“Medical care began at 3:25 p.m. and concluded at 3:40 p.m. Vital signs: Blood pressure 120/60; 84 heartbeats per minute; oxygen saturation 99%; heartbeat regularity 88,” the statement said.

“During the medical care Rolando Álvarez Lagos expressed that he feels well and continues to exercise. The doctor reported that Rolando Álvarez’s vital signs and state of health are fine. He did not undergo blood tests because he had eaten food,” the dictatorship’s statement concluded.

The images released show the bishop looking thinner. The last time he was shown to the media was at the end of November 2023, when the regime shared photographs of another medical examination.

The images and the official statement were published shortly after the U.S. State Department again urged the Nicaraguan government to “immediately and unconditionally release” Álvarez.

“President Daniel Ortega and Vice President Rosario Murillo have unjustly incarcerated Bishop Rolando Álvarez for 500 days,” reads the Jan. 2 statement by State Department spokesman Matthew Miller. “During that time, Nicaraguan authorities have kept Bishop Álvarez in isolation, blocked independent evaluation of the conditions of his imprisonment, and released staged videos and photographs that only increase concerns about his well-being.” 

The statement notes that, in addition to the bishop of Matagalpa, many religious leaders remain “unjustly” detained in Nicaragua, including Bishop Isidoro Mora and several priests.