Róger Ordóñez was hospitalized for respiratory problems last week. When his son Enrique went to visit him the next morning, the 69-year-old retiree was already being buried by Health Ministry employees, dressed from head to toe in white protective suits, in a cemetery on the outskirts of Chinandega, a city of 133,000 inhabitants in northwest Nicaragua.
The hospital advised the Ordóñez family to be quarantined for two weeks, but denied that the father had a coronavirus, although they did not show them the test results.
The government of Daniel Ortega resisted imposing measures to control covid-19 for more than two months from the appearance of the first case in Nicaragua.
Now, doctors and family members of the alleged victims say the government has gone from denying the presence of the disease in the country to actively trying to hide its spread.
“I begged the doctor to tell me what happened to him,” Enrique Ordóñez told The Associated Press (AP). “I needed to know if I was infected. I have an 18-month-old girl, my mother has a variety of ailments and we need to know if my father died of covid or not.”
The government assures that in the country of 6.5 million there are only five deaths from the covid-19 and 16 confirmed cases since the first case was confirmed in March. The Nicaraguan Ministry of Health (MINSA) went almost a week without updating.
Businesses and government offices remain open. Schools remain open. The central markets of cities and towns, including Managua, are open. While neighbors like Costa Rica to the south and Honduras to the north have measures in place to stay at home, practice social distancing and restricted border movements, and the government in Nicaragua actively promotes sporting events and other mass events.
After a week without reporting the coronavirus, the Minsa broke the silence on Tuesday and raised the death toll to eight and the confirmed cases of the disease to 25, this time without assuring that there is no community transmission.
In its most recent report, the NGO Obsertario Cuidadano, made up of doctors and activists, claimed to have identified 1,033 suspected cases of covid-19 in the country as of Saturday.
According to the NGO, they say there are at least 188 deaths.
Nicaraguan doctor Álvaro Ramírez, who was head of Epidemiology during the Sandinista revolution and currently lives in Ireland, said that the number of infections is already much higher and that the next few days “will be decisive” for Nicaragua.
He estimates that in two weeks there could be about 18,000 infections, of which 890 would be serious.
For the past week, plainclothes police and government supporters have detained journalists in the vicinity of a hospital in the capital, Managua, and in a cemetery in Chinandega, where the pandemic is becoming difficult to hide.
The presence of men in white suits onboard trucks with sealed coffins has become commonplace for residents. And it seems that everyone knows someone who has become ill. Or died. But no one is talking openly.
“There is a lot of nervousness here,” said Pablo Antonio Alvarado, a university student who said that a couple of acquaintances were infected in the city. “They say we are the epicenter of the pandemic, like Wuhan in China.”
Also on Tuesday, doctor Ciro Ugarte, director of health emergencies of the Pan American Health Organization (PAHO), expressed in a videoconference concern regarding the reporting of cases in Nicaragua. He noted that unofficial reports indicate a “high” number of patients who have been hospitalized with symptoms of acute respiratory infection.
“Nicaragua is the only country or territory in the Americas where the type of transmission is undetermined, according to our reports,” he indicated. “As you recall, more than a month ago, PAHO expressed its concern regarding the evidence, regarding the follow-up of contacts, the reporting of cases, and these concerns remain.”
Ugarte also noted that “the call for massive events continues to manifest itself in the country.” PAHO, he added, is waiting for the official information in Nicaragua “to have a level of detail” that allows the Organization to make an adequate analysis of the situation.
A doctor from Chinandega, who asked to speak anonymously for fear of retaliation, said that she knew four people who died. One of them was one of her patients and was buried two hours after he died, she added.
“Everyone who believes they have died of atypical pneumonia is buried immediately,” she said.
Most diagnoses are made based on symptoms and lung X-rays of patients because tests for the virus are strictly controlled by the Ministry of Health and are difficult to obtain.
An informal network of Chinandega doctors “counted 25 alleged deaths from covid-19 as of last Sunday,” the doctor said. “If we can survive this, it is because God is great. There is no other explanation.”
Dead and buried
Enrique Ordóñez, who is a sales executive, knew that his father suffered from chronic ailments such as hypertension and respiratory problems, but noted that last week he was suddenly having trouble breathing. He took him to the hospital on Thursday and that same night he died.
“The hospital organized everything, they supplied the coffin and the cemetery plot,” he said, recalling that when he went to ask about his father on Friday morning, he learned that he had already been buried. “I tried to identify the grave as best I could, because earlier, at dawn, they had buried others and there were seven or eight more graves next to it.”
“I wonder: if my father did not die from coronavirus, why did they not let us bury him? I didn’t bury my father, they buried him. But you know, we can’t raise our voices much. Fear is widespread in our country,” he added.
According to the latest report from the Central American Integration System (SICA), as of Monday, 24,257 people have fallen ill with coronaviruses in the region and 818 died. Countries like Honduras and El Salvador adopted strict measures against the disease, and many wonder why Nicaragua has so few cases without taking any preventive action.
Requests for comment by the official government spokesperson of the Ortega administration, vice president, and first lady, Rosario Murillo, get no response.
But it seems that many agree that the government is beginning to recognize what lies ahead.
In late April, the Ministry of Health summoned all hospital directors and high-level medical authorities to a meeting.
“They were told that this is getting serious and that everyone should prepare,” Róger Pasquier, president of the Nicaraguan Association of Anesthesiology, said in an interview with AP News. In his opinion, the measure is too late.
“Isolation measures have not been taken here, health workers have not been protected, there are not enough beds in any hospital in Managua, nor in any regional hospital,” he added.
“Contrary to what is officially shared, I know through my medical colleagues that we have a large number of sick people in Managua, Masaya, Matagalpa and Chinandega, where there is an outbreak that could be very dangerous,” said Pasquier.
Although many doctors fear speaking publicly, almost 600 specialists signed a letter in early May demanding protection equipment for all health workers from the government. José Antonio Vásquez, president of the Unidad Médica de Nicaragua, an organization that was formed after the April 2018 protests, said the group has identified more than 42 apparently infected doctors, nurses and technicians.
Sources: Today Nicaragua, La Nacion, La Prensa, 100% Noticias, AP News