The first person in Nicaragua to receive a coronavirus vaccine was Marco Antonio Aráuz, 62, who was given a dose of the Russian Sputnik V treatment at Managua’s Blue Cross hospital.

Afterwards, he was quick to credit the country’s Sandinista rulers. “I’m very grateful to the government of commander Daniel Ortega and [his wife] compañera Rosario Murillo, because they are giving us a great opportunity to stay alive – and for free!” he told reporters from state media (the only outlets allowed to attend).

Nicaragua is the only Central American country that has not introduced sweeping public health measures to contain the spread of Covid-19, and the only one not to have launched a testing campaign, so news of the vaccination in early March raised hopes that finally the government was taking action.

Since then, however, Nicaragua’s vaccination campaign has been rolled out amid the same secrecy and doubt that has characterized the authoritarian government’s response to the pandemic.

President Ortega has promised “vaccines for all” but has not published any plans for the rollout, nor given details on which groups will be prioritized.

Health officials make public expressions of gratitude to the president and his wife (and vice-president) Murillo for the vaccines – which were donated by Russia, India and the UN-backed Covax programme.

Critics say that, in an election year, the Ortega-Murillo regime is using the vaccine campaign to boost their image, which had been battered by its handling of the pandemic – and the brutal repression of an anti-government uprising in 2018.

And the independent Nicaraguan Medical Association has warned that there is still no clear timetable for a universal vaccination programme.

“There should be a plan which follows the recommendations of the Pan American Health Organisation, laying out the priority groups according to risk. But doctors and health workers still haven’t been included – there is no news of vaccines for them,” said Josefina Bonilla Zúñiga, president of the NMA.

“We are moving very slowly and there is not enough information.”

From the start of the pandemic, the Sandinista government joined the chorus of denialist governments across the Americas, including Jair Bolsonaro in Brazil and Donald Trump in the US. Officials downplayed the severity of the disease and held mass rallies of supporters.

“Nicaragua hasn’t carried out some of the most basic steps to confront the epidemic,” said Dr Bonilla Zúñiga.

In the first few months, information on the pandemic was handled as a “state secret”, according to the NMA. Officials attempted to hide the number of deaths, with so-called “express burials” in which the bodies of Covid victims were rushed from hospital for burial in the dead of night.

According to Jorge Huete, a molecular biologist and member of the Nicaraguan Academy of Science, no efforts were made to test and trace the spread of the illness.

As deaths surged between April and July 2020, local media reported that officials concealed the scale of the disaster by falsifying death certificates to say that Covid victims had instead died of diabetes, pneumonia or other illnesses.

That helps to explain how – officially at least – Nicaragua has suffered the lowest rate of Covid-19 fatalities in the region. Officially, Nicaragua, a country with a population of 6.4 million, has seen just 6,500 Covid cases and just 176 deaths. Honduras (population 9.9 million) has logged 189,000 cases and 4,605 deaths, and Costa Rica (5.1 million) has recorded 217,000 cases and nearly 3,000 deaths.

In stark contrast to the official figures, Nicaragua’s independent Citizens’ Covid-19 Observatory have logged more than 13,200 suspected cases and 3,000 deaths from coronavirus.

Independent experts warn that Nicaragua may be facing a second wave of infection, as the population grows weary of social distancing and mask-wearing becomes less and less common. But the true impact of the disease is likely to go unrecorded as the government has kept tight control on testing kits, charging $150 for each test.

“Private labs and health networks don’t have specific diagnostic tests for Covid. And there is still no clarity over how vaccines will be administered,” said Bonilla Zúñiga.

One of the biggest uncertainties is the vaccination programme: Nicaragua has received just 341,000 doses in donations from Russia, India and the UN-backed Covax programme, and it remains unclear how or even if the government intends to obtain more.

“There are vaccines, but there aren’t enough for the whole country – and definitely not enough for two doses,” said Mauricio Gutierrez, a dentist in the capital Managua.

“The health ministry still has told health workers when we will get vaccinated – even though we are on the frontlines. I’m just going to carry on wearing my mask and keeping my distance.”

This content first appear on the guardian

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