In several hospitals in Nicaragua, designated for the care of patients with Covid-19, they have begun to observe a slight increase in coronavirus cases in recent weeks. This situation, several doctors warn, is linked to the relaxation of preventive measures against the pandemic. They say it could be the beginning of a possible outbreak of the disease. Thus far, the peak of infections occurred between the end of April and mid-June.
A medical source from the Aleman Nicaraguense Hospital said that they currently have seven patients with Covid-19. Hospital authorities have begun to insist on preventive measures to the staff.
“There has been an increase in deaths, one or two every day,” the source said.
A similar situation has been observed in other hospitals, such as the Vivian Pellas Metropolitan Hospital. There, at the beginning of this month. they had an increase in cases, reaching up to eight hospitalized patients.
“This week we have four patients with Covid-19,” said a hospital source. “The average in the last two months were two patients and at some point, we didn’t have any hospitalized cases.”
Doctors consulted by Confidencial also reported an increase in cases in Chontales, Madriz, Rivas and the South Caribbean. Also, a few weeks ago, there was an increase in cases, mainly of children, in Leon.
“Deaths have not stopped”
The Ministry of Health (MINSA) has reported that, from October 13 to November 24, only seven people have died from Covid-19, one every week. Meanwhile, the independent Covid-19 Citizen Observatory reported 37 deaths in the same period, with a slight increase in recent days.
The independent monitoring by a network of doctors and volunteers who monitor the pandemic, recorded that only in one week (from November 12 to 18) there were seven deaths, the same amount that according to the MINSA occurred in 43 days.
In its most recent report, from November 19 to 25, the Observatory verified nine deaths from Covid-19. The total to date stands at 2,805 deaths and 11,357 suspected cases. MINSA has much lower figures. They state that from March 18 to November 24, 160 died from Covid-19 with 5,784 confirmed cases.
“Under-reporting of MINSA cases persists, Covid-19 infections and deaths have not stopped,” a member of the Observatory explained to Confidencial. She preferred to remain anonymous, to avoid reprisals that hinder her work against the pandemic.
The source said her tally has also decreased. She noted it is based “on a network of voluntary informants and they are also afraid. It is likely that they only report serious cases and deaths to us, with mild cases going unreported.”
“We do not report unless we confirm the information. With the stigmatization of the disease, there are those who don’t want others to know,” she says.
However, she insists that from the Observatory they were “certain that the cases were continuing.” They stopped the count for a week “because we did not want to report the few we were receiving and give a false sense of security.”
“People want to hear that this nightmare is over,” she argues.
“The second wave is near”
The epidemiologist and former official of the Pan-American Health Organization (PAHO), Rafael Amador, expresses that the outbreak of Covid-19 can occur in the short-term “if we take into account the social behavior in Nicaragua towards the relaxation and irresponsibility regarding the virus.”
“One can see crowds in the streets, full shopping centers, people without masks. With the preparation for “La Purisima” (Virgin’s Day) you see full markets,” he explained.
Added to that, he points out that hurricanes Eta and Iota caused many people to move to shelters. The did so “without taking social distance measures.”
“All these elements can cause an outbreak of cases in the coming days,” he insists.
He recalled the estimates from the Imperial College of London that projected a “progressive increase in cases with isolated outbreaks, in different communities.” They said it would reach its maximum peak in December and January.
“That is why we continue to insist on the need to protect ourselves and take prevention measures. This is still necessary to save lives,” he emphasized.
Amador assesses that Nicaraguan health personals are now “more knowledge” about the Covid-19 pandemic. Therefore, the response capacity is greater.
“At present, not many cases reach the hospital. That’s something doctors advised from the beginning of the pandemic to prevent the health system from collapsing. It’s not that there are fewer cases, but many more people are taking care of themselves at home,” he says.
The epidemiologist highlights that “under-reporting has been increasing” because many patients do not report their cases. They are cared for by doctors “outside the system.”
He reiterated that social distancing measures must be taken, wearing masks, and frequent handwashing. “Many patients are asymptomatic, like some children, who put more vulnerable groups such as the elderly at risk.”
“People continue to be relaxed”
A doctor from the Japan-Nicaragua Friendship Hospital in Granada explains that cases have “decreased considerably” in recent weeks. “Few cases are being hospitalized, because many are cared for by private doctors and stay at home,” she acknowledged.
However, she assures that the “calm” in that hospital “does not make us believe that everything is over. We are preparing for an increase in cases in the coming weeks.”
“The Christmas season is coming, and many people will visit with their families, despite the call to stay at home. That is why we insist on the need to take precautionary measures because the pandemic has not ended. She further noted that many countries are experiencing an intense second wave of outbreak.”
The doctor warns that “many people continue to go out into the streets without masks.” She notes “the fear they had in the first months of the pandemic, seeing hospitals collapse and the express burials are no longer seen. However, the virus will still be around for a good while.”
Lack of information is unfortunate
The Covid-19 Citizen Observatory reported that up to November 25 they’ve received information of 882 health workers with associated or presumptive symptoms of Covid-19 and 109 of them have died.
Although the current situation of the pandemic does not compare with that of the months of April, May or June, when hospitals were saturated and express burials were constant, doctors recommend maintaining preventive measures since the risk of infections persists.
“From the beginning of the pandemic until now, the Nicaraguan people continue without access to tests. They also lack information on the places of contagion. That reality hit Nicaraguan households hard when there were deaths followed by express burials,” says the Observatory source.
The Observatory volunteer warns that “the outbreak has already begun” and is associated with the lack of prevention measures by the State.
The Ortega-Murillo government has been criticized by doctors and institutions such as the World Health Organization (WHO). They cite the non-compliance with the recommendations to deal with the pandemic, such as not suspending classes.
“At the beginning, people began to protect themselves, to apply the internationally recommended measures and that decreased cases. However, the discourse of normality (from the government) made people drop their guard. So now, the second wave has already started,” warns the volunteer from the Observatory.