MONDAY, JUNE 18, 2018

Cuban civil defense teams keep swine flu at bay

HAVANA — Cuba is ready to use just about everything at its disposal, from its well-oiled civil defense system to the soldiers of a totalitarian government, to keep swine flu cases to a minimum.

Everything but a vaccine.

As the U.S. prepares an extensive health survey for side affects from its massive inoculation plans, Cuba’s No. 2 health official says relying on a shot to contain a world pandemic is risky as best — and demoralizing at worst.

“Nobody knows if it would work,” Dr. Luis Estruch told The Associated Press in an interview. “How safe would it be?”

Cuba’s sophisticated public-monitoring system and geographic isolation as an island have kept swine flu cases to 435 in a country of 11 million — and no deaths to date. That’s roughly one in 25,000 people, compared with one in 6,900 in the U.S. and one in 4,000 in Mexico.

Swine flu plans for the new season involve all ministries, including the armed forces. If necessary, the government will isolate neighborhoods or entire villages, shut down highways and dispatch medical teams to communities affected by swine flu, Estruch said.

Soldiers can go door-to-door to enforce mandatory quarantines and evacuations — and authorities think nothing of severing areas from all contact with the outside world.

“In a matter of hours, we can determine what resources to send,” Estruch said. “We’ve thought it out. … We’ve considered what to do if we have to paralyze a town, if we have to stop public transit, if we have to close the schools.”

It works — but only at the cost of individual freedoms, said Jose Azel, an economy specialist at the University of Miami’s Institute for Cuban and Cuban-American Studies. Cuba “certainly has advantages to do what it wants to do that we can’t — commanding people,” he said.

Globally, the virus has caused at least 3,205 deaths since it first appeared in Mexico and the U.S. earlier this year, the World Health Organization says. More than a quarter-million cases worldwide have been confirmed, though most are mild and don’t require treatment.

It’s not that Cuba isn’t up to the task of developing a vaccine.

Cuba’s Center for Genetic Engineering and Biotechnology makes nearly 100 products, including more than three dozen drugs to fight infectious diseases. The island also has 12,000 registered scientists, reflecting the importance the government places on medicine and science.

Dr. Jarbas Barbosa of the Pan American Health Organization praised Cuba’s close collaboration with international health agencies. But he questioned the government’s methods of isolating people to stem the spread of the virus.

“In general, we have no evidence that they work,” said Barbosa, who is chief of health surveillance and disease management. “And they can produce a profound social and economic impact.”