed 346 new cases, bringing the total to 1464, including 55 deaths and 953 recoveries.[50]

On 16 June, the weekly bulletin showed 359 new cases, bringing the total to 1823, including 64 deaths and 1238 recoveries.[51]

On 23 June, the Ministry of Health reported 346 new cases, an increase to 2170 cases in total, with 10 new fatalities, bringing the total deaths to 74, alongside 1489 recovered patients.[52]

On 30 June, the new figures showed 349 new cases for a total of 2,519, 9 new deaths for a total of 83 and 1,750 recovered.[53]

July

On 7 July, figures showed a total of 2,846 cases, with 91 deaths and 1,993 recovered.[54] On 14 July figures showed 3,147 cases, 99 deaths and 2,282 recovered.[55] On 21 July figures showed 3,439 cases, 108 deaths and 2,492 recovered.[56] The 28 July figures show 3,672 cases, 116 deaths and 2,731 recovered.[57]

August

The 4 August figures showed 3,902 cases, 123 deaths and 2,973 recovered[58]; the 11 August figures showed 4,115 cases, 128 deaths and 3,072 recovered.[1]

Response

Sporting events

Nicaragua was unusual in that many sporting events continued during the pandemic, at a time when they had been cancelled in many countries.[59]

On 25 April a boxing event was staged in Managua, under strict conditions. All spectators had their temperatures checked on entry and were forced to sit three seats apart while wearing masks.[60] The boxers were sprayed with disinfectant before the fight.[61]

Alternative estimates

An organisation calling itself "Citizens' Observatory" has claimed that the true figures are much higher. It claimed that, on 8 June, the number of deaths was 20 times the official figures, with at least 980 deaths compared to 46 in the official figures at that point. The number of COVID-19 cases was also estimated at 4,000 compared to the official figure of 1,118. It was claimed that the under-reporting of deaths was due to attributing "atypical pneumonia" as the cause of death rather than COVID-19.[8] However the organisation gave no indication of the provenance of these claims and, according to the Council on Hemispheric Affairs, consists of "anonymous 'experts,' who create their own figures which come from 'civil society, networks, digital activists and affected families.'"[9][62]

See also

• COVID-19 pandemic in North America
• COVID-19 pandemic by country and territory
• 2020 in Central America
• History of smallpox in Mexico
• HIV/AIDS in Latin America
• 2013–2014 chikungunya outbreak
• 2009 swine flu pandemic
• 2019–2020 dengue fever epidemic

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