A woman wears a mask against the spread of COVID-19 disease, as she attends a funeral at the Central cemetery of Managua, Nicaragua, Monday, May 11, 2020. President Daniel Ortega's government has stood out for its refusal to impose measures to halt the new coronavirus for more than two months since the disease was first diagnosed in Nicaragua. Now, doctors and family members of apparent victims say, the government has gone from denying the disease's presence in the country to actively trying to conceal its spread. (AP Photo/Alfredo Zuniga)
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MANAGUA, Nicaragua (AP) — Nearly three dozen medical associations in Nicaragua have called on people to observe a “national quarantine” of at least three or four weeks in an attempt to slow the coronavirus pandemic, a step the government has not taken.

“The exponential increase of COVID-19 cases has caused the collapse of the public and private health systems,” the groups said in an open letter Monday. They said hospitals were full, there weren’t enough beds, medicines were lacking and essential things like oxygen were in short supply.

The government of President Daniel Ortega has not enacted the social distancing measures of its neighbors despite growing evidence of the virus’ spread. Schools remain open and the government has continued to organize mass gatherings even as Nicaraguans report that some people are being rushed from hospitals to immediate burial by workers wearing protective suits..

The medical associations called for the voluntary closure of nonessential businesses, urged people to remain in their homes, limit grocery shopping to once a week, maintain a safe distance from others and wear masks.

Doctors have complained that they are ill-equipped to handle COVID-19 patients and a number have been infected. The letter came shortly after the death of a well-known dermatologist, Aldo Martínez Campos. Róger Pasquier, president of Nicaragua's Association of Anesthesiologists said Martínez had died from COVID-19, making him the 29th health worker to die from the disease.

The letter warned that Nicaragua was “in the phase of accelerated expansion and community spread, which will continue worsening with greater loss of life if the corresponding auhtorities do not urgently take measures on a grand scale to try to contain the pandemic’s advance.”

The Pan-American Health Organization has urged Nicaragua to take steps to slow its spread, but said its offers of expert assistance had been declined. The government has reported more than 700 confirmed infections and 35 deaths, but it has done little testing, and the nongovernmental group Citizen Observatory has counted nearly 4,000 suspected infections and some 800 deaths.

Ortega has blamed his political opposition for exaggerating the virus threat, saying that it's the same people he accused of trying to overthrow him in 2018. He has said Nicaragua cannot afford to stop working.

The gravity of the situation in Nicaragua had led the Costa Rican government to impose strict rules at its borders on commercial truck drivers. Initially, it refused any showing symptoms and made others await test results before allowing them to enter the country.

Nicaragua reacted angrily and closed the border, cutting road routes that connect the whole region. After nearly three weeks of interrupted cargo traffic, the border was reopened Sunday. Central American governments signed an agreement Saturday on basic health protocols for cargo drivers after Costa Rica agreed to relax its rules slightly.

Costa Rica Foreign Minister Dyalá Jiménez said truck drivers would have five days in the country to deliver a load and pick up a new one before leaving.