By John Perry – Sep 22, 2020
No country can yet claim to have defeated Covid-19, but clearly some are having more success than others. Nicaragua is one of these, and could yet be recognized as a world leader. With under 5,000 Covid-19 cases since the pandemic began, according to official figures, its infection level is far below that of Panama (105,000), Guatemala (85,000), Honduras (71,000), Costa Rica (63,000) or El Salvador (27,000). Of course, it is certain that Nicaragua’s figure, like those of the other countries, undercounts the real incidence of the virus. But even the so-called ‘independent’ Citizens Observatory, which is closely linked to Nicaraguan opposition political groups, only reports around 10,000 cases – still well below the incidence in adjoining countries. And the observatory’s figures – as its website makes clear – are not based on testing but on unverifiable sources, including ‘rumors’ (which it defines as ‘spontaneous public opinions’).
What evidence is there that Nicaragua’s epidemic is under control? Over the past six weeks, since early August, there have been only around a thousand new cases. The weekly level of new cases is down to 143 (mid-September) from a peak of 480 per week at the end of May. This reflects experience on the ground – hospitals are now dealing with a limited number of Covid-19 cases, and the Managua hospital that was dedicated solely to treating the virus, the Alemán Nicaragüense, has opened its doors to other patients. In the streets, while people still take precautions and most wear masks, there is little sense that the pandemic is everyone’s biggest worry, as it was four months ago.
The Pan American Health Organization (PAHO) reports that Nicaragua has the lowest Covid-19 death rate in the Americas. Also, according to Forbes, at the end of August Nicaragua had the best Covid-19 recovery rate in the region (see chart), with more than 90 per cent of patients recovered. These are encouraging figures, although truly comparable data will only be available when national mortality rates can be examined for the different countries over the period of the pandemic.
Nicaraguan government policies have differed sharply from those of its neighbors. Nicaragua prepared early – equipping 19 hospitals to handle severe respiratory illnesses, training all 36,000 health staff in dealing with the virus, maintaining strict health checks at frontiers with supervised quarantine for new arrivals, making house-to-house visits with volunteer health brigades dispensing advice (some five million visits in total), tracing the contacts of the vast majority of known cases, and setting up a free telephone helpline to advise people with symptoms.
What it didn’t do was impose a lockdown, arguing that suffering would be much greater if it did, as the many Nicaraguans who need to work to eat each day wouldn’t have been able to do so. The peak of the pandemic coincided with the planting season: how would the 40 per cent of Nicaraguans in rural areas have survived without new crops? In contrast, the adjoining countries imposed strict lockdowns, provoking demonstrations and causing extreme hardship, dealing with violations by tough fines or even by violent repression (bread sellers in Honduras were shot by police for breaking the lockdown; one died). All of these countries have since been forced to relax their restrictions in part because of the considerable damage caused to people’s livelihoods, even as numbers of cases have continued to grow.
What has happened in Nicaragua is not what was supposed to happen, according to opposition media and the international press. Early on, exaggerated figures from the Citizen’s Observatory were given more credibility by international media than the government’s own figures. For example, when on May 26 the health ministry, MINSA, reported 759 proven cases of COVID-19, the observatory was reporting over 2,600 cases with a further 2,000 as ‘suspicious’, none of them based on testing.
Right-wing NGOs and media channels produced forecasts that were clearly intended to scare people, and regrettably a proportion of Nicaraguans did believe them. For example, a report by the notorious media channel 100% Noticias on April 2 predicted that 23,000 Nicaraguans would die from the virus by early May (in fact by early May there were just six deaths). The BBC carried a report which included a forecast by a local NGO called FUNIDES that by June there would be at least 120,000 virus cases and 650 deaths. In the same report the BBC cast doubt on the Nicaraguan government figures, but it reproduced the obviously exaggerated FUNIDES prediction without questioning it. FUNIDES does not work in the health sector and in 2018 it received over $120,000 from the US-government supported agency, the National Endowment for Democracy, to promote ‘democracy’ in Nicaragua and $253,245 from USAID. These and other rumors and predictions have been collated in a video by Juventud Presidente, Falsas matemáticas sobre el Covid-19 en Nicaragua.
There have also been numerous articles criticizing the Nicaraguan government for its supposed inaction in the face of Covid-19. One of the most influential appeared in the international medical journal, The Lancet. A letter from 13 health professionals, all based in the USA (except for one in Costa Rica), belittled the Nicaraguan government’s response to the epidemic as ‘careless’ and ‘perhaps the most erratic of any country in the world to date’. It drastically understated the availability of a crucial item of medical equipment – ventilators – because it relied for its information on one of the local opposition media, Confidencial.
Fortunately, the editors of The Lancet were happy to publish a response. This set out some of the steps the government had taken, challenging the original letter-writers to accept that they were wrong in calling Nicaragua’s approach ‘careless’, even if they didn’t agree with it. They then replied, but did not address most of the key points made in contesting their original arguments. They quoted the PAHO as criticizing Nicaragua – but while there was specific disagreement on the advisability of a national ‘lockdown’, the Nicaraguan government has been working closely with the PAHO (part of the World Health Organization) since a joint commission was established to confront the epidemic on January 30, when it was one of the first countries outside Asia to recognize the potential impact of the virus.
Not surprisingly, the international bodies that have constantly criticized the Nicaraguan government used the pandemic to renew their attacks. For example, the Inter-American Commission on Human Rights, in a lengthy missive on May 29, concluded by expressing ‘their concern over the Nicaraguan population’s access to the right to health,’ apparently unaware that Nicaragua has far more free, public hospitals than neighboring Honduras (which has a 50% higher population level), that 19 of these had been built since 2007 when the Sandinistas returned to power, and that Nicaragua spends a bigger proportion of its government budget on health than practically any other country in the Americas. The Inter-American Development Bank recently ranked Nicaragua second in Central America and fourth in all of Latin America in health investment.
Amnesty International, also quoting the Citizens Observatory figures, has used the pandemic to renew its criticisms of Daniel Ortega’s government, this time (in August) focusing on prison conditions. It continues to argue that there are 80 political prisoners in Nicaragua, despite the various amnesties that the government has held, and ignoring the fact that those who have been arrested in recent months (many of whom were previously amnestied in 2019) have committed serious crimes. Certainly the most egregious of these was the murder of two children in Mulukukú; the accused (now arrested and charged) had taken part in the opposition attack on the police station there in June 2018, in which three police officers were killed. While prison conditions in Nicaragua have attracted Amnesty International’s attention, it has ignored the far worse conditions in Honduran prisons where, indeed, there have been many Covid-related deaths, including those of political prisoners such as dissident journalists.
There are some signs that Nicaragua’s success is, at last, gaining some appreciation. The left-wing website, Toward Freedom, ran an overwhelmingly biased article about Nicaragua’s approach to the pandemic in June, Coronavirus met with denial and silence in Nicaragua. But they are now apparently having second thoughts (despite rejecting a response jointly written by the late, great Kevin Zeese, which instead was published in Popular Resistance). The website New Humanitarian published a similarly biased piece, using largely opposition sources, in September. It has now agreed to take a second look at the issue.
Most encouragingly, a health worker in the UK, Rita Drobner, a biomedical scientist in a London hospital, says that the correspondence in The Lancet, including the detailed response to the criticisms from the doctors in the US, has been important in dealing with unfounded criticisms of Nicaragua in the UK. Her view is that The Lancet was in error to publish a piece that was ‘so scientifically light-weight and unsubstantiated’ but that now there has been some public discussion in a prominent place, ‘where the arguments of a poor country mounting a measured and responsible public health campaign come out stronger and clearer.’
It can only be a matter of time before Nicaragua’s effective response to the pandemic is recognized by the corporate media, especially as it is in such contrast to the experience of most other Latin American countries, and of course that of the US and the UK. In the meantime, opinion polls show that Nicaraguans’ trust in their health service, undoubtedly affected by the opposition propaganda campaign earlier in the year, has recovered substantially. It is also clear that Nicaragua is resuming its economic recovery, after the severe damage cause by the 2018 attempted coup, again despite the opposition’s forecasts of impending economic disaster.
John Perry is a writer based in Masaya, Nicaragua whose work has appeared in the Nation, the London Review of Books, and many other publications.