Hospital España, a Covid-19 Hot Spot in Chinandega, Nicaragua

About twenty doctors and Health personnel have been infected with the new coronavirus, most of whom were sent to their homes

By Juan Carlos Bow (Confidencial)

HAVANA TIMES – The image of a desperate mother who screams “let me be with my son”, was the signal that something was wrong at the Hospital España, in Chinandega, Nicaragua.

Two weeks after the publication of the video, the hospital has become a hot spot of the pandemic in the city. Around twenty clinical staff, according to medical sources in Chinandega, have tested positive for covid-19, while patients continue to be admitted with symptoms.

After Managua and Masaya, Chinandega is the city hardest hit by the pandemic. The government has only reported one positive case in that city to the northwest of the country. However, the independent Citizen Observatory records at least 73 suspected cases of covid-19 in Chinandega, as of May 9.

In addition, after Managua, Chinandega is the city with the most covid-19 infected medical personnel. Across the country, according to the Nicaraguan Medical Association, there are at least 60 health professionals listed as positive cases. “They are hospitalized doctors as well as other MDs who have already overcome the crisis. Some were serious, but did not die,” Greta Solís, president of the Association, told a local newspaper.

In the Chinandega hospital, Covid-19 has spread quickly, infecting “surgeons, gynecologists, laboratory workers, nurses, interns, orthopedists and primary care doctors,” a local medical source told Confidencial.

The hospital director, the assistant director, the head of the Intensive Care Unit and the head of nursing are also positive cases.

Sent home

“Today (May 12th) they gave the tests to several doctors from the Chinandega hospital. Five in all, all positive. They were all sent home. All stable,” said a medical source.

The sister of a doctor with covid-19 reported that her family member had no contact with the covid area of the hospital, but that six patients were infected and transmitted the disease to medical personnel in that area.

“(The hospital) put her on paid leave to protect herself at home. But it wasn’t until today (Sunday) that they confirmed that she had Covid, after taking the test on Tuesday,” said the source.” She demanded that Minsa (Ministry of Health) do the test, because they had only sent her home,” she explained.

“It was difficult, because basically Minsa didn’t tell us anything. Everything we’re doing to treat her comes from her own knowledge and that of other relatives who are doctors,” she said.

Replacements and absences

The crisis at the hospital has caused changes in its management, as well as in its operations. The director infected with covid-19 – Freydell Ulloa – has been replaced by Dr. Valeria Sevilla, internist and the hospital’s emergency room director.

In the case of doctors, the hospital has been reinforced by primary care doctors, assigned to the internal medicine area, and by doctors from health centers in the department (state).

“Internists from other centers who used to do shifts at the public hospital every five days will now take shifts every three days,” said a hospital doctor. This week they hired three more internists.

So far, no hospital doctor or nurse has, according to sources. “Only the interns of UCAN (Universidad Cristiana Autónoma de Nicaragua) stopped arriving, but they are private,” explained one of the doctors consulted.

The only defections from the hospital have come from the cleaning staff, where “approximately” 50% or more have stopped attending their jobs. “They haven’t resigned, they just don’t show up at the hospital, which is in chaos with garbage and dirty clothes,” explained a doctor from the hospital.

Some primary care doctors have come to reinforce the internal medicine area, “but you cannot replace the infected staff, nobody is going to go to work in a hospital that is contaminated,” said a medical source from Chinandega.

Also, in the face of the emergency, last week Minsa authorized the clinics that serve pensioners to take charge of some cases of covid-19, and even admit them to their centers. Before the threat of a saturation, these clinics referred all suspected cases to the hospital.

Express burials

In a special report on Chinandega, the private organization Citizen Observatory noted that, from March 14 to May 4, they received information from family members of 24 people who died in that department; of these they managed to “verify” 18, of which 12 occurred between April 30 and May 6.

Since last week, videos have been circulating on social networks, showing men dressed in white uniforms from head to toe, who travel in vans with sealed coffins. Their destination: the two cemeteries of Chinandega.

These semi-clandestine burials are carried out especially at night and early in the morning, according to the testimony of witnesses. However, sometimes the scene is repeated during the day.

Relatives have told local and foreign media that the deceased were diagnosed with “atypical pneumonia” or “severe pneumonia,” and that Minsa’s instructions are to “bury them immediately.” However, Nicaraguan doctors have warned that the Government is trying to cover up deaths from covid-19, with this type of respiratory ailments.