The lower number cases in Cuba is due to the fact that its health system devised a strategy for dealing with the developing coronavirus crisis in January 2020.
So close and yet so far away: 106 miles from Havana to Key West, Florida as the crow flies, and a one-hour flight from Miami to Havana.
By Penny Gardner Women Against Military Madness Vol. 38 Num. 4 Fall 1 2020
Comparing Cuba and the U.S.
[i]“Coronavirus Updated.” Worldometer. worldometers.info August 28, 2020
The lower number cases in Cuba is due to the fact that its health system devised a strategy for dealing with the developing coronavirus crisis in January 2020. The plan included educating medical personnel as well as the public, so citizens would be informed about virus warning signs and preventive measures. Quarantine and treatment facilities were put in place before the first cases of COVID-19 were confirmed among three Italian tourists in early March. By then, a system of contact tracing and isolation protocols was already in place.
When the number of confirmed virus cases rose to 21 on March 20, containment actions were instituted. Tourist arrivals were stopped, a significant decision given the reliance the Cuban economy places on tourism. According to WorldAware, a risk management company, by early April public transportation was shut down and restrictions on nonessential shipping were implemented. Essential transport, such as medical services, was allowed to operate, with the use of facemasks mandated. In addition, the government “requested that all foreign sea-going vessels withdraw from Cuban waters, with limited exceptions.” Cargo operations and humanitarian flights were able to continue. Schools, gyms, theaters and cultural centers had previously been ordered closed. Some localities had curfews and restrictions of movement in or out of the community in place.
A Study of Cuba’s Response
Helen Yaffe, an historian and lecturer in economic and social history at the University of Glasgow, specializes in Cuban and Latin American development. In her article “Leading by Example: Cuba in the COVID-19 Pandemic,” she has written in depth about Cuba’s response to COVID-19. Yaffe notes that:
the population went under ‘lockdown’ on March 20. Business taxes and domestic debts were suspended, those hospitalized had 50% of their salaries guaranteed and low-income households qualified for social and family assistance schemes, with food, medicine and other goods delivered to their homes. Workshops nationwide began to produce masks, bolstered by a grassroots movement of home production, and community mutual aid groups organized to assist the vulnerable and elderly with shopping for food as long queues became the norm.
Cuba considers healthcare a human right and has a public health system that focuses on disease prevention. According to Yaffe, in 1983 Cuba instituted a system of neighborhood family medicine practices, and with this system, the doctor or nurse lives above the practice, providing 24-hour availability:
“Once the first cases were confirmed, the family-doctor daily house visits were extended and became the single most important tool for active case detection to get ahead of the virus. Some 28,000 medical students joined them going door to door to detect symptoms.”
Cuban medical team arrives in South Africa. Photo: European CEO
Yaffe describes the outcome of these daily home visits:
People with symptoms were remitted to their local polyclinic for rapid evaluation. Those suspected of having COVID-19 are sent to one of the new municipal isolation centers where they remain for 14 days receiving testing and medical attention. If symptoms proved not to be COVID-19, they return home, but must stay indoors for 14 days and are followed in primary care. In addition, the homes and communal entrances of patients sent to isolation centers are disinfected by ‘rapid response teams’ consisting of polyclinic directors and vice directors, alongside of family members.
Regarding medications, Yaffe indicates that Cuba has used 22 drugs in prevention (focusing on measures to enhance immunity) and treatment. Most of them are produced in Cuba. Heberon, an interferon Alfa 2b, showed promise. (Interferons are naturally occurring proteins that have anti-viral properties. Interferons have been used worldwide to treat viral infections such as dengue fever and hepatitis B and C.) Further, Yaffe explains that:
on April 14, it was reported that out of the 93.4% of COVID-19 patients in Cuba who had been treated with Heberon, only 5.5% of those reached a serious state. The mortality rate in Cuba reported by that date was 2.7%, but for patients treated with Heberon, it was 0.9%.
Yaffe also cites the preventive use of Heberon in China: “In Wuhan, China, nearly 3,000 medical personnel received Heberon as a preventive measure to boost their immune response: none of them contracted the virus. Meanwhile 50% of another 3,300 medics who were not given the drug did get COVID-19.
Due to this success, many countries have requested access to Heberon. Cuba also has other drugs in use and in development, as well as vaccines.
A History of Medical Internationalism
The success of Cuba’s biomedical industry is inspiring given the challenges of the six-decades- long U.S. criminal blockade, which includes food and medicine. After Cuba lost the support of the Soviet Union in 1989, the U.S. tightened the blockade in the 1990s, and by 1999, fearing penalties from the U.S., very few international pharmaceutical companies were trading with Cuba, causing serious shortages of medications and materials to manufacture medicines.
Cuba has a long history of medical internationalism. According to an article in Al Jazeera, as early as1960, “Cuba sent a team of medics to Chile after a devastating earthquake hit the country.” In 1963, Cuba sent medical workers to help newly independent Algeria build its healthcare sector. Currently (from remarks on July 30 by Cuban President Diaz-Canel) “a total of 45 Henry Reeve brigades specialized in disasters and major epidemics are now working in 38 countries with 3,772 members – including 2,399 women – who have assisted more than 250,000 COVID-19 patients.”
In the U.S., Reactionary Forces
Although Cuba had provided these invaluable medical services, on June 17, three senators, Rick Scott and Marco Rubio, both of Florida, and Ted Cruz of Texas, introduced the bill “Cut Profits to the Cuban Regime Act.” The Cuba Solidarity Campaign (CSC), a British organization that advocates for Cuba against foreign intervention, strongly condemned the bill, which, it says, “aims to punish countries which accept Cuban medical missions. If passed, the act would list those nations with Cuban medical brigades in the State Department’s annual Trafficking in Persons (TIP) report, unless they complied with U.S.- imposed regulations on how they worked with Cuba.” Contrary to what the senators allege, the facts are, as CSC, explains:
Depending on the resources of those countries, the brigades either work free of charge, or the Cuban government receives payment from the host nations. Those who volunteer abroad retain their salary at home, which is paid to their families while they are away, as well as receiving an agreed percentage of the host nation’s payment. The remainder is used to support medical brigades in poorer nations and Cuba’s health service at home.
Characterizing the medical brigades as human trafficking is simply a guise designed to discredit the Cuban medical project. Usually human trafficking refers to the coerced use of persons for labor or sexual exploitation. In an interview with The Nation, “Dr. Gracilliano Diaz, a veteran of the campaign against Ebola in Sierra Leone 2014, dismissed the idea that he is a victim of trafficking: ‘We do this voluntarily, it doesn’t matter to us that other countries brand us as slaves. What matters to us is that we contribute to the world.’”
In addition to U.S. government officials, the nongovernmental organization Human Rights Watch (HRW), which has been much criticized for its U.S. political bias, also leveled an unjust attack on the Cuban medical brigades. On July 23, 2020, HRW released a report, “Cuba: Repressive Rules for Doctors Working Abroad,” that claims:
the Cuban government imposes draconian rules on doctors deployed in medical missions globally that violate their fundamental rights… Governments seeking support from Cuban health workers should press Cuban authorities to modify applicable regulations and laws that violate the right to privacy, freedom of expression and association liberty and movement among others.
Consideration for the Nobel Peace Prize
In response, on August 11, 2020, the Cuba Nobel Organizing Committee, which is promoting the Cuban medical brigades to receive the Nobel Peace Prize, released a statement: “Misrepresentative and Flawed Human Rights Watch Report on Cuba.” The organizing committee charges that the HRW report is “spurious, repeating shameful and already debunked accusations.” Cuba Nobel points out that although the volunteers are “not diplomats in a formal sense, it makes sense that they are discouraged from visiting places that will damage their prestige, need authorization to speak to the media and to participate in public acts of a political or social nature.” The regulation “protects them from false accusations of political interference.” The regulation also reassures a country like Honduras – where the government is the ideological opposite of Cuba – that the doctors it receives will not interfere in domestic Honduran affairs.”
After excoriating HRW for its attack on the medical brigades, Cuba Nobel concluded that “it would be more relevant to ask the U.S. government to lift the sanctions on Cuba that violate international law and the right of the Cuban people to their basic needs, including food and medicine, during a pandemic.”
Calls for Collaboration with Cuba
The National Network on Cuba (NNOC) has called for collaboration between the U.S., Canada, and Cuba to fight against COVID-19. In the U.S., municipal entities, including Richmond, California, and San Francisco, have passed resolutions supporting collaboration with Cuba to fight COVID-19 in their communities.
Women Against Military Madness formed the Solidarity Committee on the Americas (SCOTA), which includes members with medical and public health backgrounds. SCOTA was instrumental in creating SF4619, a resolution introduced by Minnesota State Senator Sandra Pappas, calling for Minnesota and the United States to actively pursue medical and scientific collaboration with Cuba to effectively fight COVID-19. A companion bill, HF4690, was introduced in the Minnesota House by Representative John Lesch. On August 9, 2020, Senator Pappas sent a letter to Governor Walz urging collaboration with Cuba to learn from its success in dealing with COVID-19. The letter was signed by four other state senators and six state representatives.
SCOTA is also pursuing an online forum between MEDICC (Medical Education Cooperation with Cuba) and some of the deans in the Academic Health Center at the University of Minnesota to explore the possibility of collaboration.
Certainly, Cuba’s development of innovative pharmaceuticals in the fight against COVID-19 is important and should be acknowledged as a significant achievement. However, it is clear that low-tech, people-powered interventions such as mobilizing public health resources, rigorous daily monitoring for early detection, enforcing quarantine practices, educating the public and medical providers, providing early testing, and reinstituting lockdown when new cases surge in a locale are the most important reasons for the containment of the virus in Cuba.
Penny Gardner is a member of Solidarity Committee of The Americas (SCOTA) and serves on the WAMM Board. A retired registered nurse, she has visited Cuba.
ACTIONS & INFO:
Endorse the Saving Lives campaign at firstname.lastname@example.org.
Sign the petition at cubanobel.org promoting the nomination of the Cuban International Medical Brigade for the 2021 Nobel Peace Prize.
Follow SCOTA on Facebook and at womenagainstmilitarymadness.org
Join a SCOTA meeting: contact email@example.com
 “Coronavirus Updated.” Worldometer. worldometers.info August 28, 2020
 “COVID-19 Alert: Cuba Imposes Public Transportation and Commercial Restrictions as of April 10” worldaware.com April 10, 2020
 “Leading by Example: Cuba in the COVID-19 Pandemic.” Yaffe, Helen. CounterPunch. counterpunch.org June 4, 2020
 “Cuba has a history of sending medical teams to nations in crisis.” Petkova, Mariya. Al Jazeera English. aljazeera.com
 “Anti-imperialist unity is the tactic and strategy of victory,” from remarks by Cuban President Diaz-Canel at a videoconference on July 30, 2020. National network on Cuba. nnoc.info August 27, 2020
 “CSC condemns U.S. threat to medical internationalism.” Campaign News. cuba-solidarity.org.uk July 1, 2020
 “Cuba Has Sent over 2,000 Doctors and Nurses Overseas to Fight COVID-19.” Agustin, Ed. The Nation. thenation.com May 22, 2020
 “Cuba: Repressive Rules for Doctors Working Abroad.” Human Rights Watch hrw.org July 23, 2020
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