By Ismael Lopez
MANAGUA (Reuters) - Nicaraguan hospital wards are packed with patients suffering respiratory problems, according to more than a dozen health workers, casting doubt on the country's official tally of just 16 coronavirus cases and its ability to cope with the pandemic.
Twelve medical professionals and two administrators told Reuters many of the beds intended for patients with COVID-19, the disease caused by the virus, were full in Nicaragua, which has not imposed strict measures to contain the outbreak.
In contrast to other Central American states, such as El Salvador and Honduras, that have ordered stringent quarantines to shield their fragile healthcare systems, Nicaraguan President Daniel Ortega has not suspended classes, closed businesses or banned large gatherings, warning such measures would harm the country and its economy.
As of Monday, the government had reported only five deaths from COVID-19 in the nation of more than six million people.
"The health system is not prepared to face this pandemic and because of the government's strategy, it could get out of hand," said Roger Pasquier, president of Nicaragua's Association of Anesthesiologists.
The Nicaraguan government did not respond to requests for comment on the health workers' accusations.
Ortega's office did not reply to requests for comment. The government's press office and Vice President Rosario Murillo - Ortega's wife and spokesperson - also declined to address questions posed by Reuters about the handling of the pandemic.
The government has previously said that all those who require treatment are receiving it. Reuters has no independent evidence to suggest otherwise.
Ortega, a leftist former guerrilla leader, said in a speech on April 30 that "radical" sanitary measures would harm Nicaragua. But he conceded the virus would have an impact.
"It's impossible there won't be deaths, it's impossible there won't be infected people," he said. "The world is interconnected."
Five health workers said dozens of patients in nine public hospitals were diagnosed with atypical pneumonia, an unusually high number for the time of year. They spoke on condition of anonymity because they were not authorized to speak publicly.
"Everything that is atypical pneumonia at this time, when winter hasn't yet begun, is related to COVID-19," said respiratory specialist Jorge Miranda, a member of the Nicaraguan Pneumology Association.
While there is no official data to corroborate this, Miranda noted such cases have jumped at both private and public hospitals since the start of April, based on reports that his association has received from doctors treating the illness.
At the public Hospital Aleman in Managua, all 62 beds intended for coronavirus patients are full, said a doctor there.
"Everything is about to collapse," the doctor said. "We are seeing too many atypical pneumonias."
Neither the Hospital Aleman nor the health ministry responded to requests for comment from Reuters, which was unable to confirm the doctor's accounts.
Supporters of the Ortega administration denied that Nicaragua's healthcare system was under stress.
"It's a lie that hospitals in Nicaragua have collapsed, are full, overwhelmed or can't cope," Carlos Lopez, a pro-government lawmaker, said in a video on his YouTube channel. "The COVID-19 outbreak has never exceeded the capacity of any hospital."
According to Lopez, Nicaragua has never had more than four active COVID-19 cases at the same time, and has 11,732 available hospital beds, 562 in intensive care units, and 449 ventilators.
Nicaragua's government has not published data on how many cases it has registered of atypical pneumonia, which can produce symptoms similar to the coronavirus.
While the government puts the COVID-19 infection tally at 16, the Observatorio Ciudadano, a civil society group, has kept a separate tally, estimating the number at 781. The group says it bases its estimate on information it receives from doctors and other groups, but declined to provide more detail.
In Nicaragua, only the government can authorize tests for the coronavirus, but it has not said publicly how many have been done.
The Central American Integration System (SICA), an economic and political organization which groups data for the region, said on Saturday that Nicaragua had conducted 26,000 tests. It said that figure was based on data it received from the Nicaraguan government, without elaborating.
Nicaragua's government maintains there is no local transmission of the virus.
"Even if a patient walks in with all the coronavirus symptoms, the COVID-19 test is only conducted if he has been travelling or been in contact with other people who were travelling," said the doctor at the Hospital Aleman.
But Nicaragua's head of intensive care, Juan Tijerino, was diagnosed with COVID-19 last month, according to his family. His sister, Melba Tijerno said he told family members he contracted the virus in Nicaragua, along with his wife.
"My brother had no contact with anyone from abroad. If he contracted the virus it was because of his work," she said.
Juan Tijerino declined to comment.
At Hospital Espana, the sole public hospital in the city of Chinandega, the small coronavirus ward is at capacity, according to two medical staff there.
Equipped with six beds and three ventilators, a health worker said the unit has been treating eight cases, including three people requiring ventilators.
In addition, seven doctors and two nurses at the hospital were infected with COVID-19, the staff member said.
On April 30, the mother of a radiologist who was hospitalized with COVID-19 and had seen patients with atypical pneumonia, died at the Hospital Espana, according to a relative who spoke on condition of anonymity.
She had been diagnosed only with atypical pneumonia. Hours after her death, she was buried by medical workers in a local cemetery without any family present, the relative said.
The Hospital Espana did not respond to calls for comment from Reuters.
(Reporting by Ismael Lopez; Writing by Daina Beth Solomon; Editing by Daniel Flynn and Daniel Wallis)