A health worker measures a woman’s temperature at the entrance of Managua Cathedral in Managua, Nicaragua. Photograph: Inti Ocón/AFP/Getty Images

A letter published in the Guardian, arguing that the UK should take the lead from Nicaragua, where early strict measures have kept the coronavirus death rate one of the lowest in the world.

In learning lessons about how to handle Covid-19, another country could be added to the list (The UK and the US need to learn from countries that better handled Covid-19, 29 December). The Johns Hopkins University data shows that Nicaragua has one of the lowest death rates per 100,000 population in the world – 2.55 compared with over 100 for both the UK and the US. The pandemic has abated here even while it is resurgent in the US and Europe. Currently there are just 55 Covid-19 patients in Nicaragua’s public hospitals.

Although Nicaragua has had no lockdown, three factors appear to have been important, in addition to the country having a relatively young population. One is that, at an early stage, house-to-house visits took place, using trained volunteers, to dispense advice on how to avoid infection. A second is that in suspected cases other family members had to quarantine, and this was monitored actively by health officials. The third was that there were relatively few international travellers, but all had to quarantine and compliance was enforced.

As Laura Spinney says, many of the measurable factors in managing the pandemic have proved to be poor indicators of the outcome, as was the assumption that richer countries would do better. Another factor is that many tropical countries have had experience of dealing with other epidemics. They’ve learned what works best for them, even if this runs counter to what the experts advise in the US or Europe.
John Perry
Masaya, Nicaragua