Cuba Reports One #COVID19 Imported Case from Nicaragua

Cuba’s Ministry for Public Health reported 39 new cases of COVID19. One of these cases is a woman who arrived on the Island from Nicaragua on March 16.

The woman was identified as a 54-year-old resident of Santa Clara. She started showing symptoms on March 26, was hospitalized the same day, and is stable. Her contacts, 10 in total, are being monitored for signs of infection.

Screenshot of MISAP COVID19 update

Cubana contrajo el Coronavirus en Nicaragua.
Ciudadana cubana de 54 años de edad, residente en el municipio Santa Clara dio positivo del Coronavirus diez días después de haber viajado desde #Managua, confirmó el ministro de Salud de Cuba.#Nicaragua #COVID19 #Cuba pic.twitter.com/JmPy0fZt7A

— Trinchera de la Noticia (@LaTrincheraNic) March 28, 2020

Vice President Rosario Murillo reported Nicaragua’s first COVID19 case on March 18. The patient was described as a 40-year-old Nicaraguan male, who flew in from Panama City on March 15.

“It is not a homegrown case. It is a case that began in a foreign country […]. He contracted it abroad, came back to Nicaragua, presented symptoms, and is being cared for,” said Murillo.

Since then, the government’s official line has been that there are no homegrown cases of COVID19 in Nicaragua. All four reported cases thus far have been “imported.” Murillo repeated this information in today’s address

We will say this again: We have one case that tested positive on March 18. that case is almost ready to be discharged, thanks be to God. [We have] The brother that died, and the two positive cases from yesterday, both imported from the United States. [Those two} are being cared for. We also have, we repeat, the 14 people who are under preventative surveillance, and who are being monitored and are about ready to be discharged. […] But we should bear in mind that these fourteen brothers and sisters were in contact with the imported cases, or returned from Countries with severe outbreaks. They doing will, not showing symptoms, and we hope in God that they will continue well.

According to Murillo, the fourteen individuals under surveillance received a physical exam, which helped determine that they needed closer follow up. “No other tests have been performed, since the cases do not warrant it,” added the vice president.

Dr. Tedros Adhanom Ghebreyesus, director general of the WHO, has reiterated the need for a “comprehensive approach” in their response to COVID 19. This includes testing and isolating all suspected cases. “You cannot fight a fire blindfolded, and we cannot stop this pandemic if we don’t know who is infected. We have a simple message for all countries: Test, test, test.”

The WHO has no say on domestic policy, so it is up to each individual state to establish the protocols to be followed in the response to COVID 19, according to Article 2, paragraph 4 of the International Health Regulations of 2005 (IHR). However, the IHR also indicates that states “shall assess events […] which may constitute a public health emergency of international concern” and “notify” the WHO within 24-hours of assessment. Ongoing communication is to be maintained, by providing “accurate and sufficiently detailed public health information available […] where possible, including case definitions, laboratory results, source and type of risk, number of cases and deaths, conditions affecting the spread of the disease and the health measures employed” (Article 6).

The viability of the WHO reporting and monitoring system, following the IHR, very much depends on the willing cooperation of member states. In fact, should non-governmental sources contact the organization to report public health threats in any country, the WHO requests verification from the state, rather than seek it from independent entities or engage their own resources to investigate claims (see articles 9 and 10 of the IHR).

Official case reports from Nicaragua indicate the country only has four confirmed cases to date. One patient died on March 26.

Yet, in light of the Cuban announcement, it is more than likely that Nicaraguan authorities are underreporting the extent of COVID-19 contagion in the country. MINSA authorities have been very tight lipped about basic information, including testing numbers, though MINSA’s Secretary General Carlos Sáenz indicated that they have tested around 200 people. Sáenz also dismissed suspicions of underreporting.