Cuba’s epidemiological approach

by Merriam Ansara, June 7, 2019

Dr. Franscisco Duran Garcia, Cuba’s National Head of Epidemiology has said:   

“In Cuba we don’t wait until someone is diagnosed to begin therapeutic actions.  We administer [Cuban produced] PrevengHo-vir and Biomodulina-T to certain at risk groups such as elders, as well as in certain situations an anti-meningococcal vaccine that is of Cuban production.  What we seek with these actions is that these people’s immunologic system is strong enough that they don’t develop complications if they contract the virus.” 

In fact, PrevengHo-vir has been administered by the local family doctors to the whole population.  Of Cuban origin, it is a homeopathic medicine containing as well miniscule amounts of other epidemic diseases such as dengue, that had been used as a prophylactic in previous epidemic situations.”

Other measures taken:

• Daily door to door surveys in every neighborhood to check if anyone in the household has symptoms of any kind that can be related to the Covid-19 virus.

• Door to door sampling via rapid test in certain neighborhoods judged at risk, to screen especially for asymptomatic Covid victims

• Contact tracing of every person with which an infected person has come into contact in the 14 days prior to showing symptoms, or in the case of asymptomatic persons, days prior to testing positive.  Isolation/quarantine of those contacts for 14 days 

• All people quarantined for two weeks in observation centers are immediately treated even before showing symptoms. Treatment includes Interferon, Kaletra (an antiretroviral used in HIV/AIDS), chloroquine if necessary, and others 
• Obligatory two-week quarantine for all returning Cubans including medical personnel doing international missions abroad.
• Quarantine of neighborhoods or apartment complexes in areas where there have been significant numbers of cases or contacts of cases, for up to 28 days of the last diagnosed case or more as required.
• Use of protocols involving Heberon Alpha-2 Interferon, together with a monoclonal antibody and a peptide to treat serious or gravely ill patients
• Use of Cuban produced monoclonal antibody Itolizumab to prevent or lessen cytokine storm
• Once clinically released from the hospital, there is a two-week obligatory quarantine in one’s home under supervision of the local family doctor. If the PCR at the end of the two weeks remains negative, one is then designated as epidemiologically cured
• Daily work meeting of president and prime minister with all relevant ministries and structures to review, analyze and modify where needed the ongoing multi-sectoral work dealing with the prevention and control of coronavirus throughout the country.

The social measures taken:

• Required use of masks in all outdoor situations

• Required 3 feet distancing in all outdoor situations

• Shutdown of all public, interprovincial and international transportation, with special transportation provided for essential workers and for special social cases (i.e. patients who regularly need to go to hospital for dialysis or cancer treatments, etc.)

• Shutdown of all non essential businesses; certain eating establishments can provide take out or delivery service with strict hygiene measures observed

• Shutdown of all schools, primary through university, with special TV channels and hours dedicated to online classes; daycare centers with special measures in place may remain open for children of parents in essential jobs

• Rotation of all medical personnel attending patients:  14 days on; 14 days in quarantine; 7 days off

• Unified national approach with each province provided its share of equipment, general and ICU hospital beds, ventilators and PPE

• Mobilization of national and provincial Civil Defense to work with national and provincial public health systems in neighborhoods as they would in cases of natural disaster

• Mobilization and synchronization of scientific, medical and biotechnological workers with resources to work on solutions to virus

• Mobilization and synchronization of geographers, mathematicians, computer scientists and others to work on modeling progression of disease and on national and international forecasting of trajectory of the disease

• Daily television, radio and newspaper updates on current situation, with daily television roundtables with a rotating roster of ministers and specialists

• A special call-in line at the Ministry of Public Health where health personnel responds to questions and concerns from the public. Another special line for those needing psychological counseling and/or advice.