Government Management and Cuban Science in the confrontation with COVID-19 Díaz-Canel-Bermúdez M, Núñez-Jover J. Anales de la Academia de Ciencias de Cuba [online journal]. 2020 [citado 2020 Jun 26]; 10(2)
The main purpose of this essay is to systematize and reflect on the experiences accumulated in the confrontation with COVID-19 regarding the link between scientists and government. It shows the working system used, the main actions and research carried out and summarizes the assessments and lessons learned from this experience. It notes the important role played by national science and technology, organically linked to governance, with a view to providing a social, scientific, political and health response capable of meeting the challenge that the pandemic has posed to us. Considering that the COVID-19 crisis is global, the essay begins by exploring some features of neoliberalism that hinder the overcoming of crises such as the one caused by the novel coronavirus (SARS-CoV-2). The convergence of several crises at the global level and the increasing complexity of the challenges to be dealt with emphasize the need to escape the trap of neoliberalism. The text emphasizes that what has been achieved in Cuba also has an ethical and political significance.
Use of mobile health in Cuba to fight COVID-19. Vialart Vidal, M.N., Vidal Ledo, M.J. and Pérez Matar, R. Revista Cubana de Salud Pública. v. 46, n. Suppl 1, e2545. ISSN 1561-3127. Spanish only
From March, 2020 when the first cases of COVID-19 appeared in Cuba, it was implemented an intersectoral work strategy that was conceived some months earlier and directed by the Ministry of Public Health, the Civil Defense System and the Government to contain the risk of contagion and spreading of the new coronavirus in the national territory; as well as to minimize the negative effects of a pandemic in the country. This strategy includes the strengthening of epidemiological surveillance, the organization of medical care in healthcare facilities, the training of all the public health’s personnel for diagnosing and care of COVID-19 patients, and the protection of the personnel working with positive cases. For its compliance, there are implemented measures that entail, among other solutions, social distancing which implies when possible remote study and work. It is then when the information and communication technologies become essential for the implementation of these procedures which are linked to actions directly related with electronic health, in general, and particularly with mobile health. Thus, it is the aim of this article to show the experiences related to mobile health in the confrontation to COVID-19 in Cuba, because its use has turned into an ally to face the current sanitary contingency caused by this disease, while it helps in communication, education and health promotion’s processes with a positive impact while bringing to people’s daily life, in a truthful and appropriate way, all the information needed to protect their health. Keywords: Information´s technology; coronavirus; health; electronic health; telemedicine; mobile health
The Basic SIR Model and Antiepidemic Policies in Public Health against COVID-19 in Cuba. Abelló Ugalde, I.A., Guinovart Díaz, R. and Morales Lezca, W. Revista Cubana de Salud Pública. v. 46, n. Suppl 1, e2597. ISSN 1561-3127. Spanish only
The basic SIR (Susceptible-Infected-Recovered) model of Kermack-McKendrick is a compartmental model in which the population under study is divided into epidemiological classes, in between which a flow is described. A robust health system that provides reliable data to the model and combined with coherent public health policies contributes to controlling the impacts of epidemic contingencies. Hence, the objective of this study is to apply the SIR model, without delving into the mathematical apparatus that accompanies it, to know the impact of COVID-19 in Cuba, with an emphasis on Havana, as the center of the epidemic in the country in the period from March 11 to July 16, 2020. To do this, the model is shown with variable coefficients over time, together with its usefulness as a dynamic model to make projections in epidemic situations. It is applied to specific local regions and its potentialities to analyze outbreaks are manifested by the onset of local events that are far from the foreseen predictions. This work is part of the efforts that, in all orders, the Cuban Ministry of Public Health has developed to confront the COVID-19 pandemic. Keywords: epidemiology; mathematical models; public health
COVID-19, external migration and territorial displacement in Cuba, a deferential look at the population residing in the country’s capital Aja, A.; Rodríguez, A.; Orbea, M. Novedades en Población, Centro de Estudios Demográficos, Universidad de La Habana, Cuba; Vol. 16, Núm. 32 (2020) Spanish only
The pandemic caused by COVID-19 has had an unprecedented impact on all areas of human life, including migration and mobility. Starting from the fact that, if the epidemic is contained in one place and in others it is not very likely that it will constantly re-emerge, without a doubt, an important aspect for the gradual and effective recovery of society will be the effectiveness with the that population mobility is contained and subsequently restarted. Based on this scenario and taking into account that human mobility constitutes the main risk of importation and dissemination of the SARS-CoV-2 infection, it has been decided to carry out an analysis of the epidemiological situation and of international mobility and migration in Cuba -with emphasis on Havana- since this province is the capital of the country and the epicenter of the epidemic in the national territory. The fundamental sources of information come from the National Statistical Information System; the Ministry of Public Health; the Ministry of Labor and Social Security; the Ministry of Transport; of the Directorate of Identification, Immigration and Aliens and of information published on the website Our World in Data.
La ciencia cubana en el enfrentamiento a la COVID-19. Velázquez-Pérez L. Anales de la Academia de Ciencias de Cuba [revista en Internet]. 11(1):[aprox. 0 p.]. Editorial https://orcid.org/0000-0003-1628-2703 Spanish only
Pesquisador Virtual: IT solution for the detection of suspected COVID-19 cases. Pierra Fuentes A, Vazquez Cruz Y, Hernandez Heredia Y, Montesino Perurena R. Revista Cubana de Informática Médica [revista en Internet]. 2020;12(2). Spanish only
ABSTRACT This article presents “Pesquisador Virtual”, a computer solution developed by the University of Informatics Sciences (UCI) in collaboration with the Ministry of Public Health (MINSAP), which, through surveys, allows the capture of information about the population’s health status, as a complement to the active inquiry process in the context of the epidemiological response to the COVID-19 pandemic. A mobile and Web solutions are available for the presentation of the survey. The results of the survey (statistical and nominal information) are monitored in real time through graphics and statistics by the different MINSAP structures at the national, provincial and municipal levels, with variable access depending on the level of the structures. With this information, different departments of the health system act immediately, especially Primary Health Care (APS), to prevent the spread of the epidemic and to provide early care for those who may be infected.
Análisis de Modelo Matemático con percepción de riesgo para la CoVid19. Resultados para Cuba. Meció Padrón L, Bayolo Soler L, Marrero Severo A. Revista Cubana de Informática Médica [revista en Internet]. 2020;12(2). Spanish only
ABSTRACT In Epidemiology, Population Models have played an important role, dividing the study population into subpopulations according to the attributes that distinguish them, allowing the dynamics of social contagion of a given disease to be represented, especially at times of epidemic outbreak. This work explains how the transmission of diseases is represented through mathematical models defined by differential equations. In this proposal, a mathematical model defined by differential equations is formulated to represent the transmission of SarsCov2, distinguishing between symptomatic and asymptomatic infected populations of CoVid19, with functions that simulate government and individual actions in the face of risk perception. An analysis of the results obtained in Cuba is also presented.
Contributions of the National Medical Sciences Information Center to the fight against COVID-19. Alfonso Sánchez IR, Alonso Galbán P, Fernández Valdés Md, Alfonso Manzanet JE, Zacca González G, Izquierdo Pamias T, Reyes Pérez CM, et al. Revista Cubana de Información en Ciencias de la Salud [revista en Internet]. 2020; 31(3). DOI: http://dx.doi.org/10.36512/rcics.v31i3.1716 Spanish only
ABSTRACT The fast spread of SARS-CoV-2 has posed big challenges, some of which are related to information management and visibility. Professionals from information institutions have been faced with having to reorganize their services in a short time, with an essential technological component to achieve virtuality in face of the unavoidable imperative of physical distancing. The National Medical Sciences Information Center (CNICM/Infomed) plays a fundamental role in the response plan implemented by Cuba during this health crisis, serving as facilitator and provider of specialized scientific information services, sources and tools, and supplying the required technological platform for the entire national health system and the population. The present document is aimed at describing the workflow devised by this institution, the spaces and modes used for the production and dissemination of scientific information during the epidemic, and the contributions made to the creation of products and the development and implementation of tools and services to support health scientific research and decision making during the COVID-19 pandemic.
Primer acercamiento histórico-epidemiológico a la COVID-19 en Cuba Beldarraín-Chaple E, Alfonso-Sánchez I, Morales-Suárez I, Durán-García F. Anales de la Academia de Ciencias de Cuba [revista en Internet]. 2020 [citado 2020 Jun 26]; 10(2) Spanish only
The events that occurred during the first month of the presence of COVID-19 in Cuba are presented, with the objective of analyzing the containment measures that were taken and assessing whether they were adequate. The historical method was followed, supported by the documentary review technique. The daily reports published by the Ministry of Public Health (MINSAP) from March 11 to April 9 were examined. The reports are available on the websites created for that purpose on Infomed and Cubadebate. Tables and charts were prepared to explain the information presented. In conclusion, we can say that in Cuba the first cases of COVID-19 occurred late in relation to the epidemic in the rest of the world. The creation of a multidisciplinary group to study the epidemiological situation allowed us to work on the evaluation and monitoring of the evolution of pandemic, to design early community intervention strategies, to prepare the health care system for the future appearance of cases, to use science and research in concrete actions and to advise the authorities on designing the national plan to tackle the disease. It constituted a strength together with the detection and early admission of cases and low mortality in the first month of the disease occurrence in the country.
PREPRINT How Mathematical Approaches Could Help Decision-Making to Epidemic Control? The Successful Experience against COVID-19 in Cuba. Sanchez, Lizet and Lorenzo-Luaces, Patricia and Sebrango, Carlos and Torres, Antonio and Fonte, Claudia and Crespo, Marelis and Valdes, Jose E. and Baldoquin, Waldemar and Fonte, Paula and Almeida-Cruz, Yudivián and Estévez-Velarde, Suilan and Piad-Morffis, Alejandro and Morales, Wilfredo and Pérez, Nancy and Araujo, Rafael and del Carmen Pria, Maria and Corral, Ariadna and Noriega, Vivian and Vidal, Maria and Lage, Agustin and Guinovart, Raul and Mas, Pedro, (June 17, 2020). Available at SSRN: https://ssrn.com/abstract=3629271 Posted: 26 Jun 2020
Background. There is a gap for the effective use of mathematical models for real-time decision-making. We aimed to illustrate with the Cuban experience to control the COVID-19, how mathematical models can be put in place to answer key decision-makers´ questions. Methods. A science-policy partnership was created to mutually define questions, communicate results and facilitate the translation of modeling advice into actions. For forecasting and planning at national level mechanistic models and machine learning based on the epidemic patterns in other countries were used. Statistical models to explain the variability of transmission was used to stratify control actions. The effect of interventions was assessed using branching process models, time varying reproduction number (Rt) and social mixing patterns by location, and by age group. Findings. The mathematical approach implemented contributes to successful control of the COVID-19 in Cuba. The urbanization, living conditions and the economic index explain the 73% of the variability of the transmission at provincial level. Increased risk of transmission was identified in 33 municipalities mostly in densely populated urban areas with high aging index. Control intervention reduced the transmission from R0=2.84 (95% CI: 1.52 – 4.76) to Rt=0.6 (95% CI:0.2-2.38 ). The highest transmission was detected among adolescents and from people older than 60 years. Conclusions. Understanding the key questions for decision-making at all times, translating problems into a mathematical language, integrating different approaches to their solution and being able to present the results in an easy-to-understand way is vital to have a timely impact on controlling the epidemic.
PREPRINT Physical-mathematical modeling for decision-making against COVID-19 in Cuba Sánchez Vargas, Héctor Eduardo; Ramos Sánchez, Luis Beltrán; Galindo Llanes, Pablo Ángel; Salgado Rodríguez, Amyrsa June 23, 2020 DOI: https://doi.org/10.1590/SciELOPreprints.815
Objective: Apply physical-mathematical modeling to the dynamics of COVID-19 for decision-making associated with the mitigation and eradication of the epidemic in Cuba. Methods: The modeling was applied to characterize the peak timing of epidemic and behavior of the epidemic, in both cases using MATLAB tools and functions. The peak timing was determined with the application of the SIR model, after some adjustments. It was adjusted with the GlobalSearch optimization strategy. For its solution, the ode23tb function was used, which uses a combined Runge-Kutta algorithm with a trapezoidal rule algorithm. For forecasting epidemic behavior, an exponential model was adjusted using the Curve Fitting tool. Main results: The parameters of the SIR model were identified with an adequate adjustment error and the forecast of the peak timing was achieved by simulation, both in date and magnitude, two weeks in advance and with satisfactory precision. For the peak date, the susceptible, accumulated infected and recovered were also predicted. The calculated basic reproduction number (R0) of 3.62 made it possible to determine that, to eradicate the epidemic by vaccination the immunized population must be greater than 72%. The calculation of the effective reproduction number (Ref) allowed evaluating the effectiveness of the mitigation measures. Reflection was made on the conduct to be followed to eradicate the epidemic. Conclusions: The SIR model demonstrated the ability to predict the peak timing of the epidemic. The R0 of the SARS-CoV-2 allowed to corroborate its high transmissibility. Mitigation measures have been effective and should be maintained until the epidemic is eradicated, even for Ref <1, as long as 72% of the population is not immunized to achieve irreversible eradication.
