Cuba's people-first response to COVID-19

Issue 
While South America is emerging as the new epicentre of the COVID-19 pandemic, Cuba stands out as a counter example. Photo by Otmaro Rodríguez, OnCuba.

Many people around the world have heard of Cuba's inspiring and unmatched international medical solidarity efforts in the COVID-19 pandemic. About 2000 Cuban doctors and nurses have been send to countries around the world struggling to deal with the pandemic – from Italy to South Africa, and even Brazil, whose right-wing government had previously dismissed Cuban doctors working there on ideological grounds.

More than 40 European organisations are backing a proposal to award the Nobel Peace Prize to Cuba's international medical brigade for its contribution to the global battle against COVID-19.

But how is Cuba faring in the struggle against the pandemic at home?

Cuba's COVID-19 statistics give us a clue. As of May 28, Cuba, with a population of 12 million people, had 1974 confirmed cases, based on tests using World Health Organization (WHO) protocols. Of those, 1724 (87%) have recovered. Cuba had just 82 COVID-19 deaths, even fewer than a rich, relatively remote island state like Australia. 

COVID-19 is hitting South America hard. On May 27, Brazil surpassed the United States to become the country with the highest daily COVID-19 death toll of 807. WHO has warned that South America is emerging as a “new epicentre of the coronavirus pandemic”, with nearly 800,000 out of 5 million global cases and more than 143,000 deaths reported on May 25.

What is the secret of Cuba’s success? First of all, Cuba was one of the countries to respond swiftly and promptly to the pandemic. Its socialist government took the opposite response to the Trump administration in the US and the Boris Johnson’s Conservative government in Britain.

By January, a comprehensive “prevention and control” plan had been prepared, according to a report in The Conversation by Emily Morris, a University College of London (UCL) research associate and Illan Kelman, professor of disasters and health at UCL. This plan included the training medical staff, preparing medical and quarantine facilities, and informing the public (including tourism workers) about symptoms and precautions. 

By the time the first three reported cases were confirmed on March 11, arrangements were already in place to trace and isolate contacts, mobilise medical students for nationwide door-to-door surveys to identify vulnerable people and check for symptoms, and roll out a testing program.

“Cuba has several advantages over many states, including free universal healthcare, the world’s highest ratio of doctors to population, and positive health indicators, such as high life expectancy and low infant mortality,” explained Morris and Kelman.

“Many of its doctors have volunteered around the world, building up and supporting other countries’ health systems, while gaining experience in emergencies. A highly educated population and advanced medical research industry, including three laboratories equipped and staffed to run virus tests, are further strengths.

“With a centrally planned, state-controlled economy, Cuba’s government can mobilise resources quickly. Its national emergency planning structure is connected with local organisations in every corner of the country. The disaster-preparedness system, with mandatory evacuations for vulnerable people, such as the disabled and pregnant women, has previously resulted in a remarkably low loss of life from hurricanes.”

However, Cuba is still a Third World country struggling to escape the consequences of hundreds of years of distorted economic development forced upon it by colonial and neo-colonial exploitation. This painful economic legacy is prolonged by the economic blockade still enforced by the US, its big rich imperialist neighbour.

Housing is still in short supply and Cubans are often forced to live in cramped conditions. Infrastructure, such as transportation and energy supply, is underdeveloped and subject to extreme resource shortages because of the US blockade. So “social distancing” is difficult to practice.

Tourism is a major and growing source of foreign exchange for Cuba, so the COVID-19 pandemic is inflicting huge economic costs.

Nevertheless, explain Morris and Kelman, on March 20, with just 21 confirmed cases reported, the government announced a ban on tourist arrivals, lockdown for vulnerable people, provision for working from home, reassignment of workers to priority tasks, employment protection and social assistance.

“As issues arose, the Cuban government adjusted its response. For example, when face-masks and physical distancing proved insufficient to keep public transport safe, services were suspended and state and private vehicles and drivers were hired to transport patients and essential workers. And to reduce crowding in shops, the distribution system was reorganised and online shopping introduced. Physical distancing enforcement has also been stepped up in response to instances of non-compliance,” they said.

Janice Argaillot, and Latin American studies scholar at the Université Grenoble Alpes in France, explained in another report in The Conversation (May 5), that another major strength of the Cuban response to COVID-19 was its effective public health information an education.

“The Cuban population is well prepared for what awaits it on its territory. They know that the virus is already present on the island, with several dozen cases detected in a few days (48 confirmed cases by March 24, 57 on March 26, 119 on March 29, 186 by April 1, 814 on April 14). Twenty-four deaths had been registered at that time, and nearly 2500 people were hospitalised because they presented the symptoms of the disease,” Argaillot explained.

“The first cases having been 'imported', the Cubans understood the government’s decision to close the country’s borders,” wrote Argaillot.

Cuba is largely dependent on tourism, an industry that brought Cuba more than US$3 billion in profit in 2018, according to Argaillot.

“The tourists still present on the island (32,500 according to Prime Minister Manuel Marrero) have been placed in quarantine. President Díaz Canel also announced the closure of schools for a month, saying it was the responsibility of families to ensure that children remain safely inside their homes. He also insisted on the need to respect social distancing, including in the queues that Cubans know only too well, especially in front of state shops.”

Information about the pandemic and steps that can be taken to avoid spreading the coronavirus has been sent out through official channels, she added. “Everyone thus can measure the role they have to play in the war against this invisible and ultimately unknown enemy.”

“Citizens and cuentapropistas (Cubans who work independently) are becoming dressmakers and making cloth masks because supplies of surgical masks are insufficient. Residents are practicing social distancing while waiting for a possible lockdown.”

Cubans understand the seriousness of the situation, reported Argaillot, even if fears of a food crisis are strong. They remember the difficult “Special Period” caused by the fall of the former Soviet Union, which had been Cuba's main economic partner and source of aid.

The neighbourhood-based Committees for the Defense of the Revolution (CDR) help spread instructions given by the government and monitor the appearance of symptoms among the population.

“This is an unprecedented crisis for many people on this planet,” wrote Argaillot, “but Cubans are used to living with violent upheavals, whether caused by the ravages of a hurricane or the financial and political blockade imposed by the United States, which has been further strengthened since Donald Trump came to power.

“There is thus no risk of seeing them fighting in supermarkets for a few rolls of toilet paper, as they have been living for decades with a ration book (the libreta) and are experiencing shortages of all kinds on a daily basis.”

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