International COVID-19 Megathread

[Bismarck]

What’s going on in Japan? As far and I can tell they aren’t doing anything to combat the virus and yet they have no surge. Are they just lucky? Or not testing? Or did they do something to control the virus early in that Im unaware of?

[Bismarck]

Is the spread really slower in countries like Brazil, parts of Africa, and Malaysia orbare they just not testing? Also is Turkey an emerging hotspot?

[Bismarck]

Cuba is highly respected for the international medical brigades that assist the health services of Italy and Andorra even in Europe. But the island itself is also confronted with COVID-19. The first infection was detected on March 11: an Italian tourist in the busy town of Trinidad.

More than three weeks later (April 3, 2020), 233 patients with the coronavirus Covid-19 / SARS-CoV-2 were infected in Cuba. Unfortunately, six of them died. 2,742 people are in hospital for observation and another 26,000 people are monitored at home from primary health care.

One of the best developed public health systems
The corona crisis is not tackled in a vacuum, but within the political and social context of each country. The Cuban context is quite unique. Socialist Cuba has one of the best developed public health systems in the world. That with a gross domestic product (GDP) that is 10 times lower than that of Belgium. About 30% of the national budget goes to health expenditure. By comparison, this is about 13% in Belgium.

It is this preventive health system, which draws on the mass participation of the population, that better prepares Cuba for the fight against Covid-19
All health indicators in Cuba are at EU level, far above the values ​​in the US. This is because the focus is mainly on prevention and primary health care. For example, diseases are combated preventively and it also costs health care less money. It is this preventive health system, which draws on the mass participation of the population, that better prepares Cuba - much more so than other countries - for the fight against Covid-19.

Of course, Cuba also faces major challenges, if only because it is a venomous virus. But also because of the economic impact of the stricter US sanctions against the island. “The Sars-CoV-2 virus is one of the greatest challenges for humanity in our history. But Cuba is facing it as the blockade places huge economic and financial constraints on our country, ”said José Angel Portal Miranda, Cuban health minister.

Tracing and isolation
The Cuban approach is different from the Belgian one. Tracing and isolation are central, and this with limited testing capacity. Cuban health services want to cut all chains of infection immediately. Suspicious cases are being tested. With a positive test, that individual is completely isolated and the entire network is mapped (contact tracing), so that possible other infections can also be tested and isolated.

People with moderate symptoms that may indicate contamination are immediately hospitalized and cared for. There is no waiting for a test to determine whether they are infected or not. A much larger group of people without or with mild symptoms - today more than 26,000 people - are under daily medical supervision in home isolation or in recently established isolation centers. This is because they have had contact with suspicious cases, because they have just returned from abroad or because the health services have screened them as "potentially infected".

Still, Cuba has limited testing capacity. The tests cost money, the reagents (chemicals) must be sufficiently available, as well as test material such as swabs. Due to the economic and financial blockade from the United States, this is not evident for Cuban health services. A large shipment of test kits and protective equipment from China could not be delivered to Cuba. This is because the transport company in the US wanted to avoid fines for going against US legislation about the blockade.

Well prepared
Since January, at the start of the outbreak in Wuhan, China, a prevention plan has been developed. Special “hearings” were organized in all neighborhoods, companies and committees. It was the social organizations, such as the union division, the women's organization or the neighborhood committees that organized these information meetings. Cuba strongly counts on the full participation of the Cuban people. Since the internet has become more accessible, Cubans have also been sold on their smartphones. That is why Cuba developed a Covid-19 app full of medical information and updates.

Crucial was also the education and training of all health workers in the country, from neighborhood practices to outpatient clinics and general hospitals to specialized reference hospitals. In Cuba there are two renowned tropical institutes active, which immediately got under way to centralize all information about Covid-19.

Since February, the outpatient clinics and hospitals have set up separate consultation rooms, isolation rooms and separate waiting rooms and outside doors for patients with respiratory problems, so that they do not cross the other patients. All these measures have not only been decided but already implemented before the first positive cases surfaced.

A lot of home visits
Cuba has one doctor for every 150 people. The neighborhood health centers with general practitioners and nurses form the heart of healthcare. These doctors and nurses live in the district or village and know the people they care for. Cuba prides itself on knowing the detailed health of the entire population. There is an enormous amount of statistical material available, not only from the people who frequently have health problems but also from the healthy population. All Cubans receive a preventive check-up several times a year from the family doctor, who works in the health post in his / her neighborhood.

This approach, which focuses on prevention, already provides a solid basis for dealing with extraordinary situations. It is the same network of health workers who proactively screen the population that is now being used en masse to detect corona infections. Cuban health services have their "most vulnerable" populations and can therefore work towards them more specifically.

The majority of patients now in home isolation have been identified in a large campaign of home visits. They have one goal: not to wait for people to come to health care, but to consciously look for infected persons and detect them in time.

The local health workers are assisted by 28,000 medical students, social workers and militants from the women's federation, youth organizations and neighborhood committees. They go from door to door, make no physical contact and keep a sufficient distance. They go through a questionnaire and ask how you are doing. If someone has a dry cough or fever, this is immediately passed on to the health post. Because many Cubans have already had a "white coat" at the front door several times, this also takes away their fears.

The home visits are repeated daily as much as possible. In addition to proactively detecting health problems, they also serve to support all Cubans, especially the vulnerable groups. For example, help can be offered with groceries. These home visits have so far reached nine million people, some three-quarters of the Cuban population.

Well thanks for the daily dose of communist propaganda. Anyone whose been to Cuba knows it’s a horrible place. Seems way poorer than Vietnam despite having 4x the per capita gdp. I’m pretty sure they inflate a lot of the their metrics. Like by not counting any infant mortality to boost their life expectancy.