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Gravediggers wearing suits and face masks to prevent the spread of the novel coronavirus bury a body Friday at the Jardínes del Recuerdo cemetery in Managua, Nicaragua. (Inti Ocon/AFP/Getty Images)

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MANAGUA, Nicaragua — Guillermo Maltez called his son late one night to say goodbye. The 59-year-old taxi driver was being disconnected from a respirator in a Nicaraguan hospital.

“My father sensed he wasn’t going to survive,” Silvio Maltez said in a telephone interview from his home in neighboring Costa Rica.

Within hours, at 3 a.m. on May 1, another son got a call from the hospital. The taxi driver had died. The official cause: respiratory problems. The body was being whisked to a nearby cemetery for immediate interment, the son was told. “They let him watch the burial from afar,” Silvio Maltez said.

Such “express burials” have become increasingly common in this Central American country, raising suspicions that the authoritarian government is trying to hide the extent of the coronavirus tragedy within its borders.

As the virus that causes covid-19 has spread across the globe, Nicaragua has stood out in Latin America for an almost complete lack of restrictions to contain it. The government of President Daniel Ortega has kept offices and schools open. Authorities deny the virus has spread widely; in this nation of 6 million, one of the poorest in the Western Hemisphere, they insist there have been only 25 cases and eight deaths.

The president has vanished; his wife, the VP, says the coronavirus isn’t a problem. Nicaragua declines to confront a pandemic.

Health officials give far higher estimates. And the speedy burials are hardly the norm for victims of common respiratory illnesses. Often, they are carried out at night by white-suited medical personnel, with police or members of pro-government paramilitary groups watching nearby.

They come as signs of the outbreak are multiplying.

Sixty-seven doctors or other health-care workers have been infected with the coronavirus, according to the independent Nicaraguan Medical Unit. It bases its count on symptoms and lung X-rays, because tests are scarce and controlled by the government.

Around 90 patients with severe respiratory disease were being treated Friday at the Hospital España in the western city of Chinandega, where Maltez died, according to hospital officials who spoke to The Washington Post on the condition of anonymity for fear of reprisal. Doctors there suspect most are covid-19 cases. Among those who are believed to have been infected recently are top hospital officials, radiologists, internists and nurses.

The government doesn’t recognize any of those infections as covid-19. It did not respond to several requests for comment.

“The hospitals are overwhelmed, the health system is maxxed out,” said Taki Moreno, president of the Pulmonologists’ Association.

From the start of the pandemic, Nicaragua has been a radical outlier.

As neighboring countries imposed strict quarantines and curfews, the Sandinista government encouraged festivals, beach tourism and professional sporting events.

Nicaraguan authorities say they have made preparations for the pandemic, training tens of thousands of health-care workers, and sending teams door-to-door to promote measures to avoid contagion. But in April, the Pan American Health Organization criticized the government for “inadequate infection prevention and control.”

Analysts say the government may be downplaying the epidemic for fear of more damage to the already slumping economy.

Ortega, a former Marxist rebel who first came to power in the 1979 Sandinista revolution and returned to the presidency in 2007, has said the country will have to “learn to live with the pandemic.” But the government has declined to say how many people have been tested for the coronavirus. Authorities have said the confirmed cases in Nicaragua are all tied to foreign travel, and there has been no community transmission.

Silvio Maltez thinks otherwise.

He believes his father was infected while driving his taxi in Chinandega, a city of a half-million people. His family was not allowed to view the body before burial, he said. “They only let my brother see through a window that they’d wrapped him in black plastic,” he said. Guillermo Maltez is not one of the country’s eight recognized coronavirus deaths.

As coronavirus fears grow, doctors and nurses face abuse, attacks

Nicaragua’s official count pales beside those of its neighbors. Costa Rica, with one of the strongest health systems in Latin America, has reported 863 confirmed cases and 10 deaths from covid-19, according to a tally by Johns Hopkins University. Honduras had 2,565 cases and 138 deaths.

“Of course there’s an undercount,” said Álvaro Ramírez, the epidemiologist who led Nicaragua’s response to the cholera epidemic that swept through Latin America from 1991-93. “The government isn’t reporting the real number of deaths or those infected.”

A Sandinista legislator, Carlos Emilio López, said in a video on May 6 that Nicaragua was prepared to confront covid-19. “It’s not true that in Nicaragua, the hospitals are collapsed, full, overwhelmed or saturated,” he said.

Outside hospitals, though, the reality is different: desperate families seeking information about their relatives, hearses driving away with bodies.

Then there are the “express burials,” documented in cellphone videos shared on social media and in local news reports.

Late last month, a 57-year-old government worker was quietly interred in Managua, after dying of what was classified as cardiogenic shock, a heart problem.

The burial was so swift that “they put him in the coffin in his hospital gown,” said the man’s daughter, who spoke on the condition of anonymity for fear of reprisal. “At 5 in the morning they buried him without his family present.”

A group of 600 Nicaraguan doctors and other health professionals signed a letter late last month calling on the government to impose social distancing, suspend classes in schools and provide protective equipment for health personnel. Ortega and his wife, Vice President Rosario Murillo, have not responded. They have also not appeared in public since April.

Meanwhile, the hospitals are filling with mysterious cases of a severe respiratory disease.

Sheridan reported from Mexico City.

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