(QCOSTARICA) “Clearly, we are a threat to neighboring countries due to the irresponsible and negligent handling of the phases of the pandemic. Nothing has been done, the pandemic in Nicaragua is developing naturally; we have done nothing despite the doctor’s union has tried to advise.
“In the beginning, people got the message and self-quarantined, but then they relaxed and that is the fault of the message that the Government gives. The message that the Government gave with its daily reports was confusing and many people perceived that we were not at risk, that there was no real threat.
“People said, ‘Today we have three cases, today we have two cases.’ That, in the way of being of the people, is interpreted as that there is no risk. Many people do not wear a mask in public places and that is the fault of the government’s message. We are a threat to ourselves and to producing infections in other countries,” said Jorge Miranda, a Nicaraguan pulmonologist, who works at the Monte España Hospital in Managua.
The doctor, with 22 years of experience, said that every day, on his morning rounds, he finds from one to three suspected covid-19 patients dead.
Miranda is one of the few doctors who dares to speak publicly about the crisis the neighboring country is facing with the pandemic.
According to Nicaragua’s Ministry of Health (Minsa), up to May 26, the country had 759 confirmed cases of covid-19 and 35 deaths.
“The reality is different, we are talking about almost 3,000 infected. Included are a lot of health personnel and of the dead they must be approximately 300,″ commented the doctor in an interview with La Nación.
One of the factors that hinders the work of health professionals is the denial by the Ortega-Murillo dictatorship because at the beginning of the wave of infections they were ordered not to use protective equipment in order not to alarm the population.
Additionally, physicians do not have access to the written results of tests performed; there are only verbal reports.
“The situation in the hospital is chaotic, the room designated to serve patients by covid-19 is always full, whenever I go to visit in the morning I find one, two or three corpses, they are people who wake up dead, that is daily. This is very hard to see, since you go to the ER you find a lot of beds with patients face down with oxygen, very tired and there is a shortage of medicines and resources.” Jorge Miranda, Nicaraguan pulmonologist
“In many cases, they tell us that the test did not come out negative or positive, but was indeterminate. I, as a technician and connoisseur of the test, could see and interpret it and say whether it is indeterminate or not, but they only inform us by telephone; so we don’t know the real results,” he criticized.
Doctors and nurses must also deal, day by day, with discouraging scenes in the corridors and hospital rooms.
“The situation in the hospital is chaotic, the room designated to serve patients by covid-19 is always full, whenever I go to visit in the morning I find one, two or three corpses, they are people who wake up dead, that is daily.
“This is very hard to see. From the emergency room, you find a lot of beds with patients face down with oxygen, very tired and there is a shortage of medicines and resources,” he said.
“I have had to attend to colleagues with symptoms of covid-19 and when we do the test, they tell us that the result is indeterminate. Many are complicated and even intubated,” he added.
In Nicaragua, the Government does not communicate the statistics of contagions, deaths and recoveries up to date, as it happens in many countries, but rather issues weekly reports with little or confusing detail.
Days ago, President Daniel Ortega assured in a press conference that they have a controlled pandemic.
However, contrary to what happens in other countries, in Nicaragua, as the infections progress, Health authorities restrict the profile of the patient to whom they submit tests to determine if they have the new coronavirus.
Dr. Miranda says that now only the patient who is admitted to due to pneumonia is tested.
“Only admitted patients. If someone with pneumonia comes in but is stable and can go home with treatment, they are not tested. That generates a huge source of underreporting,” he said.
The good doctor said he has suffered retaliation for publicly pointing out Nicaragua’s deficiencies in the face of the pandemic. At the hospital where he works, he has been excluded from the committee that manages the crisis for covid-19, for example.
“But I have been that way since I was a doctor; I have always liked to say what happens. I have closely followed the political situation in the country and I have always said things as they are.
“Thank God, I have not suffered severe retaliation compared to other people. I have never been sent a van full of police to my home. I did receive threats during the 2018 protests, because my position was to expose the things that were happening,” he said.
“I have been excluded from important decisions, I am the only pulmonologist in the hospital. However, there is a double standard, because when a very difficult case appears, they call me and consult me,” he said.
Miranda also works at the Vivian Pellas private hospital. There are more resources to work with there and, he says, they prepared in time for the emergency.
However, there is a high demand for beds as it happens in public medical centers.
“Hospitals are under enormous demand for beds and ventilators. For example, in the private hospital where I work, all the ventilators are in use, in such a way that if a patient arrives who requires a ventilator or intensive care, we have to intubate him and then transfer him to a place where there are beds.
“But people who can pay for private services refuse to be transferred to public hospitals,” concluded Miranda.