Cubaʼs health system in acute distress as COVID cases soar

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Cubaʼs health care system, long a source of national pride, is in acute distress, writes The New York Times.

After fending off COVID-19 last year, Cuba is now being ravaged by the highly contagious Delta variant, sending case rates soaring and swamping the medical system.

More than 9,700 new cases were reported last Monday, six times the number of new cases just two months ago. Oxygen supplies are low, and the factory producing the nationʼs canisters is currently shut down. Mortuaries and crematories have been overwhelmed, as the death surge on some days climbs to about eight times the usual number.

Last weekend, after Cubaʼs prime minister Manuel Marrero Cruz said that Cubans were complaining more about doctors and their poor service than they were about the shortages, nearly two dozen young physicians and medical students took to social media to state, one by one: “I am publicly declaring that doctors are not to blame for the collapse of the public health system.”

On Tuesday, the government published a new cyber-terrorism law, making it illegal to use telecommunications to post “offensive” material that disrupts public order or hurts the country’s “prestige”.

President Miguel Díaz-Canel Bermúdez acknowledged that the pandemic “exceeded the capacity” of the healthcare system, but blamed the US trade embargo for the shortages the country suffers. With shortfalls of medicine and other critical supplies, hospitals have neither the doctors, nor the medicine, nor the oxygen to treat the increasing patient load.

Hundreds of Cuban doctors work abroad, but recently more have stopped working in the country because they are infected with COVID-19 or have chronic health conditions that make them vulnerable, said Alexander Pupo, 31, a doctor in Holguín who lost his neurosurgery residency last year after criticising the government.

“Patients are admitted as pure protocol, because the availability of medicines to treat them doesnʼt exist in the hospitals,” he said. “They go in to die.” And when they do, it might take three days for someone to pick up the body.

While the pandemic has strained medical systems worldwide, the calamity in Cuba is particularly significant because for decades, the government has held up its free healthcare system as a signal accomplishment of the socialist revolution. But the growing crisis has revealed a frayed system that, while often producing medical breakthroughs, is also ill-equipped and underfunded.

Cuba has long earned billions in much-needed foreign currencies by sending nearly 30,000 doctors to countries worldwide. But that practice is becoming harder to defend as more Cubans die of COVID-19. Several hundred doctors serving missions overseas were brought home this month to work through their vacations.

The medical crisis comes as Cuba also grapples with a severe economic crisis and a social uprising last month that brought thousands of people into the streets, leading to a government crackdown landing hundreds of people in prison. On Monday, the president urged doctors to dispense oxygen carefully, because there was not enough to go around.

Eduardo López-Collazo, a Cuban infectious disease researcher living in Spain, said his sister Norma, 64, tested positive for COVID-19 last month even after two doses of Cubaʼs vaccine, and spent days in a waiting room hoping to be admitted. Even when her oxygen level dropped to a worrisome 92, doctors said she did not meet the “international criteria” for admission to an intensive care unit, he said.

She died on July 30. Despite two positive COVID-19 tests, the death certificate listed her cause of death as pulmonary thrombosis. López-Collazo believes the government is undercounting deaths to present a rosier picture than warranted. The countryʼs official death toll from the virus is 4,088.

Statistics from the Cuban Health Ministry showed that about eight people died daily of COVID in the city of Guantánamo in the first week of August. But an official there told a TV news station that in the same period Guantánamo saw 69 deaths in one day, when the average number of daily deaths before the recent wave was just eight.

The government has said in state-run media that the caseload and fatality rate are improving in Havana and a few other cities, and that the death toll should subside as more people get vaccinated. Cuba, however, has a shortage of the syringes needed to administer doses, according to Global Health Partners, a non-profit that has organised a campaign to send millions to the island.

About a quarter of Cubaʼs 11.3 million residents have received one of three vaccines that were developed and produced in the country, reports The New York Times. Professor Arachu Castro from the Tulane School of Public Health and Tropical Medicine, said the country had one of the best coronavirus responses in Latin America in the pandemic’s early stages. But this changed after November, when tourists were allowed back into the country, and worsened again after Motherʼs Day and Fatherʼs Day, when many Cubans gathered with their families.

The number of new daily cases increased exponentially for nine straight weeks this summer, and more than 100,000 people are currently in COVID-19 isolation centres for monitoring, about half of whom have tested positive, says a 9 August report by the Pan American Health Organization.

Ciro Ugarte, the agencyʼs director of health emergencies, said COVID deaths in Cuba had risen 20% last week compared with the previous week. The lack of essential supplies to treat COVID-19 and other illnesses deepened the problems, he said, adding that the organisation sent testing kits and other materials to Cuba.

Dr Alexander J. Figueredo Izaguirre said he was fired earlier this year when he criticised the poor state of Cuban hospitals after his grandfather’s death. “The health care system has collapsed,” he said. “The funeral homes canʼt cope, the hospitals canʼt cope, the clinics canʼt cope. We have been struggling for a year and a half in this battle against this disease — without weapons — when hundreds and thousands of people are dying.”

 

New York Times article – Overwhelmed by coronavirus, Cubaʼs much vaunted health system reels (Restricted access)

 

See more from MedicalBrief archives:

 

Ramaphosa: 'Private individuals' not govt that donated medical supplies to Cuba

 

Head scratching over donation of SA medical supplies to Cuba

 

Cuban anti-COVID drug cost R200m and used on only 1 patient

 

SANDF applies to SAHPRA to trial illegally imported Cuban drug

 


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