Nicaragua's response to COVID-19 - Authors' reply.

In challenging our observations of the Nicaraguan Government's failure to confront the coronavirus disease 2019 (COVID-19) pandemic, John Perry does not address key issues.

First, while proposing reasons why the Nicaraguan Government has not promoted physical distancing, Perry offers no explanation for why the government has encouraged mass gatherings since the pandemic started. The ability to physically distance is certainly a privilege, and people from low-income and middle-income countries face starker challenges to adopt these measures. However, repeatedly encouraging mass gatherings when science supports banning large group meetings as a basic preventive strategy to reduce the risk of infection in the context of a global pandemic is troublesome.

Second, Perry suggests that, despite the absence of physical distancing measures, Nicaragua has the lowest infection rate in the Americas. However, the Nicaraguan Government has not revealed how many tests it has done. It is, therefore, impossible to know the real number of cases, much less make comparisons across countries.

Our concerns are widely shared by leading voices in the areas of public health and human rights.4, 5, 6, 7 Since publication of our Correspondence on April 6, 2020, the Pan American Health Organization stated worries about the absence of physical distancing, convening of mass gatherings, testing, reporting of cases, and inadequate infection prevention and control. Both Human Rights Watch and the Inter-American Commission on Human Rights have expressed concern for the human rights of the Nicaraguan people in the context of the government's response to the pandemic. Amnesty International puts the problem thusly: “The Nicaraguan authorities' response to the serious threat posed by COVID-19 shows once again that the Ortega administration is not taking any responsibility for the human rights of the Nicaraguan people, leaving them completely vulnerable.”