Cuban health system collapses under pressure from overwhelming Covid surge | Cuba


Julia, a community doctor in Havana, was drafted into the intensive care unit shortly after Covid-19 first reached Cuba.

Last week, her cousin died from the virus. This week, she also tested positive amid an increase in the number of cases that has pushed the island’s much-vaunted health service to its limits and has drawn rare public criticism from Cuban doctors.

“It hurts to see people dying from this terrible virus,” she said, recovering at home from nausea after being injected with an immune stimulant. “The mood of doctors is getting worse by the day.”

After recording one of the lowest Covid rates in the world last year, Cuba now has one of the highest rates in the Western Hemisphere. The island, which reported 12,225 confirmed cases in 2020, has reported nearly 50 times so far this year. And with the Delta variant having taken hold, the lack of medical supplies is crippling the medical response.

“There are no antibiotics, no painkillers, the basic list of drugs is almost completely out of stock,” said Daniela, a family doctor in Havana who has had virtually no day. leave since the start of the pandemic.

Faced with the extreme shortage, doctors are increasingly prescribing herbal remedies. The morgues are overwhelmed. The country’s main oxygen plant recently broke down, exacerbating the critical care crisis.

Cuba hospitalized everyone who tested positive for Covid last year, including asymptomatic cases. But even for a country with the the highest doctor-to-patient ratio in the world, an average daily case load of 9,000 made this protocol impractical. Now children, the elderly, pregnant women and severe cases are hospitalized, while others have to isolate themselves at home.

Hundreds of doctors have been brought back from international “missions” abroad – a major generator of hard currency for the state – to support exhausted colleagues. But that move was not enough to keep the system, which last year was a model of testing, tracking and isolation, from unraveling.

“I was at home for eight days and no one came to see me,” said Oscar, a hotel worker in Cienfuegos who contracted Covid last month.

The pandemic, which has wiped out tourism, and US sanctions have pulled billions of dollars from state coffers, creating a severe economic crisis and contributing to unprecedented political unrest on the island. Cash-strapped, Cuba’s public health system has been forced to perform a triage: focusing on the expensive production of vaccines at the expense of other medical supplies.

Prime Minister Manuel Marrero last week acknowledged the depth of the crisis in unusually frank language.

Provinces “lack antigen testing [and] drugs, ”he told party officials in Cienfuegos. “But there are more complaints about subjective problems than objective problems. When you add the [complaints about] lack of drugs, they are lower than the number of complaints of ill-treatment, lack of care and home visits.

His comments sparked an uproar on social media, and 23 doctors in the eastern province of Holguin posted a video rebuttal on Facebook.

“We want to continue saving lives,” Heart specialist Dr Daily Almaguer said in the video. “We are not responsible for the collapse of health care in our country. “

The doctors have since been summoned by the authorities.

The peak, unimaginable last year, comes as Cuban scientists rush to gain immunity through vaccination. Cuba is the smallest country in the world to have developed its own vaccines against Covid. Soberana 2 and Abdala both have an efficacy rate of over 90%, according to clinical trials.

But US sanctions – supercharged by Trump, left in place by Biden – have slowed the rollout.

Children wearing masks as a precaution amid the spread of the new coronavirus cross a street in Havana. Photography: Ramón Espinosa / AP

Since the outgoing Trump administration designated Cuba as the “sponsor state of terrorism,” businesses have grown scared and only a handful of banks around the world will now transfer funds from Cuban entities, making imports difficult.

Cuban scientists say industrial-scale production of Soberana 2 has been stalled for weeks because they could not source an essential component.

“The lack of a little ingredient or a little controlling element can really disrupt production,” said Gail Reed, editor-in-chief of Medicc Review, a peer-reviewed health journal.

“The US sanctions have had a detrimental, if not deadly, effect on Cuba’s ability to cope with the latest wave.”

Although slow to come out of the starting blocks, Cuba now has the third highest vaccination rate in Latin America (behind Chile and Uruguay). Twenty-seven percent of the population are now fully immunized and 44% have received at least one dose.

By September, scientists say, the island will have produced enough doses to vaccinate the entire population.

“We remain in the fight against the pandemic,” said Dr Gerardo Guillén, lead developer at Abdala. “The vaccines are working, as the data is now showing,” he added, referring to falling infection and death rates in Havana, where the mass vaccination campaign has started.

Until millions more are fully immunized, the country’s exhausted army of underpaid doctors must trudge on.

“We are doing the impossible,” said Julia, the community doctor still mourning the death of her cousin. “Despite the lack of drugs, gloves and oxygen, doctors are fighting to save lives. They really are heroes.

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