Covid-19 realities and the case of Cuba
By Charles McKelvey
May 11, 2020
An article by Georgi Marinov, entitled “Coronavirus: Scientific Realities vs. Economic Fallacies,” was published on May 5 in LeftEast. The article also has been posted on popularresistance.org as well as distributed on moving-beyond-capitalism-discussion-group. The author, who is from Bulgaria, is a post-doctoral fellow at the Department of Genetics, Stanford University, California.
Marinov writes that “important policy decisions are made based on the blind belief that lifelong immunity will develop after any relatively mild SARS-2 infection.” Marinov maintains lifelong immunity develops for many viruses, but not all. In fact, neutralizing antibodies have not been found with respect to the six coronaviruses prior to SARS-CoV-2. Marinov observes that at this stage, we do not know if people who recover from COVID-19 will have life-long immunity, and policy decisions based on this belief may prove to be a tragic mistake.
Because immunity may not be permanent, Marinov is opposed to the policy of herd immunity, which occurs when seventy percent of the population has contracted the virus and recovered, giving them immunity from future contagion. Adopted as a strategy, herd immunity involves the physical isolation of the vulnerable population, such as older persons or those with associated health conditions, while younger and healthier people go to work and have less restrictions. Many will get sick with mild symptoms, will recover, and will have immunity. Arguing against this approach, Marinov maintains that if immunity lasts for only two or three years, there would be periodic waves of new deaths from the disease. In addition, the fatality rate is not yet known; it may be 2% of both symptomatic and asymptomatic cases, which would be unacceptably high for the use of the herd immunity strategy.
Although it may be the case that in many nations of the world policies and commentaries assume that lifelong immunity will develop, it is not so in Cuba. In the case of Cuba, scientists repeatedly have pointed out that the SARS-CoV-2 is a new coronavirus, and therefore very little is known about it. They have made clear that it is not yet known if permanent immunity develops for those who have contracted and recovered from the disease. In Cuba, no present policies or plans for the future are based on the assumption that those who have contracted the disease will have immunity.
Moreover, Cuban scientists recognize that the death rate is not yet known, and in addition, the long-term effects on an individual’s health are not known. Therefore, the Cuban approach has been to mobilize all resources on prevention and treatment. This cost is secondary, and it will be addressed when the pandemic passes. For now, the priority to given to saving lives.
With respect to vaccines, Marinov maintains that policies and commentaries are far too optimistic concerning the possibilities for developing a vaccine. He notes that attempts to create a SARS-1 vaccine were unsuccessful. He explains that most vaccines are based on a strategy of inducing an attenuated form of the disease in order to induce an immune reaction. However, the development of vaccines is a long process of trial and error, usually taking more than ten years, with the exception of the Ebola vaccine, which took five years. Marinov notes that it is common to say these days that a vaccine should be expected in twelve to eighteen months, but in reality, no vaccine has ever been developed this quickly.
In Cuba, the constant message of the leaders and the scientists is that the only vaccine that we now have is the vaccine of disciplined compliance with the measures of hygiene, social distancing, and physical isolation; no one should expect that there will soon be available a miraculous or magical solution.
Cuban scientists, however, are inclined to accept the estimation of twelve to eighteen months for the development of a vaccine. They recognize that this would be unprecedented in the history of vaccination, but they argue that we are in an unprecedented situation. Never before in history have so many scientists throughout the world been working on the same problem with a sense of urgency. So Cuban scientists say that it is not unreasonable to expect a vaccine in twelve to eighteen months in response to the global emergency, but in the meantime, discipline with respect to the health measures is the vaccine that will prevent the spread of the disease.
At the same time, Cuban scientists are working fervently on what they describe as a general interim vaccine, taking an approach different from the norm. Rather than trying to get the immune system to react to a virus substitute, the strategy is to stimulate the immune system to react; to react to any virus, not specifically SARS-CoV-2. A drug of Cuban creation, Interferon, has been used in the past in the treatment SARS-1 and other illnesses, and it works on the principle of stimulating the immune system to react. In the treatment of COVID-19 patients in Cuba, Interferon and other Cuban drugs, powerful stimulators of immune reaction used for the treatment of other diseases, are being tried, with positive results. In fact, an immune reaction specific to COVID-19 is being observed in these trials.
Cuban scientists are hopeful with respect to their efforts to develop a general interim vaccine, which they see as effectively containing the virus while a specific vaccine is in development. There are given ample space in the Cuban media to explain what they are doing. But, it should be noted, they invariably conclude their enthusiastic discourses by saying that, for now, the disciplined practice of hygiene and physical separation and isolation is the vaccine that we have, and everyone, without exception, should take this vaccine, readily available without cost in every Cuban home.
Marinov sees “almost nothing positive” in the current world situation. Many governments have adopted policies based on false assumptions, and when correct measures have been adopted, it has been too late. He believes, however, that even in this complex situation, it is possible for a country to attain control of the virus in its national territory, through the implementation of prolonged quarantine measures. Such measures would be effective, since SARS-CoV-2 dies, if it is not transferred to another person within a few weeks. Any country that implements quarantine measures for as long as is necessary from a scientific point of view could eliminate the virus from the local population, if it were to exercise strict control over entry into the country.
In Cuba, a version of prolonged quarantine measures is being implemented. Cuba has closed its border, and the few persons with permission to enter the country must enter quarantine for fifteen days. Restaurants are confined to take-out services, and many are closed. Public events have been cancelled. Schools and universities are closed. Public and private transportation has been stopped. The people are confined to their homes, except for necessary work and for the purchase of food and other necessities. Active door-to-door inquiries are conducted to identify and test suspicious cases. All confirmed positive cases, both symptomatic and asymptomatic, are hospitalized. Persons under suspicion because of respiratory symptoms and/or contact with a confirmed case are separated, either in hospitals or home confinement. Local transmission events, in which there has been a breakout of cases, have been identified, and these specific communities are placed in fifteen-day quarantine.
Many countries, however, are not in a position to implement such measures for a period of time necessary to eliminate the virus, because it would provoke the collapse of their economies. This global economic reality leads Marinov to a discussion of the economic structures of most nations, and the necessity to develop new economic structures. We will reflect on his comments in our next editorial commentary on Wednesday, where we will see that, once again, Cuba stands in sensible and intelligent contrast to the global norm.
