NicaNotes: Personal Experience with Nicaragua’s COVID-19 Containment Efforts

On March 31 my husband and I traveled from Mexico City to Managua. In the Nicaragua airport all passengers were tested for temperature – this is a measure taken by the Sandinista government since another epidemic in 2009. These checks are also done at all the border crossings. Trained Health Ministry staff met for more than ten minutes with each passenger asking about any symptoms, if you have been near anyone with Covid-19, etc. Our address and phone number in Nicaragua were requested multiple times. They explained to us the importance of maintaining a fourteen-day quarantine at home, and that others with you should do the same. They emphasized we should leave everything including our clothes outside the home for three days in the sun. Since then an epidemiologist has called every other day. This is a great example of how Nicaragua keeps the virus from entering the population.

The emphasis of the free public health system is community-based prevention; instead of waiting until people are sick, it works to prevent illness and to prevent the spread of illness. For example, Nicaragua has nearly 100% vaccination rates for children 0 to 6, and pregnant mothers, and does educational campaigns for prevention like the current one where health staff and trained volunteer health workers visited more than two million three hundred thousand families to educate for prevention of Covid-19.

 

Below Jorge Capelan explains more in his recent article.

 

Nicaragua and COVID-19 – Western media’s best kept secret

By Jorge Capelán, April 6th 2020, Translated by Stephen Sefton


https://managuaconamor.blogspot.com/2020/04/nicaragua-y-la-covid-19-el-…

One of the best-kept secrets amidst the cacophony of panic and media terrorism caused by the current Covid-19 pandemic has been how successfully Nicaragua, a small, impoverished country in one of the most climate change-prone regions on the planet, has been tackling the arrival of the new coronavirus.

With 6.5 million inhabitants, Nicaragua had as of April 5th only 6 cases of COVID-19, all imported from other countries, of which 3 were active, 2 were recovered and one, ill with AIDS, had died. At the same time health authorities kept close surveillance on people who had contact with those six, although they tested negative.

By comparison, in the Central American region, on that same date there were 4,598 confirmed cases of Covid-19 of which 4,360 were active, 167 dead and 71 recovered. In the region, only Belize, with less than 400,000 inhabitants, has fewer confirmed cases than Nicaragua, with 5, all active.

In terms of cases per million inhabitants, Nicaragua has the lowest number of cases in the entire region – 0.93 cases. It is followed by Guatemala, with 4.22 cases; El Salvador, with 9.56 cases; Belize, with 12.24 cases; Honduras, with 32.54 cases; Costa Rica, with 89.76 cases; and Panama, with 471.22 cases per million.

Note that the two countries with which Nicaragua has extensive and porous borders (Honduras to the north and Costa Rica to the south) have much higher levels of infection.

Likewise, in two countries characterized by draconian confinement and curfew measures to address the pandemic (El Salvador and Honduras), infection rates per million inhabitants are also much higher.

Sectors linked to the violent 2018 opposition coup attempt claim that the government figures are false and that it is not really doing anything to combat the pandemic. They say that there are so few confirmed cases because massive testing of COVID-19 has not been applied to the population.

These arguments are only viable for consumption abroad and for certain groups out of touch with domestic opinion in the country, effectively living an illusion, since for any normal person living in Nicaragua the situation is obviously not like that.

Clearly, no health center in Nicaragua is overwhelmed with people with respiratory symptoms. According to statements by the Director General of the Ministry of Health, pneumonia cases this April, which generally increase nationally, show lower levels than 2019. Last year, the population was given about one million vaccines against influenza (B, H1N1 and H3N2), while the pneumococcal vaccine was given to the elderly and to people suffering from chronic diseases.

And where are the street protests against alleged lack of government action on the pandemic? Nowhere, only in cyberspace, in the fevered minds of people based in Miami and in some European Union countries.

The Sandinista Government’s response to the Covid-19 emergency is based on a number of pillars:

Firstly, the development of a social state based on the rule of law that has prioritized as central the social and economic rights of the population, especially health, education and the right to food. In Nicaragua, contrary to the propaganda of the Western media, there is no antagonistic relationship between the State and the population, which in the vast majority (even among a great many of the opposition minority) is confident that the police and health authorities are seeking the public good.

The second pillar has been the broadest possible development of public health. It should be no secret that genuine public health policy in Nicaragua only began with the 1979 overthrow of the Somoza dictatorship and the triumph of the Sandinista Revolution. Before July 19th 1979, the poorest sectors were forced to sell their blood to the Plasmapheresis company in order to survive while endemic diseases were widespread in a country where more than half the population could not read or write.

With the first stage of the Sandinista Revolution in the 1980s came massive vaccination, prevention and hygiene campaigns, as well as training of health personnel and development of health infrastructure, all in the midst of and despite a bloody terrorist war directed by the United States. This was because this policy was a fundamental part of the historic program of the Sandinista National Liberation Front, formulated many years before the 1979 triumph. All that human infrastructure formed during the 1980s, based on valuing health as a basic and inalienable right, resisted the neoliberal counter-reform of 1990-2007, which sought to totally privatize health. So when the Sandinista Front returned to government in January 2007 it was able to implement the successful community health model that today confronts Covid-19.

During the last 13 years, the Sandinista Government has built 18 hospitals: 15 primary, 1 departmental and 2 national, all of them operating free of charge. In the medium term, there are plans to build 15 more hospitals, six of which are already under construction. In addition, countless health centers and heath posts have been built from scratch or else refurbished, as well as Maternal Homes in Nicaragua’s prize winning system of maternity care for women from rural areas. Also, and as if this were not enough, there is a massive year round program that  actively visits urban barrios and rural communities week-in week-out providing information and free medical attention to the population who, for different reasons, cannot go to a health center.

To all this we must add the recent inauguration of a WHO approved modern molecular biology laboratory capable of analysis and testing for various diseases, including Covid-19. This laboratory is the second most advanced in the region.  In addition, since the end of 2018, Nicaragua has a drug plant with the capacity to produce 12 million influenza vaccines per year. The Cuban drug Interferon Alfa-2B, which has been successfully used to treat patients with COVID-19, is planned to be produced there.

Along with the development of this material base, the Sandinista Family and Community Health Model, conceptually formulated as early as 2008, has a broad social infrastructure in the form of sectoral, municipal, departmental and national networks that articulate public, community and private health resources that have been promoting all kinds of health campaigns for many years, especially to prevent diseases such as dengue, zika and chikungunya, in addition to all their other routine health tasks.

Several months before the alert about COVID-19, in July last year, the government had already declared an epidemiological alert to combat the above-mentioned diseases. In fact, for many years Nicaragua, due to its geographic location, has been in a permanent situation of epidemiological alert that the authorities have addressed together with local communities, resulting in better health levels along with broad experiences in dealing with this type of threat.

Due to its physical characteristics, Nicaragua is obliged to have a warning system for all types of threats including epidemiological, climatic (e.g. hurricanes), tectonic (seismological and volcanic) in preparation for which for many years the Sandinista government has been carrying out gigantic civil defense exercises involving millions of citizens.

As can be seen on the website of the Ministry of Health, it is false that the Government does not report on the progress of the pandemic; in addition to the daily press conferences by its health officials there is abundant information provided through the media. In Nicaragua there is unrestricted freedom of disinformation, since not a single one of the deceitful right-wing media outlets has been shut down, so too there is genuine information communicated via the country’s Citizen Power media.

Since the end of February, the Nicaraguan Government has been announcing the policy to be followed in the face of the coronavirus:

  • Nicaragua has not established, nor will it establish, any kind of quarantine.
  • People who have symptoms of Covid-19 and have some link to someone with the proven disease will be admitted to a health unit for testing and follow-up.
  • Those who test positive for COVID-19 will be admitted to one of the hospitals for the treatment of patients with the disease.

On January 21st, the day after Chinese authorities reported a third death from Covid-19 and 200 infected people in Hubei province, the Health Ministry, together with Pan American Health Organization, announced the epidemiological alert.

Ten days later, the Inter-Institutional Commission in charge of dealing with the emergency had drawn up a detailed protocol, based on its experiences and those of the WHO, covering all aspects of the strategy for dealing with the pandemic, which is updated as knowledge of Covid-19 advances.

The protocol contains detailed measures on epidemiological surveillance, laboratory and sampling procedures, organization of health services, inter-institutional organization, communication plans, etc.

During the first weeks, all health personnel were trained and all the medical infrastructure necessary to deal with the pandemic was prepared, including the inauguration on March 3rd of the molecular biology laboratory mentioned above, which allows testing for the new coronavirus.

Already on March 12th, the presidents of Central America (except Bukele of El Salvador) participated in a virtual conference to coordinate actions. In addition, the Nicaraguan government held meetings with its border neighbors Costa Rica and Honduras to coordinate efforts.

Nicaragua, dependent on foreign trade and labor income, and without income from hydrocarbons or other energy resources, cannot “close” the economy lightly, much less when there had not even been any imported cases of COVID-19.

In Nicaragua most families live from self-employment and depend on a daily income. This is similar to Honduras and El Salvador, where the draconian quarantine measures implemented have led to strong protests and breaches of the quarantine decreed by those governments. In El Salvador, the disruption of the delivery of $300 support payments led to protests and looting. In Honduras, the failure to deliver promised food to the population forced people to take to the streets.

With similarities to Sweden’s successful strategy to tackle the pandemic, Nicaragua bases its strategy on confidence in the population’s ability to take preventive measures while avoiding restrictions on economic activity to the greatest extent possible.

In addition, Nicaragua combines public health education with a system of detection at all customs posts, ports and airports to work with border populations both to the north with Honduras and to the south with Costa Rica, and too with the activities of health centers and posts throughout the country as well as civil society structures in all neighborhoods and regions.

Nicaragua is a small country, it would be very difficult to hide a situation of the seriousness of a Covid-19 infection. The health authorities have so far been able to track down and follow-up any suspicious cases, like people reported to have crossed over blind spots on the borders between Honduras and Costa Rica.

One event heavily manipulated by the Western press, and by the coup media within Nicaragua, was the “Love in the Time of COVID-19” walk held March 15th. This national event was interpreted in a tendentious way as a show of contempt for public health and for the protection measures against the coronavirus, when in fact the Citizen Power media had been covering Covid-19 promoting preventive measures against it since the end of January.

The message conveyed by thousands of Sandinistas and people who support the Sandinista government who walked that day to all Nicaraguans was that we should not lose our heads and “shut down” the country, that we should continue working but take the precautionary measures recommended in the media for weeks.

It was not until March 18th, with the report of the first imported case of coronavirus from a citizen who had been in Panama, that Nicaragua left the initial phase of preparation to enter the phase of imported cases, in which it currently still is. Since then, five more imported cases have been reported, of which two have recovered, one has died and three are under treatment.

It should be noted that all this work is by no means limited to informing the population and preparing the health system for COVID-19. The health system continues to deal with other issues as well as providing free operations, etc. And the Covid-19 prevention campaign is carried out alongside prevention of influenza, dengue, zika, chikungunya and other diseases that threaten the population.

At present, the Nicaraguan people are enjoying the Easter holidays in peace and with great responsibility. Many people have stayed in their neighborhoods with their families. However, others have gone to the different bathing spas in the country, or are in religious activities, but avoiding large crowds and observing the rules of hygiene.

For Easter Week, state employees have been given a break from April 4th to April 17th, and students until April 20th, in a kind of soft quarantine.

The future development of the pandemic in Nicaragua is not yet known. It could be, as indicated by some U.S. researchers, that the higher levels of BCG vaccination against tuberculosis compared to those of the Euro-American countries will translate into a lower impact of Covid-19. If so, this would become a tribute to the massive vaccination campaigns that Sandinismo has promoted over the past 40 years.

One thing is certain, however: If the Sandinista Government had acted as Honduras and El Salvador have, the economic losses would have been enormous even before entering the peak of the pandemic in our region. Levels of contagion per million inhabitants in Central America are still much lower than those in Europe or North America. By the end of Holy Week, both Honduras and El Salvador will have suffered enormous losses, incurring unpayable debts and irretrievable damage to their relationship with the population.

Meanwhile, Nicaragua is still waiting for the pandemic to develop, so far without local community contagion, with all the resources of its health system intact, with valuable experience accumulated in treating the few cases that have occurred and with a strengthened relationship with the civilian population.

The Sandinista government is expert at quick organization. Examples include: the organization in a few months of the award-winning Literacy Crusade in 1979-80; the exchange of the entire national currency in less than 24 hours in 1988 (which deprived the Contra of billions of Córdobas that had fled to Honduras); the years of disciplined restraint when faced with unremitting right wing government provocations, right up to the defeat of the 2018 coup attempt, when many people outside Nicaragua believed that the Sandinista Front was defeated.

To the changing scenarios of Covid-19 the Sandinista Government will respond in a flexible but decisive manner, prioritizing the most vulnerable sectors so as to affect the popular economy as little as possible, aware that, more than a disease to be defeated, Covid-19 is a challenge to the ability of society as a whole to function, more a virus of society than a virus of the individual.

 

BRIEFS

By Nan McCurdy

Six COVID-19 Cases
In Nicaragua there have been six corona virus cases and one of those people has died. There are no local transmission cases – only imported cases. Dr. Carlos Sáenz, Secretary General of the Health Ministry stated there are three people currently fighting the disease. On April 5 an imported case of Covid-19 was detected from the US – a 33-year old man who is in delicate but stable condition. A 70-year-old man, who arrived from the United States, is in delicate health, but stable. Dr. Saenz said that a 76-year-old man, who also entered from the United States, has multiple chronic conditions, and is delicate, but stable. A 52-year-old woman, who entered from the United States with Covid-19, has already recovered and been discharged. Still another person has recuperated and one person died of the disease. (Radiolaprimerisima, 4/5/20)

Few Cases of Respiratory Diseases in 2020
Dr. Carlos Sáenz said that there is close monitoring of other respiratory diseases such as pneumonia, “and the cases this year have been fewer than previous years; it has helped that we have applied vaccines against Influenza and pneumococcal diseases.” In 2019 nearly one million people were vaccinated against influenza and pneumococcus. “And medicines used successfully in China and other nations are already being used, such as Interferon Alpha 2B, antivirals and retrovirals. The H1N1 pandemic of 2009 gave us a great deal of experience in treating respiratory diseases,” Saenz said. (Informe Pastran, 4/6/20)

Nicaraguan Efforts against Covid-19 Acknowledged
Vinicio Cerezo, the Secretary General of the Central American Integration System (SICA) said, “Your decisive support and commitment to the region in the midst of this unprecedented crisis is appreciated. We have many challenges to overcome, but at the same time it represents an opportunity to build a new region, with more solidarity, social justice and in harmony with the environment.”  (Nicaragua News, 3/31/20)

CABEI approves nearly $2 billion
The Central American Bank for Economic Integration (CABEI), approved US$1.9 billion to address the Covid-19 in Central America and the Dominican Republic through the Regional Contingency Plan. (Radiolaprimerisima, 4/3/20)

Suspension of Debt Payments Proposed
Central American governments propose to jointly negotiate the suspension of national debt payments with the World Bank Group and the Inter-American Development Bank in order to benefit the most vulnerable, and to help sustain the economies after the coronavirus crisis to avoid unemployment and impoverishment. (Informe Pastran 4/1/20)

Taiwan Donates for Covid-19
The Secretary General of the Central American Integration System (SICA), Vinicio Cerezo, reported that Taiwan donated US$4 million to support the Regional Emergency Fund for Belize, Nicaragua, Guatemala and Honduras in the fight against the pandemic. The SICA Secretary General stated, “The support of the Republic of China-Taiwan has been key in the regional integration process and Taiwan continues to show solidarity.” (Nicaragua News, 4/3/20)

Cuban Drug Interferon Alfa 2b
Nicaragua could produce the Cuban drug, Interferon Alfa 2b, at its Mechnikov vaccine plant, said Social Security Institute (INSS) President Roberto López: “The work will take a few months, but we would like to be able to produce the product by the end of 2020.” (Informe Pastran, 4/1/20)

Leaders Confident of Preparedness
Carlos Saenz, Secretary General of MINSA said, “The success is in containing the virus – those who have had contact with the positive cases are tested and given strict follow-up including people who traveled on the plane. Follow-up includes daily visits.” National Assembly President Gustavo Porras said all positive cases are imported such that monitoring people from abroad at all entry points is key. He added, “We have respiratory therapy equipment and people who know how to handle this.” (Informe Pastran, 3/31/20)

Best Strategy to Contain Covid-19
Health Ministry spokesperson Carlos Sáenz reported that Nicaragua consulted with experts from China, Italy, Spain, Taiwan, and Singapore, in order to strengthen the national strategy through a better understanding of the behavior of the virus. “The key to fighting the virus is to contain its spread through measures established by the World Health Organization (WHO) such as frequent hand washing, early identification of positive cases, contact tracing and strict monitoring of suspicious cases.” He noted that the Nicaragua Family and Community Healthcare Model is very effective for this type of situation because it is intertwined in all levels of society, helping to quickly identify a possible case. (Nicaragua News, 4/1/20)

Covid-19 Information Call Center Opens
On March 30 a National Information Call Center was opened by the Health Ministry and “stands out among the actions taken by Nicaragua in the face of the Covid-19 pandemic,” according to Prensa Latina. The Center has 150 operators 24 hours a day, seven days a week and “provides timely attention and information in the midst of the crisis,” said Dr. Humberto Román, its director. Through a free telephone line #132 operators provide information requested by the population about Covid 19 and also receive possible suspicious cases, the doctor added. The center received more than 15,000 calls in its first week. See video: https://www.youtube.com/watch?v=qqts6c8JAdM&t=1s (Informe Pastran, 3/31/20, 19Digistal, 4/6/20)

26,000 more COVID-19 Test Kits
The Central American Bank for Economic Integration (CABEI) donated more than 180,000 COVID-19 test kits for the SICA member countries thanks to a donation from South Korea. Nicaragua received their 26,000 test kits on April 6. The tests have a 99% certainty and are compatible with those used by all SICA member countries, except Belize, which is why they declined the donation. (Informe Pastran, 4/6/20, Radiolaprimerisima, 4/7/20)

Revolutionary Jacinto Suarez Dies
Jacinto Suarez died April 2 of kidney failure. He was a member of the National Assembly and chair of the International Relations Committee. The communiqué read by the head of the Sandinista legislative caucus, Edwin Castro, stated that “Jacinto suffered torture, persecution and more than seven years in prison under the Somoza dictatorship from 1967 to 1974. He never bent his principles and was an unbeatable revolutionary spirit who loved life in freedom, dignity and sovereignty. Suarez was in prison during those years with President Daniel Ortega, and with other Sandinistas led hunger strikes successful at deepening the struggle throughout the country. Peace to Jacinto, who leaves us a formidable legacy of revolutionary attitude, conduct and practices.” Suarez was 73 years old. (Radiolaprimerisima, 4/3/20)

CABEI Loan for Low-Income Housing
On April 1, the Central American Bank for Economic Integration approved a loan of US$171.65 million to finance the “National Program for the Construction of Social Interest Housing.” This program aims to improve the living conditions of Nicaraguan families in extreme poverty through the construction and/or acquisition of decent, safe and easily financed housing. This project will directly benefit 7,000 families in conditions of extreme poverty under a subsidy plan, and 11,660 families with low or moderate income under a subsidy and credit program, administered through one or more bank trusts. CABEI’s Executive President Dr. Dante Mossi stated, “We recognize the importance of having a dynamic housing sector for the sustainable development of the country. ” (Radiolaprimerisima, 4/1/20)

No Moratorium on Bank Loans
The Nicaraguan banks are not going to grant any kind of loan payment moratorium to clients. If some believed that they were not going to have to pay their loans to the banks for three months, Bank sources told INFORME PASTRAN that the banks have losses and less profitability due to the 2018 violence and that they are not willing to lose more at present. (Informe Pastran, 4/3/20)

Cases of Diseases Lower than 2019
A Ministry of Health report shows that dengue cases have fallen by 64% and that pneumonia cases have fallen by 11%, with 35% fewer deaths from this disease, compared to the previous period. Malaria decreased by 20% compared to the same period in 2019 and there were 45% fewer cases of influenza. This week MINSA is attending 64,000 people with Mobile Clinics in 900 communities with the participation of 4,500 health workers. This video is from February: https://www.youtube.com/watch?v=TRi1evzQP4w  (Informe Pastran, 3/31/20)

Another Women’s Police Station Re-launched
As part of the security and life-promotion plans, a Women’s Police Station was re-launched in District IV of Managua. It will attend to and provide security for 56,000 women, who will be able to file complaints and demand services with women police. (Informe Pastran, 4/3/20)

Solidarity Food Packages
As of April 13, the government will deliver 54,000 Solidarity Packages to Mothers of the Fallen, to people in Critical Social Emergency, and people with disabilities. (Informe Pastran, 4/3/20)

International Reserves Increase
The Central Bank announced that, as of February 2020, the country’s Gross International Reserves had a balance of US$2.4465 billion, which meant an increase of US$296.7 million compared to February 2019. (Informe Pastran, 4/1/20)

Bridge Links Granada and Caribbean Coast
April 1, the Ministry of Transportation and Infrastructure inaugurated the 210-meter-long “El Paso de Panaloya Bridge” in Malacatoya, Granada Department. “Our Government invested US$11 million in this project, and generated 208 direct jobs during the 31 months that it lasted,” said MTI Minister Oscar Mojica. He added, “Through ‘El Paso de Panaloya Bridge,’ connection is achieved between the departments of Boaco, Managua, Chontales, the Southern Caribbean Coast, Grenada and other departments of the Pacific.” (Informe Pastran, 3/31/20)

Potable Water for 50,000 People
On April 2, Enacal President Ervin Barreda announced the drilling of two potable water wells, one in Cuidad Darío and the other in Ticuantepe, which will benefit more than 50,000 people. In these two cities the existing wells have already outlasted their useful life, and with these new projects the quality of service to the families will be guaranteed. “We began drilling the two wells this week, hoping to have them in operation by the end of April,” said Barreda. (Radiolaprimerisima, 4/3/20)