CUBA STANDARD — As the number of local COVID-19 infections is accelerating, the Cuban government on April 6 activated the next phase in its response and put four towns in lockdown.

The “limited indigenous transmission” phase is activated when “cases are confirmed in which there was no link to travelers from affected zones, and they are limited to small conglomerates in localities or institutions of the country”, said Health Minister José Angel Portal Miranda.

As of April 12, the following municipalities were quarantined: Consolación del Sur (Pinar del Río province), Florencia, Isla de Turiguanó and Limpios Grandes (Ciego de Ávila), Florida (Camagüey), Gibara (Holguín), Taguasco and Cabaiguan (Sancti Spíritus).

On April 3, authorities put the Carmelo neighborhood and its 27,000 residents in the Vedado area of Havana under lockdown, after eight cases were detected there. Later the same week the Havana boroughs of Playa and Cotorro were put in lockdown.

In one month since the first cases were detected in Cuba, the count has crossed the 700 mark of confirmed Coronavirus patients.

Joining other nations around the globe, Cuba on March 24 banned non-citizens from visiting the island for 30 days and imposed social-distancing measures, effectively shutting down tourism. The travel ban excludes Cuban nationals and foreigners who reside in Cuba. All new arrivals are being quarantined.

A couple of days later, authorities ratcheted up restrictions, blocking travel within the island and travel abroad by Cubans, and closing schools through April 20. Provincial and some municipal defense councils were activated, mobilizing part of the country’s military resources. On April 1, the government suspended all international passenger flights and asked all foreign vessels to leave Cuban waters.

“The measures are beginning to yield results,” President Miguel Díaz-Canel said April 1 on the Mesa Redonda show. “But we cannot trust. We have yet to enter the most critical stage.”

As of April 13, there were 766 confirmed COVID-19 patients, up 40 from the previous day, including three in serious and nine in critical condition. There were three deaths April 12, for 21 fatalities total. More than 2,500 people are in hospitals across the island due to the virus, another 7,200 are under observation in their homes; the situation continues to be fluid, as new patients are admitted and those who tested negative are released.

On April 8, the government announced 25 infections among health workers. The biggest cluster of infected medical staff work at the Calixto García Hospital in Havana, prompting the health minister to announce a shutdown of the hospital and transfer of patients to other hospitals. The minister also mentioned “a smaller event” of contagion for staff at the Manuel Fajardo Hospital in Havana.

Experts warn that there may be undetected cases outside official statistics.

“When we say there is no spread, this is not categorical,” cautioned Francisco Durán García, chief epidemiologist at the Ministry of Health. “We have to take into account that this is a disease that begins to transmit early on, from incubation when there are no symptoms. Therefore, the person can not always be detected, unless there is epidemiological risk.”

Former President Raúl Castro, who is in charge of the coronavirus prevention and detection plan, said mid-March that Cuba’s healthcare system was “ready” for COVID-19. Three labs in Havana, Santa Clara and Santiago are equipped with cutting-edge PCR technology that can offer test results within 24 hours, but it isn’t clear whether Cuba has the capacity to keep up with testing as the numbers increase. As of April 12, more than 17,000 tests had been administered. In early April, the health ministry received 100,000 rapid test kits, for results within 30 minutes, and began testing at a rate of more than 1,000 a day, reaching 2,000 daily tests by mid-April. There are 12 hospitals in Cuba with intensive-care units, and five more with an additional 200 intensive-care beds are under preparation, the Ministry of Health said March 29. Cuba is importing “equipment to strengthen care”, the ministry said. All foreign visitors and Cubans in the capital suspect of being COVID-19 carriers are being treated at the Pedro Kouri Institute of Tropical Medicine in Havana. Cuba says it has drugs for treatment, including Interferon B. According to official media, a state enterprise in Sancti Spíritus began manufacturing masks from fabric it normally uses to make pants for school uniforms. Cuba’s Ministry of Health also posted a video on YouTube showing Cubans how to make their own masks.

China has repeatedly supplied test kits and protective gear to Cuba, as part of Chinese aid to countries around the globe. Chinese bus maker Yutong also donated protective gear. A donation of face masks and rapid test kits by China’s Alibaba Foundation was held up because a third-country shipper — apparently Colombia’s Avianca — refused to forward the donated goods to Cuba, citing U.S. sanctions, according to Cubadebate.

Some social distancing measures do not go beyond good intentions or a hard to be implemented in Cuba. The government’s call to tele-commute to work, for instance, is only backed up by limited lower-cost mobile phone data access in early mornings and 10 free hours of still-rare at-home Internet access; Internet access is very expensive for most Cubans and out of reach for many. Although the streets of Havana are eerily empty now, long lines at pharmacies or subsidized food outlets show how scarcity of basic goods in Cuba is forcing people to cluster around stores. Also, the restricted housing situation for most Cuban families is a risk factor, prompting government officials to argue for a few days that keeping schools open would be safer. Children are “more secure at school because they would be on the streets rather than at home”, Prime Minister Manuel Marrero said March 20. Even so, three days later, Marrero announced school closures through April 20; daycare centers remain open.

Economic emergency measures

The Council of Ministers created a task force, headed by Deputy Premier and Economy Minister Alejandro Gil Fernández and Domestic Trade Minister Betsy Díaz Velázquez, to research and implement economic emergency measures.

“There could be a lasting scenario, and we have to prepare for it,” Gil said, according to Cubadebate. “We have to search for solutions with the lowest economic cost and be ready to recover in as short a period of time as possible”.

Existing investment projects will be finished — particularly those related to water, renewable energy, and food and cement production — but no new ones will be started, for the time being. Idled hotels will undergo maintenance and light renovations.

Food supplies are a major concern, in a country whose calorie intake depends on 60% imports, which are increasingly unaffordable for Cuba as its hard-currency revenues are drying up.

Gil said that Cuba’s agriculture is key to maintaining food supplies, prioritizing resources for rice, plantain, bean, corn, egg and pork production. He added that the most efficient agricultural producers will be rewarded with fuel allotments.

Farmers are under increasing constraints, as imported fuel, fertilizer and pesticides are becoming scarce.

In a relief measure for private businesses, the finance ministry postponed the tax deadline to April 30.

While stepping up surveillance and control measures at airports and marinas, until March 20 Cuban authorities had resisted imposing a travel ban and lockdowns, arguing that there had been no community spread and that all Coronavirus patients in the island were infected abroad.

Impact on tourism

As part of the travel ban, most hotels are closed, and some 60,000 visitors were expected to leave the island by March 24. Foreign visitors in Cuba are not allowed in the streets and restricted to a few hotels that remain open. Nevertheless, as of April 2, more than 20,000 foreigners were still in the island, according to officials.

A Cuban tourism ministry official told Cubadebate March 14 that “some tourists have expressed their preference to weather the pandemic in Cuba, where they are more secure and better attended than in their own countries”.

Given the economy’s dependency on tourism revenues, it is not surprising that Cuban officials tried to maintain the tourist flow as long as possible.

Before the travel ban, the tourism ministry, in coordination with the health ministry, was taking 84 measures for prevention and control, including training for all tourism industry personnel that began in early February. The main aim was to reduce the number of coronavirus-positive travelers entering the country, be ready to treat those already in the country, and prevent the spread in Cuba.

However, after tour operators in some of Cuba’s main source markets — Italy, France, UK and Germany — practically stopped sending tourists to the island, airlines temporarily suspended flights to Cuba, and Canada — Cuba’s No. 1 source market — announced March 20 its decision to close borders to all non-Canadians and all Canadian airlines suspended international flights through at least the end of April, Cuba issued its ban on new arrivals.

Citing security reasons, Miami-Dade Mayor Carlos Gimenez — in a press conference March 17 side by side with Florida Gov. Ron DeSantis — called on President Donald Trump to suspend all travel between the United States and Cuba. Gimenez made the remarks just hours before he went home to self-quarantine after he had met Brazilian officials who tested positive for the virus. He did not call for travel bans to any country except Cuba.

The Trump administration did not issue a travel ban; the political efforts in Miami became moot with Cuba’s total ban on passenger flights as of April 1.

Data about the impact in Cuba is not available yet. A tourism ministry official told official news site Cubadebate that visitor numbers were within plan in January, but that there has been a decline since February due to cancellations of cruises; as of March 14, 12% of trips booked by Italians to Cuba were canceled.

ECLAC, the United Nations agency in charge of tracking Latin American economies, said in a press conference that it expects the region’s economies to shrink 1.8% this year as a result of the pandemic. Among the hardest hit will be tourism-dependent economies such as Cuba: Depending on whether travel disruptions last one, two or three months, Caribbean tourism will shrink 8%, 17% or 25% in 2020, according to ECLAC.

As everywhere around the world, it is raining event cancellations in Cuba. The Fiagrop agricultural fair in Boyeros, the Fecons construction fair, the Informática IT fair in Havana, the Alimentos 2.0 food industry fair, and the industry fair CubaIndustria fair, and the upcoming International Tourism Fair in Havana, planned for May 4-9 in Havana, have all been postponed or canceled. The “Nation and Immigration” conference, planned for early April in Havana, has been postponed, and even the May Day parade was canceled by the Communist Party. The ministry of culture called off all major events, and all major sports events are cancelled, for the time being.

Medical brigades

In a bright spot for the island’s battered economy, demand for Cuban healthcare services worldwide is soaring, and Cuba has sent 596 medical personnel to 14 countries — including two in Europe — to help battle the global outbreak. According to official news site Cubadebate, an additional 400 medics are being trained on COVID-19 prevention and treatment at the Pedro Kouri Institute of Tropical Medicine in Havana.

A first group of 52 Henry Reeve Brigade medics — made up of a logistics manager and 35 doctors, including 23 general practitioners, three pulmonologists, three ICU specialists, three infectious disease specialists and three emergency specialists, as well as 15 nurses, including seven intensive-care specialists — landed in an Alitalia jet at Milan-Malpensa March 21 and was received to standing applause at the airport. The Cuban brigade — part of a request by the health minister of Lombardy, Italy’s hardest-hit region, for medical personnel from Cuba, China and Venezuela — started working immediately at a tent hospital set up by the Italian army in Crema. In a meeting with Cuba’s ambassador, Attilio Fontana, the head of the right-wing Lega Nord government of Lombardy, personally thanked Cuba for the medical help.

In a second deployment to Europe, 39 doctors and nurses arrived in Andorra March 30.

A second contingent made up of 38 doctors and nurses was scheduled to arrive in the Italian region of Piemont April 13, on a jet chartered by Blue Panorama. According to a report in La Stampa, Italian companies — including Alce Nero, Gruppo Boero Bartolomeo and QS4B Partner Vodafone — donated equipment to the brigade.

Some 550 Cuban doctors and nurses were also flown to Jamaica, Haiti, Surinam, Grenada, Dominica, St. Lucia, St. Vincent & Grenadines, Antigua & Barbuda, British Virgin Islands, Venezuela, El Salvador, Nicaragua, Belize, Argentina, Mexico, Angola, Ghana, Nigeria, South Africa and Togo.

Meanwhile, the U.S. Department of State is urging third countries to reject Cuba’s help.

“Cuba offers its international medical missions to those afflicted with COVID-19 only to make up the money it lost when countries stopped participating in the abusive program,” the State Department tweeted. “Host countries seeking Cuba’s help for COVID-19 should scrutinize agreements and end labor abuses.”

“Medics, not bombs,” Cuba’s foreign relations ministry responded in an official note.

It is not clear whether Cuba will receive any revenues from the medical brigades. An official with Comercializadora de Servicios Médicos S.A. — Cuba’s for-profit medical arm — in Beijing said her agency will “continue to help provide wellbeing and quality of life” in China.

Also, Cuba is offering Cuban-developed Alfa B2 Interferon, which has reportedly been used in China to battle COVID-19, to other nations. El Salvador, Nicaragua and 43 other countries have requested tens of thousands of doses, according to export promotion agency ProCuba.

Pressure on the U.S. to ease sanctions

Economy Minister Alejandro Gil Fernández pointed out that tightened U.S. sanctions, including efforts to stop shipping companies from supplying the island with fuel, are making Cuba’s economic response to the crisis even more challenging.

“There is no flexibility,” Gil said, according to Cubadebate. “The pressure to prevent Cuba from accessing financing abroad continues.”

April 12, Cuban media reported that Switzerland’s IMT Medical AG notified state importer Medicuba they will suspend sales of respirators to Cuba, after the company was taken over by Illinois-based Vyaire Medical Inc.

Responding to the mounting toll of the health crises in Venezuela, Iran, Cuba and other countries, UN High Commissioner for Human Rights Michelle Bachelet urged all governments to ease sanctions.

“It is fundamental to avoid the collapse of national health systems, taking into account the explosive repercussions this could have in terms of death, suffering and broadening of contagion,” Bachelet said in a communiqué.

Bachelet called for an easing or suspension of sanctions.

“In the context of a global pandemic, any measures that hinder medical care in any country increase the risks we all face. Humanitarian exemptions connected to the sanctions must be set in motion in a broader and more efficient way, through the rapid and flexible authorization of providing equipment and medical material.”

The next day, eight pro-normalization organizations in the United States called on the Trump administration to suspend sanctions, and 11 U.S. senators, led by Connecticut Sen. Chris Murphy, urged Secretary Mike Pompeo and Treasury Secretary Steven Mnuchin in a letter to ease sanctions on Venezuela and Iran.

Amid the crisis, Mnuchin’s Office of Foreign Assets Control (OFAC) recently issued more sanctions against Venezuela, Nicaragua and Iran, and — taking the pressure to a military level — the Trump administration sent a small armada of warships to the coast of Venezuela, saying they are needed for drug interception.

Welcoming a quarantined cruise ship

In other news, Cuba welcomed the MS Braemar, after a British government request. The 929-passenger cruise ship owned by Fred. Olsen Cruise Lines was not allowed to dock in Barbados or Bahamas, after at least five people on board tested coronavirus-positive.

The Braemar arrived at the Cuban coast near Mariel March 17, docked on March 18, and 650 passengers were transferred in a convoy of Transgaviota buses — complete with police escort and tow truck — to José Martí International Airport to board three British Airways flights the same day.

All 43 Cubans involved in the Braemar evacuation tested negative after a two-week quarantine.

Cuba also allowed an evacuation flight by German airline Condor on its way back from Nicaragua to Germany to refuel in Holguín, after other countries rejected their request.

The first cases in Cuba

Three travelers, who arrived March 9 from Italy’s afflicted Lombardy region, were the first confirmed cases of the novel coronavirus in the island. One of them, a 61-year old with a pre-existing condition, became the first fatal victim in Cuba.

Francisco Durán, chief epidemiologist of the health ministry, said on state TV that the Italian patients arrived in a group of four travelers at Havana’s José Martí International Airport without symptoms, and lodged at a hostel in Trinidad. After one of them began to show symptoms, all four were taken to the Pedro Kouri Tropical Medicine Institute in Havana, where three of them tested positive.

The tourist guide and the driver who helped detect the coronavirus-positive Italians were lauded by name in official media.