{"id":7110,"date":"2020-04-18T21:55:17","date_gmt":"2020-04-19T01:55:17","guid":{"rendered":"https:\/\/latinamericasecurityreport.com\/?p=7110"},"modified":"2020-04-18T21:55:17","modified_gmt":"2020-04-19T01:55:17","slug":"coronavirus-response-why-cuba-is-such-an-interesting-case","status":"publish","type":"post","link":"https:\/\/latinamericasecurityreport.com\/?p=7110","title":{"rendered":"Coronavirus Response: Why Cuba Is Such an Interesting Case"},"content":{"rendered":"<figure style=\"width: 3762px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full\" src=\"https:\/\/images.theconversation.com\/files\/327758\/original\/file-20200414-117598-1bqzh9v.jpg\" width=\"3762\" height=\"2946\"><figcaption class=\"wp-caption-text\">Yander Zamora\/EPA<\/figcaption><\/figure>\n<p>Some countries seem to be weathering the coronavirus pandemic better than others. One country that moved rapidly to deal with the emerging threat was Cuba.<\/p>\n<p>Cuba has several advantages over many states, including free universal healthcare, the world\u2019s highest ratio of doctors to population, and <a href=\"https:\/\/www.who.int\/phi\/publications\/Cuba_case_study121115.pdf\">positive health indicators<\/a>, such as high life expectancy and low infant mortality. Many of its doctors have volunteered <a href=\"https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/0094582x07308119\">around the world<\/a>, building up and supporting other countries\u2019 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.<\/p>\n<p>Also, with a centrally planned, state-controlled economy, Cuba\u2019s 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 <a href=\"https:\/\/doi.org\/10.1002\/pad.236\">low loss of life<\/a> from hurricanes.<\/p>\n<p>However, COVID-19 presents differences. Cuba\u2019s lack of resources, which <a href=\"http:\/\/www.ijmed.org\/articles\/316\/\">hampers recovery<\/a> from disasters, also contributes to a <a href=\"https:\/\/cubaposible.com\/vivienda-cuba-socialismo-reformas\/\">housing shortage<\/a> that makes physical distancing difficult. And the island\u2019s poor infrastructure creates logistical challenges.<\/p>\n<p>Also, the pandemic comes at a particularly difficult time, as <a href=\"https:\/\/www.reuters.com\/article\/us-cuba-sanctions-investment-analysis\/tougher-u-s-sanctions-make-cuba-ever-more-difficult-for-western-firms-idUSKBN1WO2LP\">tightened US sanctions<\/a> have sharply cut earnings from tourism and other services, deterred foreign investment, hampered trade (including medical equipment imports) and obstructed access to international finance \u2013 including emergency funds.<\/p>\n<p>Given these strengths and weaknesses, Cuba provides an interesting case study in responding to the current pandemic.<\/p>\n<p>Cuba\u2019s reaction to the coronavirus threat was swift. A <a href=\"http:\/\/www.granma.cu\/informacion-minsap\/2020-02-03\/sin-casos-de-coronavirus-en-cuba-pero-alertas-y-preparados-03-02-2020-00-02-55\">\u201cprevention and control\u201d plan<\/a>, prepared in January 2020, included training medical staff, preparing medical and quarantine facilities, and informing the public (including tourism workers) about symptoms and precautions. So, when the first three reported cases were confirmed on March 11, arrangements were 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 programme.<\/p>\n<p>On March 20, with 21 confirmed cases reported, the <a href=\"http:\/\/www.granma.cu\/cuba-covid-19\/2020-03-20\/en-vivo-gobierno-cubano-encabezado-por-el-presidente-informa-reforzamiento-de-medidas-contra-la-covid-19\">government announced<\/a> a ban on tourist arrivals, lockdown for vulnerable people, provision for home working, reassignment of workers to priority tasks, employment protection and social assistance.<\/p>\n<p>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.<\/p>\n<p>With <a href=\"https:\/\/www.worldometers.info\/coronavirus\/\">766 reported cases<\/a> by April 15 (68 cases per million of population), Cuba is around the middle of the range for Latin America and the Caribbean.<\/p>\n<figure class=\"align-center \">\n<figure style=\"width: 600px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/images.theconversation.com\/files\/327652\/original\/file-20200414-117573-17rf1fl.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\" sizes=\"auto, (min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px\" srcset=\"https:\/\/images.theconversation.com\/files\/327652\/original\/file-20200414-117573-17rf1fl.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=655&amp;fit=crop&amp;dpr=1 600w, https:\/\/images.theconversation.com\/files\/327652\/original\/file-20200414-117573-17rf1fl.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=655&amp;fit=crop&amp;dpr=2 1200w, https:\/\/images.theconversation.com\/files\/327652\/original\/file-20200414-117573-17rf1fl.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=655&amp;fit=crop&amp;dpr=3 1800w, https:\/\/images.theconversation.com\/files\/327652\/original\/file-20200414-117573-17rf1fl.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=823&amp;fit=crop&amp;dpr=1 754w, https:\/\/images.theconversation.com\/files\/327652\/original\/file-20200414-117573-17rf1fl.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=823&amp;fit=crop&amp;dpr=2 1508w, https:\/\/images.theconversation.com\/files\/327652\/original\/file-20200414-117573-17rf1fl.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=823&amp;fit=crop&amp;dpr=3 2262w\" alt=\"\" width=\"600\" height=\"655\"><figcaption class=\"wp-caption-text\">Latin America and the Caribbean: reported cases per million, April 13th 2020. World Health Organization<\/figcaption><\/figure><\/figure>\n<p>The quality of data varies hugely between countries, with some governments substantially under-reporting cases. Cuba\u2019s reported cases are based on tests using WHO protocols. Two Caribbean neighbours, using similar methods, provide useful comparisons. The Dominican Republic, the most closely comparable in terms of population, income and tourism dependence, shows how the disease might have spread if measures had been less effective. In contrast, Jamaica seems to have succeeded in halting the spread of the disease.<\/p>\n<figure class=\"align-center \">\n<figure style=\"width: 600px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/images.theconversation.com\/files\/327798\/original\/file-20200414-117567-7ltqnt.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\" sizes=\"auto, (min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px\" srcset=\"https:\/\/images.theconversation.com\/files\/327798\/original\/file-20200414-117567-7ltqnt.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=361&amp;fit=crop&amp;dpr=1 600w, https:\/\/images.theconversation.com\/files\/327798\/original\/file-20200414-117567-7ltqnt.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=361&amp;fit=crop&amp;dpr=2 1200w, https:\/\/images.theconversation.com\/files\/327798\/original\/file-20200414-117567-7ltqnt.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=361&amp;fit=crop&amp;dpr=3 1800w, https:\/\/images.theconversation.com\/files\/327798\/original\/file-20200414-117567-7ltqnt.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=453&amp;fit=crop&amp;dpr=1 754w, https:\/\/images.theconversation.com\/files\/327798\/original\/file-20200414-117567-7ltqnt.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=453&amp;fit=crop&amp;dpr=2 1508w, https:\/\/images.theconversation.com\/files\/327798\/original\/file-20200414-117567-7ltqnt.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=453&amp;fit=crop&amp;dpr=3 2262w\" alt=\"\" width=\"600\" height=\"361\"><figcaption class=\"wp-caption-text\">Cumulative cases per million, Cuba, Dominican Republic and Jamaica. World Health Organization<\/figcaption><\/figure><\/figure>\n<p>Jamaica\u2019s initial response was similar to Cuba\u2019s, but fewer cases had slipped into the country undetected before tourism was halted. Having identified 16 outbreak clusters now, Cuban authorities are still struggling to prevent a take-off.<\/p>\n<p>What happens next in Cuba will depend largely on the amount of <a href=\"https:\/\/theconversation.com\/coronavirus-a-warning-to-latin-america-and-the-caribbean-to-dramatically-increase-covid-19-testing-135759?utm_medium=email&amp;utm_campaign=Latest%20from%20The%20Conversation%20for%20April%208%202020%20-%201588015209&amp;utm_content=Latest%20from%20The%20Conversation%20for%20April%208%202020%20-%201588015209+CID_cb88893669b74d0ced1341ba0a25c780&amp;utm_source=campaign_monitor_uk&amp;utm_term=Coronavirus%20a%20warning%20to%20Latin%20America%20and%20the%20Caribbean%20to%20dramatically%20increase%20COVID-19%20testing\">testing<\/a>. An indicator of commitment to this task is the ratio of tests to reported cases. According to available data, Cuba (with <a href=\"https:\/\/www.worldometers.info\/coronavirus\/\">18,825 tests done<\/a>) leads the region with a ratio of 25:1, compared with 16:1 in Jamaica and 3:1 in the Dominican Republic. (Vietnam and Taiwan have over 100:1, Germany 10:1, US 5:1 and UK 4:1.) Around 40% of Cuba\u2019s recent positive results are from asymptomatic cases.<\/p>\n<p>If Cuba\u2019s contact-tracing and testing regime gets the disease under control, its experience might offer lessons for controlling the pandemic, and more of its doctors will be available to help with the effort to combat the pandemic abroad.<\/p>\n<p>But tests are expensive, at around US$50 each, so if its hard-fought battle against COVID-19 is prolonged, Cuba\u2019s lack of access to finance could prove fatal.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img loading=\"lazy\" decoding=\"async\" style=\"border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;\" src=\"https:\/\/counter.theconversation.com\/content\/135749\/count.gif?distributor=republish-lightbox-basic\" alt=\"The Conversation\" width=\"1\" height=\"1\"><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https:\/\/theconversation.com\/republishing-guidelines --><\/p>\n<p><a href=\"https:\/\/theconversation.com\/profiles\/emily-morris-103448\">Emily Morris<\/a>, Research Associate, Institute of the Americas, <em><a href=\"https:\/\/theconversation.com\/institutions\/ucl-1885\">UCL<\/a><\/em> and <a href=\"https:\/\/theconversation.com\/profiles\/ilan-kelman-166473\">Ilan Kelman<\/a>, Professor of Disasters and Health, <em><a href=\"https:\/\/theconversation.com\/institutions\/ucl-1885\">UCL<\/a><\/em><\/p>\n<p>This article is republished from <a href=\"https:\/\/theconversation.com\">The Conversation<\/a> under a Creative Commons license.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Some countries seem to be weathering the coronavirus pandemic better than others. One country that moved rapidly to deal with the emerging threat was Cuba. Cuba has several advantages over many states, including free universal healthcare, the world\u2019s highest ratio of doctors to population, and positive health indicators, such as high life expectancy and low&hellip;<\/p>\n","protected":false},"author":124,"featured_media":7366,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"fifu_image_url":"https:\/\/images.theconversation.com\/files\/327758\/original\/file-20200414-117598-1bqzh9v.jpg","fifu_image_alt":"Coronavirus Response: Why Cuba Is Such an Interesting Case","footnotes":""},"categories":[192],"tags":[],"class_list":["post-7110","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-polity-governance"],"_links":{"self":[{"href":"https:\/\/latinamericasecurityreport.com\/index.php?rest_route=\/wp\/v2\/posts\/7110","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/latinamericasecurityreport.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/latinamericasecurityreport.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/latinamericasecurityreport.com\/index.php?rest_route=\/wp\/v2\/users\/124"}],"replies":[{"embeddable":true,"href":"https:\/\/latinamericasecurityreport.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=7110"}],"version-history":[{"count":1,"href":"https:\/\/latinamericasecurityreport.com\/index.php?rest_route=\/wp\/v2\/posts\/7110\/revisions"}],"predecessor-version":[{"id":7112,"href":"https:\/\/latinamericasecurityreport.com\/index.php?rest_route=\/wp\/v2\/posts\/7110\/revisions\/7112"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/latinamericasecurityreport.com\/index.php?rest_route=\/wp\/v2\/media\/7366"}],"wp:attachment":[{"href":"https:\/\/latinamericasecurityreport.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=7110"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/latinamericasecurityreport.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=7110"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/latinamericasecurityreport.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=7110"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}