This week in Cuba

April 19 to April 25, 2020

By Charles McKelvey

In today’s “This week in Cuba,” we review, first, the issue of asymptomatic confirmed cases of Covid-19; secondly, the treatment of Covid-19 patients with a team approach; thirdly, the support of the government ministries and the mass organizations for the Cuban Covid-19 plan; and fourthly, Cuban commemoration of the 150th anniversary of the birth of Lenin.

(1) The significance of the asymptomatic confirmed Covid-19 cases

At the press conference of Thursday, July 23, Dr. Francisco Duran, National Director of Epidemiology of the Cuban Ministry of Public Health, responding to a question on the issue, explained the importance of the asymptomatic confirmed cases. He pointed out that in the international epidemiological literature, there is a distinction among types of asymptomatic cases; namely, permanently asymptomatic, pre-symptomatic, and post-symptomatic cases. Permanently asymptomatic cases refer to persons who never develop symptoms, but they nevertheless infect other persons. The phenomenon of carriers without symptoms has been observed previously by epidemiologists with respect to other diseases. Pre-symptomatic cases refer to confirmed cases, in which the person has tested positive for the virus, but has not yet passed to having symptoms, but eventually will. Normally with Covid-19, people carry and transmit the virus for two or five days before developing symptoms. Post-symptomatic cases are patients who have developed symptoms but who no longer have them, but they nevertheless continue to test positive for Covid-19 and are able to transmit to other persons.

Dr. Duran noted that studies of the outbreak in China indicate that 80% of the confirmed cases were asymptomatic, and studies of the Covid-19 outbreaks in the world indicate that from 20% to 80% of Covid-19 cases are asymptomatic. In the specific case of Cuba, Dr. Duran notes that approximately 50% of the confirmed cases are symptomatic. Cuba undertakes active inquiries, searching for people who are under suspicion because of contacts with confirmed cases, and as a result, the Cuban process has been able to identify and treat asymptomatic cases.

The phenomenon of asymptomatic symptoms means that no one knows if they are carrying and transmitting the disease. Frequent testing is required, and social distancing measures must be maintained. He noted that many aspects of asymptomatic systems with respect to Covid-19 are not yet understood.

(2) “No doctor feels alone at the point of making a decision”

At the evening news television-radio program La Mesa Redonda on April 20, Ricardo Pereda González, an intensive medicine specialist and Coordinator of the Groups of Specialists of the Ministry of Public Health, described the treatments for Covid-19 patients. He stated that, “In developing our medical therapeutic procedures, we have learned to advance the treatment, to give the treatment earlier than we initially did. Some patients are asymptomatic, and we initiate the treatment on the basis of the most subtle manifestation, and when we do this, we find that if the disease advances to a more advanced stage, it has a less aggressive expression. All that we have done to identify suspicious cases has been very helpful, because it has enabled us to begin treatment earlier.” He further stated that “We have had positive results with extremely grave patients. Not all the treatments are equal, and one has to decide which to use, and when to use it. Moreover, the therapies are combined; each medicine has its moment. We apply one medicine in one stage, and another in a later stage. Interferon is being used along with other treatments established in our procedures.”

Randy Alonso, the program host, observed that in Cuba half as many cases of Covid-19 arrive to a critical or serious condition, and he inquired if this were a consequence of the treatments that are used in Cuba. Pereda responded that “we begin with medical treatment early, and we use them with flexibility. And we are in communication with one another across the nation. We work in a collective form. We have interchange, the flow of information, and collective decisions with the participation of specialists from distinct specializations. The situation of critical patients is complex, and decision have to be made quickly, and they are made collectively. No doctor feels alone at the moment of making a decision.”

Similarly, Dr. C. Daniel González Rubio, an Internal Medicine Specialist of the Pedro Kouri Institute for Tropical Medicine, declared that “We have had a great number of persons that have been hospitalized with factors of high risk (such as advanced age, diabetes, hypertension, and cancer) that have not arrived to a critical or serious state. That has occurred because of the effectiveness and the characteristics of our procedures. The treatment is collective; no patient is treated by only one doctor. The doctor is part of a team, which itself is connected to a national network of communication with various institutions and specialists in various fields.”

(3) “Our most vulnerable people are in physical isolation, but they are not alone.”

On the Mesa Redonda program of April 21, Marta Elena Feitó, Minister of Work and Social Security, explained that as a general norm, Cuba has social workers that attend to the most vulnerable, those with insufficient income, severe disability, or chronic illness, Now, in the context of the health crisis, Cuban has expanded the numbers that are visited by the program of social assistance. They are visited by social workers, and arrangements are made for the delivery of food or for any necessary services. Many workers who are on furlough because of the health crisis are volunteering to participate in the program, and they are being incorporated in order to expand services. In addition to individual workers, many institutions are cooperating and providing support for the social assistance program. In this situation of crisis, the Minister declared, “our most vulnerable people are in physical isolation, but they are not alone.”

Carlos Rafael Miranda Martínez, National Coordinator of the Committee for the Defense of the Revolution, described at the April 21 Mesa Redonda the activities of the mass organization, including calling upon the people to comply with the health measures; identifying vulnerable people that are in need of social assistance; and helping the active inquiry, in which potential cases of Covid-19 are identified. In addition, activists have been trained to strengthen these activities. The Committee for the Defense of the Revolution was established in 1960, and it exists in every neighborhood and community in the nation. Along with the other mass organizations, it an important structure in promoting active citizen participation in the construction of a socialist society.

Another mass organization is the Federation of Cuban Women (FMC). Since it is neighborhood based, like the CDRs, they often carry out activities together. Teresa Amarelle Boué, National General Secretary of FMC, observed that women are actively participating in a wide variety of support activities in this dynamic moment in the history of the nation, and indeed, a majority of the health personnel, on the front line of battle, are women. She observed that the national direction of FMC is giving special attention at this moment to attending to the needs of the elderly, most of whom are women; attending to the issue of gender violence, which may be increasing as a result of physical isolation; and to ensuring that attention to pregnant woman is not neglected in the context of the crisis. In all of these activities, she noted, FMC is receiving the full support of the government.

Another of the mass organizations is the Federation of University Students (FEU). José Ángel Fernández Castañeda, National President of FEU, declared that students are responding to the national call. He observed that 45,955 medical students are participating in the active inquiry organized by the medical universities and the Ministry of Public Health, and that another 2,320 are participating in various contingent projects.

In the April 23 program of the Mesa Redonda, Eloy Álvarez Martínez, Minister of Industry, described the coordination between the Ministry of Industry and the Ministry of Public Health, which ensures the fabrication and distribution of personal protective equipment, medicine, and medical equipment. On the program of April 24, representatives of the Cuban social sciences explained the incorporation of more than 100 social scientists in the national scientific advisory team, which advises the government. Social scientists are making contributions with respect to the communication of the plan and the measures to the people, the program of social assistance to the vulnerable population, and the needs of the people in the quarantined neighborhoods.

(4) Cuba commemorates the 150th anniversary of the birth of Lenin

V.I. Lenin formulated a further development of Marxist knowledge, on the basis of his observation of popular struggles. Observing the capacity of workers and peasants to form soviets (or popular councils), he discerned that the key to the struggle of the workers against capitalists, and of peasants against landlords, was the taking of political power by the workers and peasants through the formation of soviets, and the substitution of soviet power for parliamentary power. And observing the resistance of the oppressed nationalities of the Russian Empire, he arrived to understand the importance of the self-determination of peoples. When he recognized that the revolutions in Western Europe were not going to triumph, which he considered necessary for the survival of the Russian Revolution, he anticipated that the center for the global socialist revolution would pass from the Western proletariat to the oppressed and colonized peoples of the world.

Lenin taught that it is necessary to form a vanguard political party that leads the people in the taking of political power. He maintained that a vanguard political party, characterized by democratic centralization and discipline, is necessary for protecting the masses from the centralized and amoral power of the bourgeoisie.

On April 22, Cuba commemorated the 150th anniversary of the birth of Vladimir Ilich Lenin, with a gathering of leaders of the Communist Party of Cuba and the Confederation of Cuban Workers at Lenin Hill in Havana, where there is a statue of the great leader of the October Revolution. The April 22 issue of Granma has a Special Supplement dedicated to the Bolshevik leader, which included selections of his writings and well as selections from the speeches of Fidel. Fidel described Lenin as a truly exceptional human being, not only a capable of developing a theory, but also able to bring the theory to practice in the field of concrete action.