MEDICC Review continues documentation of Cuba’s COVID-19 Prevention and Control Plan and its implementation, begun with our April issue (see https://mediccreview.org/cubas-covid-19-strategy-main-actions-through-april-23-2020). This time, we present two tables: the first refers to measures taken to confront the epidemic, and the second, to the phased recovery process that is expected to lead to changes in many, if not all, sectors of Cuban society. In both cases, we have indicated the source of the information provided.
| Date | Actions |
| April | |
| Cuban Center for State Control of Medicines and Medical Devices (CECMED) approves expanded compassionate use of Cuban monoclonal antibody Itolizumab (Anti CD6) for seriously ill patients with pneumonia resulting from COVID-19. https://www.cecmed.cu/covid-19/aprobaciones/itolizumab-anti-cd6-0 |
| CECMED approves the Esperanza study, a controlled clinical trial, to evaluate safety and efficacy of Heberferón vs. Heberón alpha 2b (interferons produced by the Genetic Engineering and Biotechnology Center, CIGB, Havana) for patients infected with SARS-CoV-2. https://www.cecmed.cu/covid-19/aprobaciones/esperanza-heberferon-heberon |
| 25 | Health authorities inaugurate a 650-bed hospital-clinic at the Informatics Sciences University in Havana for potential COVID-19 patients. https://www.biocubafarma.cu/noticias/noticia-post.php?id=6 |
| 25 | Public Health Minister announces comprehensive program to provide psychological care for the general population, health workers, those in isolation centers and patients hospitalized for COVID-19, to assist them in addressing the mental health effects of the epidemic. http://www.granma.cu/cuba-covid-19/2020-04-25/diaz-canel-sobre-la-organizacion-hospitalaria-se-debe-evitar-la-sobrecarga-con-pacientes-sin-confirmacion |
| May | |
| 4 | Council of Ministers approves adjustments to the 2020 National Economic Plan, considering the impact of the epidemic. https://www.presidencia.gob.cu/es/noticias/ajustarse-a-la-realidad-e-imponerse-a-ella-con-el-trabajo/?fbclid=IwAR1sXpxGRno0bSdH90BKlAxNClDKO2ITynRmDrpW5um0C5C3DoWPuL5fqJ8 |
| 7 | Cuban Immunoassay Center develops a rapid-test kit for COVID-19, Umelisa SARS COV-2 IgG, based on Ultramicroanalytic System (SUMA) technology. http://www.cubadebate.cu/noticias/2020/05/07/desarrollan-en-cuba-sistema-diagnostico-para-detectar-anticuerpos-de-la-covid-19/comentarios/pagina-2/ |
| 11 | Over 5000 older adults treated since April 3 to date with Biomodulina T, a Cuban immunoregulator approved for use in respiratory infections, as part of prevention protocol for COVID-19. Among those treated are persons living in nursing homes. http://www.granma.cu/cuba-covid-19/2020-05-11/biomodulina-t-otro-eficaz-farmaco-cubano-contra-la-covid-19-11-05-2020-00-05-53 |
| 12 | National study begins in 1400 families (4000 persons) nationwide to discover extent of COVID-19 circulation, using real-time polimerase chain reaction (RT-PCR) tests to detect cases. http://www.sld.cu/noticia/2020/05/12/comienza-estudio-poblacional-en-cuba-para-identificar-posibles-casos-de-la-covid- |
| 21 | Cuba is using plasma from recovered COVID-19 patients to treat serious cases. http://www.acn.cu/salud/65068-cuba-apuesta-tambien-por-la-terapia-con-plasma-hiperinmune-ante-la-covid-19 |
| June | |
| 2 | Study begins on genetic implications of severe COVID-19 cases. http://www.giron.cu/realizan-en-cuba-estudios-sobre-la-genetica-y-su-implicacion-en-la-covid-19-infografia/ |
| 11 | Government announces three-phased, gradual post-epidemic recovery program. http://www.cubadebate.cu/noticias/2020/06/11/gobierno-cubano-informa-medidas-para-la-recuperacion-tras-la-epidemia-de-la-covid-19/#anexo-1381187 |
| 12 | Phase-2 clinical trial begins for CIGB 2020 vaccine candidate, for COVID-19 and other acute respiratory infections. Developed by CIGB. http://www.cubadebate.cu/noticias/2020/06/12/salud-y-ciencia-la-respuesta-integrada-de-cuba-ante-la-covid-19-video/ |
| 17 | CECMED authorizes emergency use of Jusvinza to treat serious or critically ill COVID-19 patients affected or potentially affected by hyperinflammation (“cytokine storm”); produced by the CIGB. https://www.cecmed.cu/covid-19/aprobaciones/jusvinza-cigb-258-1 |
| June | |
| 18 | Phase One of recovery begins in 13 of 15 provinces, plus the Isle of Youth Special Municipality. Havana and Matanzas Provinces have yet to enter Phase One. https://www.presidencia.gob.cu/es/noticias/nota-informativa-sobre-el-inicio-de-la-primera-etapa-y-fase-1-de-la-recuperacion-pos-covid-19/?fbclid=IwAR1DgJBm3m4vShpeu1lZa68GP31q26EW2zIjS4CLdmcnbYKbhdNv258_i6U |
| 18 | Cuba opens to domestic tourism in provinces already in Phase One of recovery, with added precautions at hotels and resorts. http://www.cubadebate.cu/noticias/2020/06/17/comercio-interior-transporte-turismo-y-la-aduana-informan-sobre-las-medidas-de-la-etapa-pos-covid-19/ |
| 22 | Council of Ministers approves detailed Three-phase Recovery Program, plus indicators for each phase. http://www.cubadebate.cu/noticias/2020/06/22/medidas-a-implementar-en-las-tres-fases-de-la-primera-etapa-de-recuperacion-pos-covid-19-pdf/ |
| 23 | Matanzas Province enters Phase One of recovery. http://www.granma.cu/cuba-covid-19/2020-06-22/pasa-matanzas-a-la-primera-fase-de-la-recuperacion-pos-covid-19-22-06-2020-20-06-33 |
| 26 | Prototype of low-cost emergency pulmonary ventilator successfully developed in Cuba, as well as non-invasive ventilator (requiring no intubation); 250 of each expected to be completed before year’s end. Participating: Cuban Neuroscience Center and the Immunoassay Center. On April 11, usual foreign suppliers of ventilators indicated they could no longer supply them, since these companies were acquired by US corporations that conform to US sanctions on Cuba. http://www.cubadebate.cu/especiales/2020/06/26/cneuro-ventiladores-pulmonares-made-in-cuba-fotos-y-video/ |
| July | |
| 1 | Cuba re-opens international tourism to several of its keys, with extra precautions, including at airports. https://www.prensa-latina.cu/index.php?o=rn&id=378158&SEO=reabre-cuba-sus-puertas-al-turismo-internacional |
| 3 | Havana Province enters phase one of recovery. http://www.cubadebate.cu/noticias/2020/07/01/la-habana-pasa-a-la-primera-fase-de-recuperacion-a-partir-del-3-de-julio-el-resto-del-pais-excepto-matanzas-a-la-segunda/ |
| 3 | Phase Two of recovery begins for 13 of 15 provinces plus the Isle of Youth Special Municipality. http://www.cubadebate.cu/especiales/2020/07/03/el-programa-de-medicamentos-en-el-pais-una-prioridad-del-gobierno-cubano/ |
| 8 | Matanzas Province enters Phase Two of recovery. http://www.granma.cu/cuba-covid-19/2020-07-08/matanzas-a-la-segunda-fase-en-la-habana-se-refuerzan-las-medidas-de-la-primera-08-07-2020-00-07-37 |
| 16 | New economic measures announced for recovery period related to increased food production, greater autonomy for state companies, design of micro-, small and medium enterprises (PIMES), possibilities extended for private businesses to import and export, greater incentives for direct foreign investment, improvements for work in non-state sectors, separation of retail and wholesale markets, and elimination of 10% tax on US dollar, among others. http://www.cubadebate.cu/noticias/2020/07/16/gobierno-cubano-informa-nuevas-medidas-economicas-video/ |
| 20 | Phase Three of recovery begins in 13 of 15 provinces plus the Isle of Youth Special Municipality. Havana and Mayabeque Provinces remain in Phase Two. http://www.cubadebate.cu/noticias/2020/07/16/a-partir-del-20-de-julio-avanzan-a-la-tercera-fase-todas-las-provincias-del-pais-con-excepcion-de-la-habana-y-mayabeque/ |
Of Cuba’s 15 provinces, 13 and the Isle of Youth Special Municipality entered Phase-One COVID-19 recovery on June 18, 2020; Matanzas Province on June 22; Havana on July 3. Entrance into each phase is determined by analyzing the following five COVID-19 indicators in each territory, established by the Ministry of Public Health:
| Phase One | Phase Two | Phase Three | |
| General measures for all phases | |
| Ensure physical distancing in all public areas, prohibiting large public gatherings | |
| Save electricity by staggering shifts in production plants and other workplaces | |
| Prohibit symptomatic employees from entering workplaces, and guarantee their immediate referral to health centers | |
| Obligate hand disinfecting at all institution entrances, as well as systematic disinfecting of surfaces therein | |
| Strengthen communication with home renters in zones where tourism has re-opened, as well as epidemiological control of all international visitors who rent | |
| Use primary health care to carry out active surveillance and case detection of patients with respiratory symptoms | |
| Take temperatures of all Cuban and international travelers upon leaving or entering the country, to or from any destination | |
| Maintain strict protection for workers in areas where they are at risk of contagion | |
| Establish multidisciplinary teams to provide 24-hour care in hotels, including on-site presence in each of a doctor, nurse and trained hygiene and epidemiology specialists | |
| Health sector hygiene and epidemiology measures |
| Physical distancing: mandate at least one meter between persons; mandate use of face masks in public places; restrict locales’ capacities for meetings and gatherings; restrict numbers in outdoor gatherings. | Mandate use of face masks only in public places that may be crowded (buses, beaches, stores, etc.) Limit numbers of persons in meetings or gatherings |
| Screening: active daily screening by primary health care personnel in the entire population to identify symptomatic persons who are referred for evaluation | Systematize targeted active screening to identify symptomatic persons, priority afforded to those living or staying in institutions, as well as vulnerable groups |
| Carry out RT-PCR on all travelers arriving in Cuba | Adjust traveler measures according to the country’s epidemiological situation |
| Mandate that a sworn declaration of health status be completed by every traveler upon entry |
| Hospital biosafety: Maintain suspension of visitors for hospitalized patients, but permit one companion during hospital stay. Maintain protections for hospital staffs. | Permit family members to visit hospitalized patients |
| Hospital services: Gradually re-open hospital activities, outpatient services and other ambulatory care, up to 50% of capacities | Re-open activities up to 75% of institutional capacities | Completely re-open hospitals for all patient care services |
| Labor and employment |
| Pay public-sector workers affected by the epidemic (in isolation or hospitalized) 100% of basic salaries during this period |
| Guarantee unpaid leave (in addition to normal paid leave under law) to mothers unable to return to work, their jobs guaranteed |
| Continue to provide special attention to most vulnerable families, in particular disabled persons, older adults and those living alone |
| Encourage telecommuting when justified and conditions permit | Improve telecommuting implementation and supervision |
| Guarantee 100% of salaries to musicians, actors and others whose performances were cancelled due to the epidemic | |
| In eventuality of workplace shutdown, transfer employees to other workplaces, and if not possible, guarantee them 60% of salary until shutdown ends | When transfer impossible, suspend pay after first month of shutdown, according to Decree Law 326 |
| Pay caregivers for children 60% of basic salaries unable to return to work because primary and special schools are closed | Eliminate this guarantee once schools re-open |
| Social activities |
| Allow religious institutions to gradually re-open, ensuring physical distancing and other hygiene measures |
| Resume visits to penitentiaries, normalizing these in Phase Two, limiting numbers of visitors |
| Services, Taxes, Commerce |
| Maintain priority for vulnerable groups sales of high-demand basic goods |
| Guarantee availability of items included in the basic family basket |
| Maintain postponement of billing for electricity, water, telephone land lines and cooking gas, except for those who can pay electronically Resume billing for electricity, water, telephone land lines and cooking gas, establishing payment timetables for accumulated debt Maintain postponement of billing for individual taxes, taxes on sales and services, and others, as well as those on personal income of artists and artisans Resume billing for payment of these taxes |
| Resume gastronomical services, limiting patron capacities to 30%–50%, with tables separated by at least 1.5 meters | Resume gastronomical services of all types, guaranteeing physical distancing |
| Re-open at 50% capacity amusement parks, zoos, botanical gardens, libraries, museums, aquariums, clubs, fairs and others. Pools at 30%. | Expand capacities up to 80% | Return to full capacity |
| Transportation | | |
| Maintain isolation areas at all airports and ports |
| Maintain medical staff in national bus and train stations, as well as airport terminals for domestic flights |
| Discourage foreign delegation visits to Cuba, and consult on those that may require an exception, due to their high priority for the country |
| Permit only residents of Cuba to enter the country, on the condition that they receive RT-PCR upon entry and remain in preventive isolation for a period of 14 days in centers established for that purpose | Permit entry to international visitors and residents of Cuba, with precautionary measures (rapid test upon entry and home or hotel quarantine followed by family doctors/nurses) |
| Re-establish limited transportation (urban public, intermunicipal, rural, government and private); buses limited to full seating capacity, 50% standing | Expand urban public transportation; buses limited to 60% standing capacity | Fully resume urban public transportation |
| Continue suspension of commercial and charter flights, except for emergencies and those carrying persons collaborating abroad, cargo, donations, or stranded foreign visitors | Continue suspension of international flights; charter flights authorized for international tourism to authorized destinations | Authorize regular commercial flight operations |
| Education |
| Keep schools closed | In September, begin completing the 2019-2020 academic year, assuming all provinces in Phase Two; physical distancing, disinfecting, no entrance for symptomatic students or staff, teachers, daily active screening. | Guarantee the 2020-2021 academic year in the new conditions faced by the country. |
| Sports |
| Continue suspension of international sports events and activities at training camps involving foreigners | Resume training |
| Keep gyms closed | Resume open-air gym activities, depending on their conditions and the country’s epidemiological situation |
| Culture |
| Resume theater, music and dance rehearsals. Performances permitted without audiences, broadcast on social media, radio and TV | Resume activities at cultural centers and theaters, maintaining physical distancing measures |
| Recreation |
| Re-open beaches, limiting numbers of people to avoid crowds | Limit crowds at beaches, all open |
| Tourism |
| Resume tourism, limited to domestic market | Resume international tourism to the northern and southern keys, ensuring tourists are separated from the general population | Begin opening all remaining resorts and tourism destinations |
| Resume all hotel services, occupancy limited to 60% | Permit hotels to apply various alternatives to expand services |
