During the Covid-19 pandemic, we have looked to the most affected great powers and countries for information and to see what measures they are taking. But perhaps we can find some interesting examples from other countries. One of the countries that has always provided good examples outside of the dominant mainstream has been Cuba. What is going on there? What measures have they taken? How have their health system and authorities reacted?
The first cases of the illness in Cuba were diagnosed on March 11. A day earlier, three Italian tourists with respiratory symptoms who had been staying at a guesthouse in the city of Trinidad, in the province of Sancti Spiritus, were identified. They had arrived at Havana airport on March 9. They were admitted to the Pedro Kourí Tropical Medical Institute (IPK) and immediately isolated. They were tested and in 24 hours diagnosed with the coronavirus.
Cuban authorities isolated seven persons who had had contact with the Italians: the bus driver, tour operator, and five persons at the guesthouse where they were staying.
Cuba had already instituted the Novel Coronavirus Plan for Prevention and Control on March 2, regulating and protecting the country’s borders with international health measures at all entry points in order to control the arrival of travellers infected with the coronavirus, as well as ensuring strict compliance with monitoring and control measures over those arriving from infected areas.
Then, on March 6, Cuba updated this Plan for Prevention and Control, adding “epidemiological observation” to travellers coming from countries that had already been infected, such as specific measures like temperature taking and isolation when necessary.
The plan required persons arriving with any symptom to present at an assistance center and follow control measures for 14 days. The prevention and contagion measures were also broadcast to the general public, along with assurances that the country had the necessary means to diagnose the virus and the medicines to treat the illness.
It was also determined that Cuban military hospitals would be used as isolation centers for sick covid-19 patients. On March 12, after the alarm over the diagnoses of the Italian tourists, the public was informed that, through incorporating the military hospitals, there would be 3,100 beds available throughout the country to treat the illness as a first step, including 100 for intensive care, and that specific centers and hospitals in each part of the country would be reserved for isolation and treatment of suspected and confirmed cases. Urgent care centers created special consultation areas for respiratory conditions, and special attention would be given to senior residences and other vulnerable groups.
On March 18, the 11th covid-19 patient was reported in Cuba, a 57 year old Canadian citizen who had arrived at Havana airport on March 14. Of the 10 previously confirmed cases, one had died early that morning and the rest were in stable condition, according to authorities. Cuba has an admitted 356 patients under epidemiological surveillance, of whom 101 are foreigners and 255 Cubans. In terms of primary care, 26,415 persons are under watch.
Cuba’s 2014 legislation determines that when natural, technological and health disasters prevent employees from performing their jobs, workers shall receive their entire salaries for one month and 60% for the rest of the time their work is suspended
To prevent the pandemic’s arrival on the island gravely affecting economic production as has happened in countries such as Spain and Italy, the Cuban government, accustomed to natural disasters, noted that its 2014 legislation determines that when natural, technological and health disasters prevent employees from performing their jobs, workers shall receive their entire salaries for one month and 60% for the rest of the time their work is suspended.
The Cuban government also approved extraordinary health spending for consumables, protection and intensive therapy teams. They also made the groundbreaking decision to activate a group of experts at Cuban research centers to investigate how to bring new products to treat covid-19 to both Cuba and other infected countries.
The Cuban Antiviral
Patients sickened with the coronavirus in China are already being treated with the Cuban antiviral Interferón Alpha 2B Recombinant (IFNrec). This pharmaceutical is being produced at the Chinese-Cuban ChangHeber factory in China’s Jilin province since January 25. It is one of the stars of Cuban biotechnology, also used against HIV viral infection, the human papilloma virus, and hepatitis types B and C. Furthermore, it has proven effectiveness against various types of cancer.
Interferón Alpha is one of the medications recommended in the treatment of covid-19 in the February 6, 2020 guide published by Chinese doctors in Wuhan, where the pandemic originated in December 2019. The medication is one of the products developed by the Cuban Center for Genetic Engineering and Biotechnology (CIGB), created on the island in 1986.
The combination of lopinavir and ritonavir inhibit and block the HIV virus and, it is hoped, will act in a similar way with the coronavirus.
Due to its good results in China, Cuban interferón began to be included in the treatment of a coronavirus patient in Seville, the first case in Spain. Authorized by the Ministry of Health, the Virgen del Rocío Hospital began an experimental treatment on a covid-19 patient that combined protease inhibitors (lopinavir/ritonavir) with interferón.
The combination of lopinavir and ritonavir inhibit and block the HIV virus and, it is hoped, will act in a similar way with the coronavirus. Interferón Beta, another pharmaceutical used in China and Seville that was studied in Cuba, has a distinct actuation mechanism. It is one of the so-called signalling proteins that naturally produce human cells when infected by a virus. Its job is to alert the other cells, thereby creating greater resistance to infection.
Four days later, health authorities announced that the Seville patient who underwent this treatment tested negative for the illness for the first time. Though the news is hopeful, more cases are necessary in order to consider it a clinical success, even though Cuban authorities have indicated that the medication has helped cure more than 1,500 patients.
Scientists insist that this not a vaccine but a palliative treatment that, and in the same way it has been used for other viral infections, from hepatitis to HIV, it has already surpassed many preliminary tests and can be used to treat the sick. In the foreseeable future, the Cuban medication will also be sent to Mexico, where scientists from that country have met with Cubans to study working jointly.
For their part, Italian organizations for solidarity with Cuba have asked the Italian minister of Health, Roberto Speranza, to seek collaboration with the Cuban government to confront the coronavirus covid-19 epidemic.
The Case of the British Cruise Ship
Cuba also took the lead on March 18 with a gesture of international solidarity that deserves mention. British cruise ship MS Braemar, with five coronavirus cases on board, was allowed to dock on the island with official authorization, so that passengers could be received and attended to before being sent on to the United Kingdom.
The boat, carrying more than 600 passengers, spent a 10 day odyssey in the Caribbean when no port would accept it. Cuba organized the complex disembarkment operation as well as the return of approximately 682 passengers to the United Kingdom, 668 of whom were British and the rest from more than a dozen European countries and other nationalities. The majority of the passengers were senior citizens, who spent a week on the British cruise ship MS Braemar as various Caribbean ports refused to accept them when five coronavirus cases were detected aboard. For humanitarian reasons and at the request of London, the Cuban government accepted to receive them and coordinated their return on four British Airways planes provided by the British government.
These acts of solidarity on the part of Cuba contrast with others, such as the decision of the Christian Social Party mayor of the Ecuadorian city of Guayaquil. She ordered several municipal vehicles to enter the country’s second largest city’s airport without authorization and block the runway, in order to prevent flights from Madrid or Amsterdam to land that were bringing crew members in order to collect European citizens and bring them back to the EU. Meanwhile, Wall Street bankers are pressuring major health corporations to raise their prices in light of the coronavirus.
Translated from its original in Spanish by Danica Jorden