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Cuba’s COVID Protocols: Saving Lives

Cuba's treatment protocols and methods of controlling virus spread have played a major role in its success. Photo: Tumisu, Pixabay

Cuba ranks 114th in the world for fatality statistics in the COVID-19 pandemic. It is exactly for this reason many countries have requested the assistance of the Cuban medical brigades in their own battles against the disease.

How have the Cubans achieved this success despite ever-increasing severity of U.S. sanctions and the devastating effects of the global pandemic?

Cuba’s treatment protocols have played a major role. Its success is based on three factors:

1) The coordinated actions of health agencies and entities working directly together to combat the disease.

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2) The merging of science and medical treatment working in coordination with a deep understanding of the solution needed to fight a pandemic.

3) The understanding by the population of the need to comply with the measures needed to help control the disease.

To understand how this works in Cuba, it is necessary to define some distinctions of the country’s health system.

To begin, health care in Cuba is free and medicines are subsidized.

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Scientific institutions have a defined role and are state-run and respond in a single direction. A government decision will instruct these institutions to work together in the face of an emergency such as the Covid pandemic.

There is no competition between institutions that allows for optimal interaction between them. The merits are collective.

Therapeutic Protocols:

Therapeutic protocols are associated with the conditions of the patient and their particular characteristics. Everything depends on the patient’s age, existing health conditions, when the patient enters the health care system, and the stage of the infection.

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The use of both Cuban and imported medicines plays an important role in Cuba’s protocols.
There are three categories of pharmaceuticals used in combatting the virus: preventive measures, those used in the treatment of moderate disease, and those used in the treatment of critical disease.

Preventive Medications:

PrevengHo®Vir: A homeopathic preparation whose function is to strengthen the immune system to fight the disease.

Biomodulin T®: A natural origin immunomodulator obtained from an extract of bovine thymus containing low molecular weight polypeptides, effective in the treatment of respiratory conditions in older adults which stimulates the production of CD4 and CD8 T-lymphocytes and the differentiation of thymus lymphoblastoid cells. It is estimated that approximately 100,000 people classified as high-risk who would benefit from the drug.

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Hebertrans® (Transference Factor): A hemoderivative obtained by leukocyte hemodialysis, which transfers immunity from an immune donor to a receptor with an immune deficiency.

Nasalferon® (nasal formulation of recombinant human Interferon (IFN) alpha-2b): Nasalferon is a formulation of recombinant Interferon-alpha-2b-human for nasal administration that, thanks to the immunomodulatory and antiviral properties of Interferon-alpha, achieves protection against exposure to SARS-CoV-2.

The essence of the use of these preventative measures is to increase the immune response to the virus, aggravated in the elderly by immunosenesis or depletion of the immune system.

Moderate COVID-19 Infections:

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Heberon® (recombinant human interferon alpha-2b): The efficacy of type I interferons is well known in the scientific world. In Cuba the therapeutic effectiveness of Interferon alpha-2b was shown in an observational study carried out in 16 hospitals of 8 Cuban provinces.
From the 814 patients with SARS-CoV-2 were treated with Heberon and 53 received the approved protocol without treatment with Interferon alpha-2b. The fatality rate for all patients was 2.95%, and for those patients who received IFN alpha-2b, it was reduced to 0.92.

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Heberferon® (IFN alpha-2b + IFN gamma): This combination in coactive proportions in a single vial demonstrated improved biological activity, achieving a higher antiviral effect and increased the antiproliferative effect from five to 10 times more than each individual interferon, with less adverse reactions.

Severe Covid-19:

Jusvinza®: An immunomodulator peptide, designed by means of bioinformatic tools, has anti-inflammatory properties. This peptide is derived from an epitope (antigenic determinant) of T cells of the cellular stress protein. To date, more than 70 critical cases of COVID-19 have been treated. The percentage of survival is higher than 94%.

Itolizumab®: Itolizumab is anti-CD6 monoclonal antibody: The CD6 glycoprotein is considered a leukocyte differentiation antigen. In the treatment of cytosine release syndrome associated to COVID-19, Itolizumab proved to be safe. There was no increase of bacterial infections by using this product. There are no reports related to immunosuppression. The ventilatory function was improved. Itolizumab reduced the risk of death in the care of critically ill patients in clinical trials. The effect was more impressive in seriously ill patients.

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CIGB 325®: A peptide with antiviral effect that achieves a significant decrease in the severity and number of pulmonary inflammatory lesions. CIGB 325 also significantly reduces the number of patients with abnormal values of inflammatory indexes (C-reactive protein) and of organic dysfunction (LDH and CPK) 48 hours after the the first use of CIGB-325.

Psycho-social Protocols:

The use of psychology and social sciences are part of Cuban protocols to fight COVID-19.

There is a system of anonymous telephone consultations available throughout Cuba.
Telephone consultations provide instructions for relaxation and breathing techniques, family games, techniques for the care of patients at home, etc.

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There is also an app available for self-diagnosis, guidance, and resources for people.

The use of the media has played an important role in generating programs and resources for psychological support during the COVID pandemic, Information materials have been created for different groups of people. An audio-visual channel has been set up for health personnel in the red zone to use in their leisure time.

Cuba’s management of the COVID-19 pandemic has been successful because of its organization, the role of science and research in its institutions, and its unified response to the pandemic. This contributes to its success and the low numbers in cases and deaths. This is exactly the reason that Cuba’s medicines and doctors are in high demand throughout the world.

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