The coronavirus pandemic has now killed over 400,000 people around the world, with the United States having the largest number of fatalities — over 110,000. The United Kingdom, Brazil and Italy follow with each nation’s death toll exceeding 30,000. With many nations and states now re-opening, public health officials warn that a loosening of social distancing practices will likely generate a second wave of COVID-19 infections that could delay a return to economic and social normalcy.
While the U.S. leads the world in the number of cases of and deaths from the coronavirus, the island nation of Cuba has one of the lowest rates of infection. In addition, Cuba has continued its 60-year practice of sending doctors and other medical personnel abroad to more than 160 countries. And, for the first time, Cuba has sent their physicians to two European nations — Italy and Andorra — to assist local medical workers care for coronavirus patients.
Between The Lines’ Melinda Tuhus spoke with Helen Yaffe, a Ph.D. lecturer in economic and social history at the University of Glasgow in Scotland — and an authority on the Cuban economy. Here, she explains how Cuba’s socialist system has developed a public health infrastructure to serve all its citizens and is sharing that knowledge with nations around the world.
HELEN YAFFE: I think the first element of importance here for assessing Cuba’s response to the COVID-19 pandemic is how quickly they responded. News only came out at the very end of December about this new virus, and by January the Cubans had drafted a control and prevention plan. They had established a national intersectoral commission for COVID-19 — a national plan for epidemics was updated. They began surveillance of ports and they sent experts to China to observe the disease there and they have good relations with China in the issues of medical science and health. So they took it very seriously.
They then proceeded to train anyone who was involved in the health care sector, so starting with the directors of hospitals and polyclinics who would then train their colleagues in the provinces and municipalities. But they also even gave this training to porters, to anyone involved in transport, to anyone in any way who came in contact with a patient. All of this was done before the first case of COVID-19 was confirmed in Cuba, which was on March 11, when three Italian tourists were confirmed as being infected.
They then went on to organize neighborhood meetings. They have an incredible system of grassroots community organizations in Cuba. They have what they call the organizations of the masses, and a key one of those is the street committees, the CDRs – and they are very capable of mobilizing basically, the whole country – but through these sort of localized street committees the local doctors and nurses came down and explained to them about this new virus and gave them advice and protective measures and so on. They have this capacity to mobilize the population. But in terms of health care, this is enacted through their incredible single system of universal public, free health care. So they don’t have a dual system of public health care and private. It’s a public health care system for everyone. They focus on prevention before cure.
MELINDA TUHUS: Helen Yaffe, it makes sense with a centralized system that you could do all this. But people in the U.S. are comparing San Francisco — which has had just a handful of deaths — and New York, which has been a disaster. So it seems that with any well thought out, humane plan, a city or state or even country could keep the numbers very low without being a socialist system. Your thoughts?
HELEN YAFFE: I’ll say something a little bit controversial. Capitalist systems, historically, when they are in crisis, have adopted mechanisms that we associate with socialism, or certainly with the state managing the economy and society. So where you have examples of capitalist states doing well, what they are doing is adopting those mechanisms of intervening with the apparatus. You’re correct that it doesn’t mean that every country that has done well has done well because it’s socialist.
MELINDA TUHUS: We just have a little time left, but I wanted you to talk a little about the Cuban response internationally, which helps others but also boosts their own standing in the world. You said that since 1960, they’ve sent 400,000 health care professionals who’ve worked in 164 countries, pre-Covid. I assume they work with the medical people in the host countries?
HELEN YAFFE: They never go without invitation, so clearly they are collaborating with health care authorities. And the missions have very different forms and the nature of them is different. So some of those are in response to natural disasters and disease outbreaks, so, emergency response. Some of those are at the invitation of authorities to help establish a health care system. At the same time, the Cubans have never sought to create a dependence on their health care workers. They have also trained the local people on site in those countries, or often they have invited tens of thousands of foreigners into Cuba to get medical training so they can gradually replace their own personnel and set up a public health care system.
MELINDA TUHUS: What has been the response, specifically, to COVID-19?
HELEN YAFFE: At the moment they are emergency brigades, so they are brigades who have gone who have expertise in disease control and disaster response. Those are the Henry Reeve brigades. And they have gone to 24 countries, as far as we know, and that’s some 2,300 professionals.