Cholera in Cuba
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What Happens If Ebola Comes To Cuba?

What Happens If Ebola Comes To Cuba? / Jeovany Jimenez Vega
Posted on October 17, 2014
By Jeovany Jimenez Vega

The Ebola outbreak on the world epidemiological scene will obviously
involve a huge challenge for every country that is reached by the
current epidemic, already registered as the greatest in history and that
in recent days has reached about 9000 confirmed cases — although experts
say that figure is an undercount. The World Health Organization (WHO)
recently reported that the epidemic is not being confronted will all the
political rigor that the moment demands on the part of the international
community and also warned that if the situation is not brought under
control in time, by 2015 it predicts an incidence of about a million and
a half cases.

It is easy to conclude that arriving at this state of things the danger
would only grow exponentially. We are confronting an extremely
contagious illness of non-vectoral transmission, that can be spread
person to person through the most subtle contact with any bodily fluid
of an infected person — and that may be transmitted sexually to boot,
given that the virus is isolated in semen until 90 days after recovery.

Although a first clinical trial for a vaccination has just been
implemented, the reality is that for now the medical treatment protocols
are in their infancy in the face of a disease that in previous outbreaks
has reached a lethality of between 90% and 100% of cases and in the face
of which one can only commit to treatments of its severe complications
and to practice the usual measures for life support.

Today is raised before man a threat by one of the bad boys of virology,
which demands the implementation of the most extreme biological
containment measures, as well as the use of the most specialized and
scrupulously trained personnel for its handling.

Such a scene places before us the most elemental question: what if Ebola
breaks out in Cuba? This is not negligible, and it stopped being a
remote possibility after the departure of a detachment of hundreds of
Cuban professionals destined for the African countries flogged by the
epidemic. Let’s remember the possibility that it was that route used by
cholera to reappear in our country, imported from Haiti after an absence
of 120 years, and not to mention the everlasting dengue fever.

The eruption of this most dangerous illness in Cuba could simply take on
shades of tragedy. Beyond how dissipated may become the customs of the
inhabitants of the alligator, I am inclined to fear by the experience of
one who has seen too often the systematic use of recyclable material,
the usual practice in Cuba, even when long ago the world definitively
committed to the exclusive use of disposable material: the idea of
treatment centers for these patients winding up recycling suits, gloves
or other materials because it occurs to some pig-headed guy from the
“higher level” that this would “guarantee” safety under such
circumstances is terrifying.

In a country where too many times a doctor does not have in his office
something as basic as running water and soap in order to wash his hands,
it will be understood what the demand for costly minimal material
demanded for handling patients with Ebola would involve, and if besides
we take into account that the almost generality of our hospital
infrastructure is not designed or prepared objectively for the
containment of this kind of scourge, now we will be able to raise a
prayer to the Virgin to save us from the trance.

On the other hand, let’s not forget how reticent the Cuban authorities
have shown themselves to be about publicly reporting on the incidence of
epidemics when one considers that this might risk the affluence of
tourists or the successful conclusion of some relevant international
event — the Cuban dengue fever mega-epidemic of 2006 is still an
excellent example in that regard.

With all these antecedents at hand, chills are felt before the
possibility here considered and the questions that remain unanswered.
Will the Cuban Public Health System be prepared to control the Ebola
outbreak with the required speed? Will we Cuban professionals have the
training, methodology and even the discipline necessary for adequately
confronting a contingency of this caliber — and that quite few seem to
have faced before? When the moment arrives, will our government be
ready to report the truth bluntly to the people and to the world? Will
this “infallible” government that has exported dozens of medical
missions around the world have the humility to recognize its inability
to control it and to seek help?

Since the strategy followed until now by WHO at an international level
may be debatable — which has accepted being faced with the most serious
epidemiological problem since the appearance of AIDS — in regard to the
transfer of the foreign sick in order to receive treatment in their
respective countries. Obviously this increases considerably the
possibility of transcontinental spread of the virus.

Instead, it would be much more recommended and safe to create adequate
conditions in the country where each case is confirmed through a
centralized and functional network of field installations correctly
equipped and with the full extent of security that is presupposed, where
each patient is diagnosed, isolated and treated on site. For example,
it would be worthwhile to consider, in order to implement this kind of
possibility, the immediate conversion of uninhabited coastal African
islands under the supervision of the experts of WHO and similar
organizations such as Doctors Without Borders.

Means analogous to these, and apart from any legal or political
assessment, would be more convenient and effective for the containment
of this epidemic. Even the UN — which came to air the topic at the
Security Council — could deliver strong resolutions that support and
regulate these variants, and it would all be justified by the gravity of
a moment that is not made for warm cloths. It requires taking the
strongest measures everywhere the illness is found, if with these
measure rapid control of the situation is achieved — including the
extreme recourse of military quarantine where it comes to be evidently
applicable and necessary.

Admittedly, this proposal may be offered to varied readers, but in
operative, practical terms it may constitute the only option that
guarantees concrete solutions that stop the advance of this fearful
scourge. It may be now or never: we live at a critical time that
demands critical measures. What is not rushed today for lack of
political will, governmental indolence or timidity by world
institutions, undoubtedly will tomorrow charge a much more dramatic and
global human and economic cost.

Source: What Happens If Ebola Comes To Cuba? / Jeovany Jimenez Vega |
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