Havana. A Cuban doctor impatiently disarms his stethoscope to be able to adapt his Y-type tube to an oxygen tank and thus be able to save two serious patients from covid-19, at a time when an explosion of infections overwhelms the health services of the island, pride and column of your social system.
On July 26, Pedro Julio Miranda, a 26-year-old doctor, faced a dilemma while on duty at the Hospital del Sur, in the central province of Villa Clara: he had four patients in serious condition and only three tanks of oxygen.
“Imagine playing God, deciding who lives and who dies. I thought that if I didn’t do something one of the four would definitely die,” Miranda tells AFP via WhatsApp.
I was looking for “something that was hollow and bifurcated at one end, until God enlightened me, I had the solution close by and I was unable to see it because it was around my neck,” he says. It was his stethoscope.
Weeks later, the Health Ministry recognized “limitations” in providing medical oxygen. And in the eastern province of Holguín, dozens of doctors denounced in two collective videos the hospital collapse in their region, something unusual in the socialist Caribbean country.
President Miguel Díaz-Canel himself said on August 12 that the situation had “exceeded the capacities of the health system, putting stress on the work of all its personnel.”
Cuba managed to manage the health crisis until last July the delta variant triggered the coronavirus infections. The average number of daily cases up to August 22 was “39.2% higher than at the end of July,” reported José Ángel Portal, Minister of Health.
As of Monday, the island, of 11.2 million inhabitants, accumulated 646,513 cases and 5,219 deaths.
For Amilcar Pérez-Riverol, a Cuban researcher at the FAPESP Foundation, at the State University of Sao Paulo (Brazil), there is “a serious situation and an explosion of uncontrolled transmission of the virus.”
“Cuba has remained for many weeks with a positivity rate of around 20%,” four times the rate indicated by the WHO “as an alarm for high viral circulation,” he said.
With an extensive network of neighborhood clinics, the country has 82 doctors per 10,000 inhabitants, compared to 32 in France and 26 in the United States, according to the WHO. Even Havana has deployed some 4,000 health professionals in some 40 countries to help tackle COVID-19.
The main asset of the Cuban health system is prevention, but at the “second level it is not a power at all,” said Pérez-Riverol.
“When an explosion of this magnitude occurs, if the first containment barrier is overwhelmed, at the second level the situation worsens very quickly,” he added.
Weaknesses
Under the US trade embargo since 1962, the country’s hospital system has for years suffered from infrastructure weaknesses, a shortage of medicines, diagnostic supplies and equipment.
“My people, I have my father in therapy with both lungs compromised,” he said on his Twitter account Mag Jorge Castro, while asking for drugs such as nimotuzumab, jusvinza and cefepime. Other messages on social networks spoke of patients who would have been intubated without sedatives.
State television reports have revealed that people wait up to 24 hours to be transferred to a hospital and AFP was able to verify the lack of antigen, PCR and drug tests in local clinics.
With a biometric industry that produces most of the vaccines for its population, Cuba developed its own immunizers against the coronavirus: Abdala, Soberana 02 and Soberana Plus, although not yet recognized by the WHO.
In addition, it began to use the Chinese Sinopharm vaccine on Sunday in the central province of Cienfuegos.
When vaccination began in May, the government proposed to have supplied the antiviral to 70% of the population by August and to complete 100% in December, but currently only 3.5 million Cubans are immunized (31.3%).
At the end of May Yuri Valdés, deputy director of the Finlay Institute, which produces Soberana, denounced that, due to the US embargo, they had not obtained supplies to make more vaccines.
“The production of Soberana has stabilized, now the vaccination must increase,” said Pérez-Riverol and stressed that there are preliminary indications of the effectiveness of the Cuban vaccine because in Havana, where the entire vaccinable population is immunized, there is no news of hospital collapse or increased funeral services.