"We are going to tackle this epidemic in the same way we tackled COVID-19," said Miguel Díaz-Canel Bermúdez, First Secretary of the Party's Central Committee of the and President of the Republic, on Tuesday afternoon at the Meeting of Experts and Scientists on Health Issues.
From the Palace of the Revolution, where specialists in various fields related to health care gathered, and among whom were familiar faces of those who contributed greatly with their knowledge when Cuba faced the coronavirus, the Head of State called for weekly meetings to provide scientific analysis and proposals for solutions to the epidemic of cases of nonspecific febrile syndrome, caused mainly by arbovirus.
The first item on the agenda—which was also attended by the Deputy Prime Minister of the Republic, Eduardo Martínez Díaz—was an update on the epidemiological situation of arboviruses on the island. In this regard, Dr. José Raúl de Armas Fernández stated that the second consecutive week of decline in Febrile Syndromes has come to an end.
This reality, he said, is due to the fact that this change has occurred in eight provinces: Havana, Matanzas, Villa Clara, Cienfuegos, Ciego de Ávila, Granma, Santiago de Cuba, and Guantánamo.
The expert stated that this has been an epidemic year, with an increase in fever cases in 68 municipalities. Turning to the topic of arboviruses, the doctor explained that 38 municipalities have been affected by dengue transmission and that, in the case of Havana, cases of this disease have been reported in all municipalities.
Regarding Chikungunya, José Raúl de Armas Fernández explained that the cumulative number of cases has risen to 21,681, of which more than 20,000 are clinically suspected cases, in 14 provinces, 93 municipalities, and 151 health areas. He stated that the provinces with the highest number of cases are Matanzas, Havana, Camagüey, Cienfuegos, Artemisa, and Villa Clara. These territories account for 98.5% of cases.
With regard to Oropouche, no confirmed or suspected cases have been reported since September 26, according to the expert.
Among other interesting facts, María Guadalupe Guzmán Tirado, PhD, commented that 119 countries have reported transmission of Chikungunya; that, due to the spread of the virus, "surveillance continues" in Cuba; and that, once the start of transmission in the province of Matanzas was identified, experts are now conducting more in-depth studies.
IDENTIFYING THE PROBLEM IN TIME
Once the meeting was over, Dr. Yagen Pomares Pérez, Director General of Primary Health Care at the Ministry of Public Health, shared valuable insights with journalists about an epidemic that is causing concern for many. She began by talking about the importance of identifying the problem as soon as the patient develops a fever.
"The fundamental objective of our system," she said, "is to admit all patients with fever syndrome. This admission can be at home, through a home admission, or it can be based on criteria that have already been approved."
On this last point, she referred to a protocol that "has already been approved in its second version." Along the same lines, she said that this is one of the lessons learned from the days of COVID-19, "when we quickly put science and research to work on the problem." She stressed the need to "admit patients."
She also referred to a challenge in primary health care: "Getting our patients with fever syndrome to comply with isolation at home is complicated, but I think this is the first aspect" that must be taken into account.
The second, she argued, has to do with "follow-up by basic health teams." In this regard, she spoke about how this monitoring has been organized "from within our own system," with the support of fifth-year medical students, "who already have all the skills necessary to do so."
According to the Doctor of Science, this was "an experience that we worked on very intensively in Matanzas," and which has now been extended to the whole country.
With regard to hospitalized patients, the expert said that "all children under two years of age with Febrile Syndrome should be hospitalized." The same applies, she said, to pregnant women, who are subject to "more exhaustive monitoring." In the case of adults, she commented that those who show warning signs such as prolonged fever, loss of consciousness, persistent abdominal pain, or other worrying symptoms should be hospitalized.
Older adult patients, as Yagen Pomares Pérez explained to the press, should also be hospitalized because they are more vulnerable, as they often have comorbidities such as high blood pressure, diabetes, or other life-threatening conditions.
ACTIONS IN THE FIELD
"We all know that the main concern of our population today is adulticide treatment, fumigation," Dr. Madelaine Rivera Sánchez, national director of Surveillance and Vector Control at the Ministry of Public Health, told reporters. She explained that "it has not been possible to reach all areas, as we have been accustomed to doing during all the years we have had epidemic outbreaks."
The specialist said that work has been done, "concentrating teams at the municipal level, to be able to reach the most complex areas, where we have evidence of arbovirus transmission."
She stated: "Based on analyses we have carried out in the country and technical issues we have been able to review, we will now have equipment that will allow us to reinforce actions, especially in the municipalities that currently have the greatest complexities with regard to transmission, particularly of Chikungunya."
The doctor stated that "we are trying to cover all the urban areas we can reach, not only where we have evidence, but also where people tell us there are cases, so that we can carry out adulticide treatments."
In another necessary assessment, the expert stated: "One problem we have had at this stage is that, precisely in these two weeks of treatment that we have been working on in November, there are some provinces where it has not gone well because equipment has been left on the ground; and these are the issues that we are going to reinforce."
She spoke of following up on what is being done, because what is unacceptable, she said, is to have the equipment, the insecticide, and even the fuel today, and not obtain the expected results due to a lack of manpower. What it is about, she stressed, is preparing them for the sake of quality, which is vital.
The doctor also emphasized community participation: "Intersectorality, everyone's perception of risk, and constant support are very important so that vector control actions can be carried out."
We are talking about a disease, she said, "that has spread very quickly due to the presence of mosquitoes; and it is against the vector that we must continue to take the main actions in order to solve this problem, which is affecting the entire population, in the shortest time possible."
