Havana, Cuba – There is a health clinic on every corner in Havana, each with a family doctor and nurse.
Over the last weeks, these health workers have been out visiting their patients in the Cuban capital, from the solares – warren-like buildings where whole families live in single rooms – to smarter apartments in crumbling art deco buildings where memories of wealth still show in grand windows looking out over the Florida Straits.
They have been telling residents the coronavirus vaccine has arrived and giving out appointments for jabs. This scene has been repeated across the city, and – so long as there are enough syringes to administer doses – will soon be repeated across the country.
In the story of the pandemic, Cuba is beginning this new chapter on a cliffhanger. Having spent 2020 largely keeping the virus beyond its shores, the number of infected patients is now rising fast, with a record-breaking 2,698 new daily cases on Saturday, and a seven-day average now above 2,000. Cuba is facing the biggest surge in the Caribbean.
And yet, last week the country announced that Abdala, one of the five vaccines Cuba has created in its own laboratories – a hugely impressive achievement for a country of 11 million with catastrophically stretched resources – has an efficacy of 92.28 percent. This compares to Pfizer-BioNTech’s 95 percent, Moderna’s 95 percent and AstraZeneca’s 76 percent.
Earlier this month it claimed another of its vaccines, Soberana-02, had an efficacy of 62 percent after two doses. On Thursday, its scientists said that a booster would bring this up to between 85 and 95 percent (Abdala also comes in three shots).
Caveats follow hard on the heels of the numbers, which could shift in the face of new variants. Domestically, the vaccines have been tested on a population that has until now been untroubled by any serious COVID-19 wave, and they have yet to be put to international scrutiny.
“I don’t have any reason to believe there is fraud or manipulation,” said Amílcar Pérez Riverol, post-doctoral fellow in molecular biology at São Paulo State University in Brazil and a veteran of Cuba’s laboratories. “This is biotechnology and eventually the general vaccination will reveal how effective they are. But like every single member of the scientific community, I would like to see the data.”
In Havana, where the population is increasingly spooked by the rising infection rate, the efficacy results have caused widespread joy. “After such a hard year of queues and food shortages, it’s so good to have something to celebrate,” said a woman leaving a local doctor’s clinic last week.
The news even reignited the 9pm applause for Cuba’s health workers. Cubans – who venerate their health service – kept up their daily applause for months, until it finally tailed off under the strain of day-to-day life. There are currently food and medicine shortages and galloping inflation. And then there are the increasing numbers of infected patients.
Early in the pandemic, Cuba’s government saw an opportunity to show off its impressively extensive health service, the “advantages” of authoritarian rule, and a biotech industry that Fidel Castro always believed the country could excel in.
Cuba’s current President Miguel Díaz-Canel called on the country’s laboratories to come up with what he called “a sovereign answer to COVID-19”.
Only there was an economic crisis developing at the same time, as tourists disappeared and the economy contracted by 11 percent. The government was struggling to pay its bills internationally while the US sought to make it ever harder for expatriate Cubans to send money home.
In November, the pressured authorities opened the borders and allowed people in. A day earlier Cuba had 27 new cases and the US had 159,003. Soon after numbers in Cuba began to rise and as of Sunday, there were 13,213 active cases in the country (more than for the entirety of 2020) and 1,253 dead due to the virus.
In May, 33 year-old Marilyn Salazar Martínez heard they were testing the Soberana-02 vaccine in her neighbourhood in the Havana barrio of Vedado. “They were looking for people aged over 60 but I went to the doctor and they agreed to take me anyway.”
She said she did not know whether she would get the vaccine or a placebo. “I wanted the chance of being vaccinated sooner, but also to be part of the search for a solution,” she told Al Jazeera.
Shortly after she was given her second injection, her partner tested positive. “I thought I would be infected as well,” she said. After he was admitted to hospital, a doctor came and gave her a PCR test, which turned out to be negative.
“Three weeks later, after he’d returned home, they confirmed I had been given the vaccine,” she said. “There is no way of knowing if it was just luck or the vaccine that prevented me catching COVID, but since we live together it seems likely it was the vaccine.”
Lack of syringes
According to the Cuban authorities, 2.2 million Cubans have received their first doses of the vaccines, with just fewer than 1 million having the required three jabs. Cuba hopes to fully protect its population this year.
As family after family now troop to their clinics or workplaces to get the vaccine, a new problem has emerged: an increasing concern about a lack of syringes. Because these vaccines require three doses, Cuba’s need is greater than that of other countries.
An international campaign has been launched to supply the island, led by Cuba’s diaspora and international solidarity movements. Global Health Partners (GHP), a non-profit group out of New York, has started a campaign to deal with a shortfall of what they say is 20 million syringes. “To date, we’ve purchased four million syringes. We hope to purchase an additional two million,” Bob Schwartz, GHP’s vice president, told Al Jazeera.
What no one has concerns about, however, is Cuba’s ability to put the vaccine in people’s arms. “Even at the very beginning, I knew that the rollout wouldn’t be the problem, because the primary health care system in Cuba is quite efficient,” said Pérez Riverol.
Gregory Biniowsky is a Canadian lawyer and longtime resident who received the Abdala vaccine at a school in Havana’s Plaza Vieja. “There were six medical staff there. The nurse said there could be flu-like symptoms and a little muscle soreness, and that is exactly what I got.”
Biniowsky believes that not only will Cuba become the most vaccinated country in Latin America in the next six months, but there will not be the reticence about vaccination seen in some other countries, including the US or Russia.
“That’s for three reasons,” he said. “One is the kind of conspiratorial movement that exists in other countries just doesn’t exist here. Then there is the strong belief in science. And the final thing is, I don’t think people will be given any option.”
Cuba has eight doctors for every 1,000 of its people, three times that of the UK or US. They know where their patients live.