Cuba reinforces epidemiological surveillance at ports of entry.

Cuba reinforces epidemiological surveillance at ports of entry.

To date, Cuba has not made the decision to close our borders to travelers from any country, but careful follow-up has been established for all passengers, especially those arriving from high risk nations.

At Havana's José Martí International Airport, the flow of travelers continues to be normal, and no flights have been cancelled, to date. Surveillance measures, however, are being reinforced, based on the confirmation of Covid-19 cases in Cuba.

According to Jorge Luis Bubaire Quintana, head of Customs at the airport, protective measures taken by personnel involved in operations are obligatory; training has been reinforced; and daily epidemiological updates regarding Covid-19, both in Cuba and worldwide, are studied.

"To date, the Cuban government has not made the decision to close our borders to travelers from any country, but careful follow-up has been established for all passengers, especially those arriving from high risk countries," stated Dr. Francisco Durán, the Ministry of Public Health’s national director of Hygiene and Epidemiology.

The director explained recently that none of the cases detected in Cuba have resulted from transmission within the country. All are related to infections acquired abroad. "Quarantine is established based on transmission and, at this time, it is not justified. We are working to avoid reaching that moment.

"Nor is it prudent to close schools or workplaces until there is transmission within the country. When there is no evident transmission and you close schools, extra stress is produced, which reduces immune response. Cuba is on the alert and it has been announced that a number of activities involving large concentrations of people have been cancelled," he said.

Additionally, Cuba ensured the timely activation of a prevention and control plan, well in advance of the first confirmed cases of Covid-19, based on the expertise and experiences of our public health system, to protect our population and proceed as indicated in protocols established by the World Health Organization (WHO) for situations of this type.

In this regard, Michael Ryan, executive director of the WHO Health Emergency Program, in a March 14 statement, reported by the Spanish newspaper La Vanguardia, stated, "The organization questions the effectiveness of banning the entry of travelers from other countries, as has been done by the U.S. with flights from the European Union. Travel measures alone do not solve anything," Ryan said. "The most important thing in this epidemic is to detect cases, isolate them and treat them.”

In Cuba, in the event that immigration or International Health Control (IHC) authorities identify a traveler with respiratory symptoms, the established protocols are followed. The first step, according to the head of customs at José Martí International Airport, is to isolate the individual from other passengers, in one of the isolation rooms set up for this purpose. "Here an epidemiological interview and a first clinical evaluation of the patient are conducted, and then transportation to the designated hospital is requested from SIUM (national emergency services)," he explained.

He noted that communication is established with every arriving aircraft through the control tower, and any incident that may have occurred on board is reported to Cuban authorities before the plane reaches the gate.

According to International Health Control specialists at the airport, in the event that the crew reports the presence of a traveler arriving from a high risk country with symptoms that could be indicative of Covid-19, this person and those who were close during the flight are isolated, and the same protocol is followed.

On the front line of the surveillance process, we hear, over and over again, the same questions: Are you feeling well? Have you had a fever or other illness recently? This is the conversation health personnel have with every passenger arriving in the country.

Responses are corroborated in the health declaration that all travelers must complete before entering Cuba, stated Ana María Pérez Gómez, International Health Control coordinator. "On the form, recorded is not only personal data, but also where the passenger will stay during his or her visit in the country, and this information is incorporated into a computerized database, which is passed on to the appropriate health care district.

"In this sense, family doctors play a very important role, because they must establish surveillance of persons who arrive from countries considered at risk, including China, Japan, Iran, South Korea, Italy, France, Spain, Germany and the United States," she said.

In the case of hotels, Pérez explained that designated doctors onsite conduct ongoing observation of targeted guests, while community primary care teams check on visitors staying at private hostels. A system has been created for proprietors to report any guest with suspicious symptoms.

When asked how a person with the coronavirus could be checked at temperature scanners and other surveillance points without raising alarm, Dr. Lautaro Fuentes, a specialist in General Comprehensive Medicine, explained that the identification of a traveler with a Covid-19 infection is based on his or her condition when passing through Immigration and Customs, at a glance, without further analysis.

It must be remembered, he insisted, that the incubation period of this virus can be as long as14 days, during which the person may be asymptomatic. Hence the importance of the surveillance process and subsequent monitoring of passengers arriving from countries at risk.

"In the event that our personnel observe a person with symptoms indicative of a respiratory illness, coughing or having difficulty breathing, we check his or her temperature, and depending on the medical data, we transfer the passenger to the isolation room or allow them to continue."

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