While almost the entire world, headed by the same capitalist system, begins to admit a profound social crisis and its complete inability to fight COVID-19, what happens in Cuba? How do you fight the pandemic starting from such a different healthcare model?
The first reported case of Covid-19 in Cuba was an Italian tourist from Lombardy on March 11. This is the moment when all precautions are taken, albeit with some caution.
Since the health system is public, free and universal, the government decides, in all areas, to control the pandemic and ensure health care for all patients. According to official statistics, there are 3,468 places available in the hospital and 477 in intensive care; hospitals and isolation centers have also been set up for sick people and cases suspected of having contracted the virus. The Ministry of Health provides official information on a daily basis, updating, among other things, the number of new cases and deaths, the State being the only source to have such statistics.
As of May 24, 94,060 PCR swabs have been performed for a total of 1,941 cases and 82 deaths.
However, the health system is not enough to adequately tackle the pandemic. The health system has developed its own treatment protocol, which is rigorous in the case approach and can count on health personnel, who makes daily efforts on the front line to prevent the spread of the virus. To better address the current situation in the country, it would be important to create action groups in all areas, from the hygienic-sanitary to the social, political, economic and institutional, that collaborated in the containment of Covid-19.
On 20 March the most important authorities appear on national television and report on the first general measures. Since then, almost 180 measures have been announced, some national and some local. But the state of emergency has not been declared in the country nor has a generalized quarantine been established.
Here are some of the measures that have had the greatest social impact: the closure of borders from March 24; the suspension of school, cultural, sporting and religious activities; the protection of low-income families; the 100% wage guarantee for the first month and 60% for the following months for public workers who saw their work interrupted; exemption from the payment of taxes by self-employed workers who find themselves unemployed.
Some protagonists of civil society have adopted individual initiatives, including making masks, creating unions of entrepreneurs to distribute food to the most vulnerable categories, reinventing small private companies.
The activity of the traffic police was also strengthened in order to guarantee public order and respect for the rules; because, on the one hand, in this historical period many positive social actions have been initiated, nevertheless a certain illegality remains especially in the most difficult contexts and where the needs are greatest.
Between March 27 and April 30, 503 people were sanctioned in the country for spreading epidemic, disobedience, resistance, contempt and panic buying and 418 sentences were pronounced, the president of the Criminal Section of the Supreme People’s Court said.
In general, crisis management is rated positive. Measures have been taken to limit rights such as freedom of movement, assembly, expression and others which allow for the accumulation of social and political capital. For example, in the management and coordination between national government and local authorities, in possible economic solutions launched by different social actors, in new forms of work organization or in actions to encourage e-commerce. Indeed, some decisions represent old requests from the population.
What were the main drugs used? There is a lot of talk about Interferon, the Cuban drug that seems to be among the best in the treatment of coronavirus. Furthermore, it was one of the first used for the treatment of the pandemic. At some point, the press stopped mentioning it. What’s its story? Is it still used in Cuba?
70 days after the appearance of Covid-19, it would seem that the situation is returning to “normal”. The last week has recorded the lowest number of cases since the outbreak and only 2 deaths. Havana continues to be the most affected city, but there are several areas in the country where no new cases have been reported for more than 14 days.
The Ministry of Health has introduced a national protocol of action against Covid-19, which defines the prevention and control of the epidemic as priorities.
Besides, it has set the steps to be followed by the population, with an active investigation to classify cases, guarantee treatment for the most vulnerable categories and follow the contacts and dismissals of confirmed cases.
It has been established that all those suspected of having contracted the virus or the contacts of confirmed cases must spend a period of time in isolation centers set up for this purpose, assisted by medical personnel. It has been also decided to use Biomodulin T, a Cuban drug that has given positive results in increasing immune defenses in people over 60 years of age who are guests of healthcare facilities; and it has been also decided to give the homeopathic drug PrevengHo-Vir to the whole population free of charge.
All cases suspected of having contracted the virus will be subjected to PCR to confirm the diagnosis.
With regard to the treatments used, cases suspected of having contracted the virus are given Interferon alfa 2b, Oseltamivir (selective influenza neuraminidase inhibitor) and Azithromycin. In addition, high-risk patients are treated with Kalestra, an antiretroviral drug used against HIV, and Chloroquine, with proven efficacy against malaria. The plasma of patients recovered from Covid-19 is also used.
Interferon, which has been controversial, is a treatment for the disease, but not a vaccine. It is a drug that supplements the deficiency of interferon caused by Sars-Cov-2 and strengthens the immune system. It is the most sold by Cuban biotechnology, formulated for the first time in 1981 and produced today in different parts of the world.
In this regard, the Cuban journalist Enrique Torres declares: “In early February, in the midst of the information wave that accompanied the spread of Covid-19, the news of a Cuban drug used in China to “cure” the illness went viral. This information created false expectations. (…) The choice of Recombinant Human Interferon Alpha-2b, marketed under the name of Heberon Alfa R, made by the National Health Commission in China responds to the tested efficacy of the drug with regard to viruses similar to the new coronavirus, but it is not a “cure”, said the President of BioCubaFarma. In addition, Marta Ayala, vice president of the Center for Genetic Engineering and Biotechnology (CIGB) of Cuba, recalled that in 2002, during the SARS crisis (severe acute respiratory syndrome), and in 2012, in the midst of MERS emergency (severe respiratory syndrome spread in the Middle East), interferons were used to prevent contagion and treat infected people. Scientists agree that it is not a real cure, but that the drug may be effective in treating Covid-19, particularly in the early stages of the disease.”
The authorities reported that in Cuba, patients who present a particularly complex clinical picture are treated with Interferon and 15 other national and three imported products.
Doctors consider it effective to treat patients even before confirmation of the diagnosis and this is to buy some days and strengthen the immune system.
After medical clearance, they must stay home for 14 days in quarantine and under medical supervision.
In addition, in various places of the country, the population is subjected to some studies carried out from a national diagnosis technology (SUMA). This allows to trace asymptomatic cases of Covid-19.
As it’s happening in the rest of the world, Cuban scientists are also looking for a vaccine or a definitive cure for the disease and there are already two ongoing clinical tests in the country that set this goal.
The work done by Cuban medical teams is well known. In the last few weeks, the international press has spoken highly of their recent work in various countries affected by the virus. What can you tell me about it?
Due to the experience accumulated in successful international medical collaboration and in response to situations of disaster and epidemics, the Cuban authorities have expressed their willingness and availability to expand medical services to cope with the current international situation.
So far 25 medical teams are already part of the Henry Reeve contingent, specialized in serious epidemics and catastrophes all over the world; they add up to the 59 teams of doctors who already work in different corners of the world, most of the times in places of difficult access and with little medical assistance.
The group was born in 2005 from an idea of Fidel Castro, when Hurricane Katrina threatened the areas of Mississippi, Alabama and Louisiana, in the United States, with the intention of bringing help to the affected populations. The hurricane never came, so the North American government did not give the permission.
In a context like the current one, the contribution of Cuban doctors, nurses and technicians around the world is based on the requests of the various countries asking for support, exhausted from the difficult situations of the health systems and aware of the experience of Cuban doctors. Those who leave their family without knowing when they will come back, risking of contracting the disease, deserve the praise and generous recognition of everyone, not only of those snatched from the jaws of death.
Given the complex situation of the island with regard to fuels, food, hygiene products and medicines, how is this being handled at the moment?
Before Covid-19, Cuba was already experiencing an economic crisis. Access to fuels, food, hygiene products and medicines was generally difficult. Now the situation is worse.
With malls closing to avoid gatherings of people along with markets that sold products in national currency at more accessible prices, and just a few shops open where you can only buy hygiene products and food, the supply of any other product becomes a real odyssey, comparable to the return of Ulysses to Ithaca, with an average queue of three or four hours to be able to enter and buy what you need.
Thanks to the “supplies booklet” it is possible to access a minimum of necessary products: rice, sugar, oil, salt, eggs, proteins, equally distributed to families. This mechanism has been in force in Cuba for several years and it is useful in this context for bringing essential foods to the greatest number of people. But it was not possible to apply it more extensively, because for some products there are not enough quantities to distribute to the whole population, stated the President.
So as for Covid-19, Cuba is the country of the queues. In times when social isolation is in force for everyone, this seems to be the only area of socialization, social life and necessity allowed to spend the days, even risking one’s health.
I suppose that, in this situation, the new measures taken on the North American economic embargo weigh even more on the Cuban population. Could you give some examples in this regard?
The North American embargo against Cuba exists and has increased over the course of Donald Trump’s administration. In recent months, difficulties have been encountered above all in the supply of fuels because, by prohibiting the entry of ships into national ports, access to North American-made products has also been prevented in the world and this makes the supply of medicines difficult.
For example, efforts have been made recently to hinder the Chinese company Alibaba, which was carrying a donation of medicines to Cuba and that only thanks to the adoption of creative solutions managed to reach the country.
The ability to send money from other countries to Cuba was also limited. Western Union can only operate from the United States and has canceled operations to Cuba from other states. This makes managing family economies difficult, since many families depend on foreign aid.
The embargo has always been an issue, not only in Covid times. It is a topic that affects all of us every day. But it is not the cause of all evils of Cuba. The reality is more complex. It is used as an alibi to justify inefficiency or mismanagement. And it is also something that has always stimulated collective creativity as our way of resisting.
How has the daily life of Cubans changed with the pandemic and in what aspects continues to be the same as always?
Cubans spend a large part of their lives outside, in constant socialization with neighbors, companions, passersby. It is very difficult to imagine Havana empty.
How would you describe the territory and the attitudes in Cuba in such a particular period? How has the life of Cubans changed and what has remained the same?
In Cuba, as in many other places in the world, the streets are desolate, empty.There are no tourists around, you don’t see children playing on the sidewalks, you don’t hear the screams during the traditional domino in the street. The popular HabaneroPromenade has been deserted for more than two months and life in general has taken on a virtual dimension, at least as far as possible, since Internet access remains limited and expensive.
Aside from the queues, looking near the shops, banks and collection points for agricultural products it would seem that the virus does not circulate around the island. The decontextualized images could give the impression of a revolutionary march, but this time the mobilization takes place in the name of a piece of chicken or a bottle of detergent.
Only the mask (also called nasobuco), an accessory that promises to stay on the world stage for a long time and a little anachronistic, considering the Caribbean heat, shows that this is Cuba after Covid-19. For the rest, life seems to flow on the same as before.
Translation from Italian by Ilaria Cuppone
*Jessica Dominguez Delgado graduated from the Universidad de La Habana in 2014, has collaborated with various media and is currently editor of Toque, an independent magazine that publishes information on COVID-19. She is particularly involved in national politics and specialises in data journalism.
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