Tuesday, May 26, 2020

COVID-19: When is it Time to Hunker Down?

As of today the 26th of May, Nicaragua has had 885 confirmed cases of COVID-19 with 35 deaths and 370 recovered cases.1   We now have community transmission and though those are the confirmed cases, we suspect that there are many, many more.  The Nicaraguan government predicts that the next three weeks will be our peak.2

All our doctors are out sick with fevers and respiratory issues.  Our general physician and our pediatrician3 have confirmed COVID-19 cases.  Our general physician has lost 30 pounds and both are having difficulties breathing.  Our radiologist (and our main physician) is sick but has not been tested…as far as we know.

Also, among the clinic staff, both cleaners, Xiomara and Luz Marina, are out sick, as well as our health promoter, Emir. Our nurse, Isamar, and our intern nurse, Reyna are so far ok, but we worry about them all as well as the two other clinic staff members who are on permanent leave: Jessenia and Petronila; both are at high risk of death, if they get the virus.

Although we have asked our patients to go to the Ministry of Health clinics to get tested, few have.  Two of our 140 chronic care patients4  have died from unknown causes in the last week.  Respiratory issues are spreading through our poverty-stricken communities like wild fire.  All the clinic staff members have been very afraid.

As a result of all of the above, we have now told all the CDCA’s staff to shelter at home for the next three weeks, with office staff only working as possible from home. 

After June 15th, we will reevaluate…with one exception… 

This Thursday, two of our pharmacy staff, Josefa5  and Danelia, will drop-off June’s monthly medicines outside each of our chronic care patients’ homes.  Rogelio, our construction guru and all-round-wizard, will drive them around the Nueva Vida community and the rural communities in our truck.  We do feel strong obligations to our patients and our chronic care patients are the most at risk of death from COVID-19. 

We have tried to think of ways to keep our staff safe and continue to work in some areas, but we cannot.  The best place for them is to shelter at home. Even with the protective gear that we made or bought, none of it was obviously working well enough.  Besides protecting our staff, we surely do NOT want to infect our patients or others.

Our staff are dedicated to this work.  Most are making a living wage, if they live a simple lifestyle which they do; but most, also, support extended family, which means many of our staff live in poverty.  Their biggest concern has been would they get their full salaries?  

We are committed to paying the staff’s full salaries during these uncertain times and while they are sheltering at home.  We depend on donations.  In other words, we depend on people like you to meet the budget.  Our electricity will be lower with projects on hold, as will all other bills.  But we will still need to pay staff not only their salaries, but their benefits as well. We will also need the funds to buy medicines for the chronic care patients, about $4,000 U.S. a month. 

If you are able and willing to help, please do.  We know needs are high across the world and with every little bit we receive, we promise to use to its maximum.


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1John Hopkins COVID-19 map reflects Nicaragua’s MINSA weekly update.
2The government release a 75-page document yesterday on its response.  I will write a blog on this after I wade through it.
3Both of these doctors also work for the Ministry of Health, so they could have picked up the virus there and brought it to our clinic.
4Chronic care patients mostly have diabetes and hypertension, though some have chronic obstructive pulmonary disease, Parkinson’s, HIV, and thyroid conditions.
5Also Clinic Administrator.