Nicaragua's response to COVID-19
Authors: John Perry
Journal: The Lancet Global Health (2020)

In criticising Nicaragua's response to the coronavirus disease 2019 (COVID-19) pandemic, Thais P Salazar Mather and colleagues1Mather TPS Marin BG Perez GM et al.Love in the time of COVID-19: negligence in the Nicaraguan response.Lancet Glob Health. 2020; (published online April 6.)https://doi.org/10.1016/S2214-109X(20)30131-5Summary Full Text Full Text PDF PubMed Scopus (23) Google Scholar fail to note that the country has the lowest level of infection in the Americas, with (as of April 22, 2020) ten cases of COVID-19. They ignore the Nicaraguan Government's measures to achieve this low number and the dilemma, recognised by Oxfam,2Oxfam InternationalHalf a billion people could be pushed into poverty by coronavirus, warns Oxfam.https://www.oxfam.org/en/press-releases/half-billion-people-could-be-pushed-poverty-coronavirus-warns-oxfamDate: April 9, 2020Date accessed: April 23, 2020Google Scholar that faces resource-limited countries in deciding when to implement physical distancing. Nicaragua has had health checks at its borders for months, far sooner than in the USA, and these checks are followed up with phone calls and house visits. Two lengthy and porous land frontiers make keeping Nicaragua's borders open preferable, to minimise informal crossings that make health checks impossible. Community-based health programmes in Nicaragua3World BankStrengthening the family and community health care model in Nicaragua.https://www.worldbank.org/en/results/2017/04/11/strengthening-the-family-and-community-health-care-model-in-nicaraguaDate: April 11, 2017Date accessed: April 23, 2020Google Scholar mean that most households have been visited three times by health advisers telling people how to combat COVID-19.4Cruz I Nicaragua records more than 3 million visits to families.https://www.tn8.tv/politica/502764-nicaragua-contabiliza-3-millones-visitas-familias/Date: April 17, 2020Date accessed: April 23, 2020Google Scholar 19 hospitals have been identified to receive individuals with COVID-19, and 37 000 health workers and 250 000 volunteers have been trained. All confirmed COVID-19 cases in Nicaragua have been travellers from abroad or their immediate contacts;5Nicaraguan Ministry of Health (MINSA)Nota de prensa ministerio del poder ciudadano para la salud. MINSA, ManaguaApril 21, 2020Google Scholar no community transmission has been judged to have taken place so far and is the reason wider measures have not yet been implemented. If self-isolation becomes necessary, it will carry a massive cost; most people need to go to work daily to eat. No reliable mechanism exists to distribute subsidies, nor can small resource-limited countries borrow money with impunity to pay for such support. Many people in Nicaragua live in cramped houses in densely populated neighbourhoods, making physical distancing difficult. Mather and colleagues cite the contrasting policies of El Salvador and Honduras. In El Salvador, President Nayib Bukele has told people to self-isolate, offering a subsidy of US$300 per family that led to massive unregulated queues outside government offices. The Los Angeles Times reported on April 7, 2020, that the lockdown in El Salvador is enforced by gangs with baseball bats.6Linthicum K O'Toole M Renderos A In El Salvador, gangs are enforcing the coronavirus lockdown with baseball bats.https://www.latimes.com/world-nation/story/2020-04-07/el-salvador-coronavirus-homicides-bukeleDate: April 7, 2020Date accessed: April 22, 2020Google Scholar In Honduras, a national curfew has led to police violence, more than 1000 arrests, and almost 900 vehicles being confiscated, according to human rights group COFADEH (Committee of Relatives of the Disappeared in Honduras).7DefensoresReport: human rights crisis during the Covid-19 pandemic.https://defensoresenlinea.com/informe-crisis-de-derechos-humanos-durante-la-pandemia-covid-19/Date: April 2, 2020Date accessed: April 22, 2020Google Scholar Despite these actions, both countries have much higher infection levels than does Nicaragua. Accusing the Nicaraguan Government of an erratic response to the epidemic, "violating the human rights of its citizens", is both inaccurate and unfair. The government is genuinely attempting to balance the fight against COVID-19 with the economic needs of the population. To impose an untimely lockdown would not only cause huge resentment and hardship but could be counterproductive. Mather and colleagues should address these dilemmas, not omit to mention them. I declare no competing interests. Nicaragua's response to COVID-19 – Authors' replyIn challenging our observations of the Nicaraguan Government's failure to confront the coronavirus disease 2019 (COVID-19) pandemic,1 John Perry does not address key issues. Full-Text PDF Open AccessLove in the time of COVID-19: negligence in the Nicaraguan responseThe response of the Nicaraguan government to the coronavirus disease 2019 (COVID-19) pandemic has been perhaps the most erratic of any country in the world to date. Directly contradicting mitigation strategies recommended by WHO, President Daniel Ortega has refused to encourage any physical distancing measures. Vice President Rosario Murillo (Daniel Ortega's wife) instead called on thousands of sympathisers to congregate in street marches under the slogan "love in the time of COVID-19". By downplaying the danger of the pandemic and increasing the risk of community transmission in the second-poorest country in the western hemisphere,1 the Nicaraguan government is violating the human rights of its citizens. Full-Text PDF Open Access