Cuba: Brace for Impact

There’s no way to explain this without a dose of drama, but it must be said. We must get ready for the possibility that every Cuban family will have a member or friend who will die in the next few months due to infection with COVID-19. We might think that, in an act of chauvinism, the national health system will underreport the number of cases, but the arrival of the pandemic is not just unavoidable, it’s a fact.

The new strain of coronavirus ended the world as we knew it a few months ago; something known in every country the disease has reached with enough time to reproduce. Cuba will soon know that too.

The global mortality rate estimated by the World Health Organization (WHO) currently sits at 3.4%. This doesn’t mean that the island may not be able to reduce that number, but such an outcome would require extraordinary measures that are yet to be implemented. The decision to put off social distancing, the closing of schools and the scaling down of the national productive cycle, has so far been criticized and defended with more political than scientific arguments.

In contrast, the countries successfully facing the disease are the ones that have mustered willpower, setting aside their internal differences.

It’s been verified that the moment and manner in which countries choose to contain the epidemic are decisive in its eventual impact. The social shutdown which has taken place in Europe and is now beginning in the US is the only effective way to contain the spreading.

The Cuban state policy of containment/mitigation and of deferring the closing of the country as a last resort is economically understandable, but it implies risks. Cuba is not conducting random testing to identify when COVID-19 will go from being an imported disease to freely circulate in the streets. Delaying isolation for too long may be dangerous, so the moment for everyone to go home should arrive soon. Success will depend on citizen participation.

The cultural traits of the population, far more used to physical proximity than that of other nations, represent a hazard when the first measure of prevention is isolation. Also, Cuba suffers economic sanctions which put the country at a disadvantage to face the crisis, while the US shows no sign of making a humanitarian gesture and scaling down its policy of maximum pressure on the island. Not even with 1100 deaths in Iran has the Trump administration reduced its sanctions. Cuba should not expect anything different.

Since it’s a new strain, it’s left to be seen whether reinfection is possible, whether a seasonal change will have some sort of influence or whether the virus can mutate. But we must get ready for the worst.

Additionally, the social practice of going to extremes, from disinformation to panic and from silence to stridency, is counterproductive in cases such as this one. The possibility of a mature debate in social media about how to face the crisis hasn’t materialized either. The public sphere is affected by the Industry of Indignation, an ecosystem of online political activists, specializing in maximizing citizen indignation in the face of any government decision.

It doesn’t matter whether the Cuban government received the MS Braemar cruise liner with British passengers or not, criticism of its decision was assured. On the other hand, triumphalism and official propaganda are amalgamated with the information provided by professionals in the Cuban medical industry, the true authority at a time of epidemiological crisis.

Cubans must prepare for true social distancing, washing their hands frequently and remaining in their homes, perhaps for months. Even with all that, many would contract the virus. The goal isn’t preventing the number of cases from rising, something for which citizens must be ready, but reducing the number of infections, and especially to not flood the national health system. According to World Bank figures, Cuba has 5.2 hospital beds for every 1000 inhabitants. Each country is different, but if the trend until now is that an elevated number of inhabitants contract the disease, then the availability of beds becomes a matter of life and death.

China and Italy applied a probabilistic selection tool which decides who can occupy a bed or a piece of medical equipment and who can’t. According to this terrible yet necessary method, the elderly –despite being a more vulnerable sector– have had to cede their place to younger patients with a better chance of surviving.

If over 20% of Cubans are older than 60, the math becomes simple and macabre. Due to the magnitude of the danger, it is prudent that the Cuban State applies a mechanism of national lockdown as soon as the first locally transmitted case is identified. This measure will have a high economic cost at a time that’s already delicate as it is, but it seems indispensable.

If the global mortality rate does not vary, thousands of Cubans may die in the next few months due to COVID-19. Since it’s a new disease, there’s no immunity, which increases the risk of infection in inhabitants. Dividing the number of deaths between the number of cases, we’re able to calculate the mortality rate. It’s still too soon to make predictions in the case of Cuba.

Anyone who needs a dose of hope in these times may find it in literature. According to the fiction novel World War Z, after a global pandemic, Cuba became the wealthiest nation in the world for its geography, political system and education. Other scientific texts describe how to face an epidemic, and history books explain how previous crises have been weathered.

If this text hasn’t been enough to take the situation seriously, let us bring some perspective. The last great pandemic was the Spanish Flu of 1918, with a mortality rate of 2.5%, and it wiped out 50 million people. It’s quite possible that one of our ancestors might have died back then. From now on, we recommend being well-informed, following the guidance of medical authorities, and perhaps finding refuge in literature in the privacy of our homes to contribute to the necessary distancing. Just be aware that some of the books we considered apocalyptic in the past may today be found in the contemporary history section.

Translated from the original