Why Cuba will do better in a pandemic than the US

Is 'when the time comes' wearing thin?

christian: Do you have a suggestion as to how to say it?

If the bird flu strikes here, I'm taking a raft to Cuba.

Revere, that is an assumption and based on a premise and not in fact. The Great Satan has never witheld food or medical supplies from Cuba. But they do expect them to pay for it. Cuba buys most of their stuff from the UK and Germany. Prior to about 98 they were just given it by the Cubans.

I would bet they fold up like a pair of deuces in front of a pair of aces and be gone as a nation within days of BF arrival. I think it would also spread like wildfire thru their nation. Find me an army Fidel and his brother would be overthrown as this augers into them without a question. Or they will be simply shot. We will have the same problems as they will. We are just less likely to go after our government.

If things are so rosy then why the aid caravans with medical supplies? Call Michael Moore if it comes then all who think that Cuba is the garden spot of medical care should charter a boat and head on down.

Its not so much about the UHC as it is the food and fuel. That is in very short supply there. They are a bit closer to their food supply but they still have to import it. As an island nation their survival is based upon fuel deliveries more than anything else. Many are riding bicycles rather than driving cars as of this post. Food is second on that list and since there is no vaccine they could have a thousand ventilators but likely no one to install or run them and you still need electricity to do that. Nothing so far yet has indicated that really anything but pure cost will be incurred in trying to keep someone alive. Nothing to point at and say Tamiflu helped, or statins (although I think this on consultation might work for better outcomes) or even having a ventilator rammed down someones throat works. Just nothing there so far.

http://seattletimes.nwsource.com/html/localnews/2003770765_cubabus02m.h…

Christian-Not really. Because if you are one of the ones that doesnt think its going to happen then by all means express yourself to that effect. On the other hand please dont tell people not to prepare because if you are wrong then they will die with an almost certainty. If I and others are wrong then you get to eat all the food you stocked up, or donate it to a food bank somewhere.

I wonder how we will be judged if it does or doesnt come. Are bragging rights post of a pandemic worth anything or would they be if it doesnt come in the next three years?

Correction to first para... Should be given it by the Russians, not the Cubans.

Socialism means the public ownership of the means of production, and health care for all. Cuba has it and the US does not.
Bird flu will probably not kill you, but MDR-TB and XDR-TB will. Once tuberculosis becomes resistant to all anti-biotics, the game is over.

Randy: Not an assumption. The embargo has affected almost everything, including the health system. They can't get spare parts and many other things they need to function. Regarding assumptions, your view is all assumption and not based on fact. I've seen Cuban health care. Have you?

I think Cuba will pull thru better than the US as the are used to shortages, no cars / riding bikes, hardships, etc.

Within two weeks, the supply chain will break here, the twinkies and Ho-ho's will be emptied out of local Wallymart and the SUV, second mortgage crowd is going to go into the fetal position and quit.

Bhah say the Sheeple, bhah. . .

I am with Revere. What does the Cuban population need fuel for? Heating their homes? They live in the tropics. A flu pandemic will likely hit during the winter, which means a lot of northerners will be SOL.

They have universal healh care, which means they have "enough" medical personnel to treat the entire population. Perhaps not to the standards that those with health care in the US get, but they have more health personnel per capita. That is important when health care providers start dying and becoming incapacitated.

There are not as many weapons there, so when the health care system starts to triage, there won't be people trying to jump the triage at the point of a gun. Once the wide-spread shooting starts in the US, there will be fires with no one to put them out. There will be looting and lots of destruction.

I hope I am wrong, but I think that flu will kill more Cubans, but the combination of violence and flu will kill more Americans.

Cuba's big advantage will be that it is in effect a huge island prison. It's own people rarely leave and the flow of foreign tourists in is tightly controlled. Meanwhile the US has shown that it has no wish or ability to control the flow of millions of illegals and the diseases they carry across it's borders. Once the pandemic hits Cuba can simply close it's ports and airports and wait things out.

John: The US probably has more people per capita in prison than Cuba. MOreover they have quite a bit of foreign travelers from other countries, just not the US, since this country is so free we aren't allowed to go there.

The idea immigrants bring disease is as old as immigration. Probably said about your ancestors, who, unless you are Native American, were immigrants. Do you know they were legal? Ever seen the documents? Given where bird flu is coming from, we are much more likely to bring it to Central and South America than the other way around. Next you'll tell me immigrants are bringing leprosy (which, BTW, is barely contagious).

Revere: That canard about immigrants bringing disease gets trotted out all over the place. In Australia, the latest trend is that African migrants will bring AIDS. I smiled a wry smile when last month's WHO Buelltin came out with this:

Andrew Page, Stephen Begg, Richard Taylor & Alan D Lopez, "Global comparative assessments of life expectancy: the impact of migration with reference to Australia"

Seems migrants have much healthier lifestyles than your typical aussie, and have been propping up our life expectancy for years. I expect the same thing could be said for our brothers-in-gluttony over in the US.

Cuba reverted to sustainable agriculture practices in the '90s, out of necessity. Big farms became small farms once again, and people recovered indigenous knowledge about how to grow their own food. Any culture that's made that transition is in better shape than we are. Our ChemLawns aren't going to feed us when the grocery store shelves are empty. I would venture that any area where people lead low-tech, somewhat more locally self-sufficient lives will fare better than we will in the land of petroleum-enabled interdependency.

The idea immigrants bring disease is as old as immigration. Probably said about your ancestors, who, unless you are Native American, were immigrants.

Ask any Native American about the diseases immigrants brought!

No Revere, havent been there. You must have gone during the J. Carter days when they were shipping us their criminals and mindless on the Air Florida flights into Homestead. Now thats where I got to see them first hand coming off the planes and in the Krome Detention center. I cant go any farther about what I know about Cuba, I can tell you that its a house of cards and likely to spin the second Castro goes, w/wo his brother.

You make an assumption about an assumption. The embargo is in place because every President since Kennedy has determined that they are not to be recognized and J. Carter almost turned that over. Right up until the revelation that there was a Russian Army combat brigade in country -55,000 of them. I guess you werent around for that briefing Revere. It was also just about the time that we boycotted the Olympic Games that it was found out. You know, this is the same regime that supported Russian when they had their little moles in Afghanistans army line up all of their tank commanders at attention and then the Russian troops just machine gunned them.

Castro did a lot of that kind of stuff too. He isnt in power because the people elect him, or UHC. Its because he is the only guy on the ticket.

Now here's another revelation. They have UHC because if they had to choose between food and housing, they would obviously choose UHC. HUH? Now did that make sense?

http://www.buildfreedom.com/tanner/evolution.shtml

http://www.globalsecurity.org/military/library/report/2004/32247pf.htm

I am sure North Korea, Saudi Arabia, Myanmar and any other police state without civil liberties will do better than the US in an epidemic of bird flu. I really do not see that as a compelling reason to imitate any of them

An obvious advantage for a totalitarian state is that it will be much better able to set up efficient quarantine, preventing spread of the disease. If this was tried in USA I suspect people would try to shoot their way out. The larger self reliance would also help in case of an epidemic severe enough to interrupt international trade.

Relatively speaking I suspect Cuba would be able to handle a large epidemic better, but I suspect that in absolute terms USA would still be left better off. At least assuming enough Americans are smart enough to dig up their ChemLawns and plant potatoes instead.

At least in Cuba if the bird flu comes least there will not be contingents of wingnuts scolding the rest of the country how their lifestyle is to blame. Forget about UHC, this is reason enough alone to emigrate

Monitoring birds has zero to do with effectively interrupting transmission of pandemic flu.

Universal health care has zero to do with effectively interrupting transmission of pandemic flu or treatment of pandemic flu without stockpiles of antivirals or even black elderberry extract.

You're speaking without knowledge of what Cuban's lifestyles are like. They are more social and outgoing than Americans. They have little refrigeration and little money. Those in small and large communities buy small amounts from vendors and shopkeepers, daily.

When pandemic flu reaches their island, they will have no PPE, no antivirals, a gregarious street and coffee-house lifestyle, nothing in their larders, and will experience the same attempt to throttle their behaviors as in the US.

Even their police state, and it is a police state, with undercover thought police everywhere (welcome to Cuba!), will not be able to function. Anyone who thinks about this realizes that social intercourse is the bane, and they need that to enforce their brand of civilization on their masses.

Not a chance that they'll do better than those in the US who live rurally, semi-rurally, who shelter in place, who are thinking middle class and above. The poor in the US will nearly all be exposed. That's how it was in the past and how it will be yet again. But to say that Cubans will fare better, now that you have a bit more info on how the place is, is a misconstruction of the evidence at hand.

Revere: I've seen Cuban health care.

Was that on an "official" tour by any chance...?

BWV: You miss the point. It isn't about whether they are or aren't a police state. Read it again. It is about a functioning public health and health care system.

Thoughtful: Everyone seems to have a strong opinion about Cuba. I am not without knowledge of Cuban "life styles." Moreover you cannot stop a pandemic, you can only manage its consequences. They are in a better position to do that than we are because they have UHC and a good public health system with social supports. The Vatican has "thought police" too, as do Iran, Iraq, Saudi, etc. They will do badly in a pandemic.

"I don't know any of the details except that they have trained personnel for the purpose and they say they have invested millions of dollars and are following what goes on elsewhere closely."

I'd be skeptical, revere, of their ability to really respond: its a sketchy article without much detail. Cuba's made some really awful investments in healthcare (it sank a huge quantity of $$$ in biotech and got little in return). They *do* have excellent expertise in immunology and vaccines, but whether they have the physical infrastructure to respond is doubtful (although the lack of infrastructure would inhibit the spread of virus also).

On the plus side, Havana (being in a police state) is a heck of a lot safer than Caracas. (But then, wandering down the middle of a freeway is safer than Caracas.)

Sock: One thing the do have is the physical and social infrastructre in public health. Take a look at the Harvard School of Public Health link in the post (and the BBC link on their health care system is informative, too). Not perferct by any means, but light years ahead of the US with only a fraction of the resources to work with.

Thoughtful - is not the first rule of containing an epidemic an efficient monitoring system? Cuba has a universal health system, with local doctors and clinics. This should hopefully pick up a problem more quickly than a 'market' system, with its barriers to entry and divided structure. Once the system responds to that first case or two, then quarantine measures can be quickly brought in, particularly because it is a 'police state', as Thomas has pointed out.

True, drugs will be short supply, and the poor will continue to be socially mobile, but in a country where travel can and is restricted, hopefully an outbreak which took place in the countryside (which would perhaps be the obvious place) can be contained within one area.

And of course, the Cubans have long had to exist without large-scale agricultural imports, as Mindspin noted, and raise poultry on a small scale. Since the UK's bird flu outbreak at a Bernard Matthews turkey plant probably originated in Eastern Europe and involved large amounts of birds in one place, hopefully Cuba would be less vunerable than many other countries.

Frankly, I don't think anyone is going to come out of it well, when it comes.

If Cuba actually does better in a pandemic situation, it will be because the government will shoot on sight anyone who leaves their house.

af: very intelligent. Not.

For my way of thinking, Cuba will suffer dramatically and far worse than the US. They are a bit closer to the food supply, but and its a big but who is going to be farming?

The premise is that they will do better because of UHC. I doubt that seriously because there is no vaccine, Tamiflu and everything else is in question on that line, and we likely have a somewhat better food supply. Also in my way of thinking, we will do poorly in the cities from onset to end because there are too many drains on the single system. Out in the boonies they are a lot more resourceful, dont depend on the system as much and most are already prepared for the better part for power outages, days of snow or heat, and they have more food on the shelves. They can also farm. A guy on a tractor can do about 300 acres with a tank of fuel and he might not get as good a yield in the fall without fertilizers, but he aint gonna starve.

Potato farming is a good idea actually. You might not get everything you need from a vitamin standpoint but you would for sure not starve either.

For my way of thinking, Cuba will suffer dramatically and far worse than the US. They are a bit closer to the food supply, but and its a big but who is going to be farming?

The premise is that they will do better because of UHC. I doubt that seriously because there is no vaccine, Tamiflu and everything else is in question on that line, and we likely have a somewhat better food supply. Also in my way of thinking, we will do poorly in the cities from onset to end because there are too many drains on the single system. Out in the boonies they are a lot more resourceful, dont depend on the system as much and most are already prepared for the better part for power outages, days of snow or heat, and they have more food on the shelves. They can also farm. A guy on a tractor can do about 300 acres with a tank of fuel and he might not get as good a yield in the fall without fertilizers, but he aint gonna starve.

Potato farming is a good idea actually. You might not get everything you need from a vitamin standpoint but you would for sure not starve either.

cuba will be able to sustain and farm
you say who will be doing the farming? the cycle and methods of farming within cuba are set sothat 1 may feed many
i know this having studied traditional agriculture, majoring on cuban.

this practice is still in use after having visited i can assure you.
also as cuba has many isolated farms with rich produce not everyone will be infected.

the usa has ghettos, office buidlings using recycled air, a massive public transport infrastructure.
these are what pandemics feed on.

i feel that my nation, new zealand will do best as our migatory bird life migrate from the south, antartica and the ice islands.
we have only 3 international air ports, all at different ends on of the country and different islands, of which only 1 services major airlines

we have an effective UHC system, easy to patrol borders, and easy to screen airports.

Cuba invested millions, USA billions.
Cuba 7.97 points in maplecroft's avian influenza risk index list, USA 9.36
not nowadays Health system is important, but what it will be in a severe pandemic.

can Cuba isolate, being an island ? Lots of Americans
with boats...

maybe panflu spreads by hurricane

Randolph - your double post about the US being in a better position with regard to food and drugs is ignoring tow things, one of which has already been mentioned.
UHC does at least provide some sort of structure of treatment. Now its true that the Cubans probably dont have stockpiles of Tamilfu, but since there is no evidence that its going to be truely effective anyway, they might not be greatly worse off anyway. And as you point out, there is no vaccine, and nor will there be until some time after an outbreak has occured. Both countries have decent biotech resources, so who knows who would develop one first?

Gilmore and Mondspin have both pointed out the vunerablities of the US (and other western) economies to bird flu, becuase of the need for electricity and petrol. Even if your farmers from the 'boonies' have enough fuel to harvest their crops, who are they going to get it to where people can eat them? True, the rural areas would probably be self sufficient in the short term, but they probably wouldn't be earning much cash, and without a functioning distribution system (either because of restrictions in movement or lack of fuel) that crop will rot. And, as you say, the cities (where most people are) are not going to fare well...

The 'just-in-time' system of food distribution which we now all live with, and depend on, will be very vunerable to an epidemic. Although I have issues with Kunstler, his 'Long Emergency' http://www.amazon.co.uk/Long-Emergency-Converging-Catastrophes-Twenty-F… outlines the sort of problems we will face during an epidemic. Its not going to be pretty. We like our creature comforts, and we are not going to be happy when we can't have them. The Cubans have got used to doing without, we hav not.

Jordan,

You were probably not aware that NZ posted the equivalent of pandemic level 5 this week for seasonal flu. There are beds available, but no one to maintain the patients. All elective procedures have been cancelled.

MikeB-Who says they are going to take that crop to market? They likely will keep it for themselves. One year into this deal will see lots of secondary types of deaths. The role playing scenario of the exercises seems to indicate that the US and other industrialized countries may take as long as a generation to recover from a panflu with a 5%, three if its 8% and two three hundred years from a 30-50%. Just too much infrastructure will be gone in people. A power grid thats set for 300 million will not work if there are only 200 million left. Light switches left on. Possible mass relocations to sustainable areas for both security and supplies.

The Cubans without inbound supplies will go down like a ship made of lead. Then, how are they going to pay for them if they do come inbound? Massive de-flation of world economies is going to happen. Large scale if its only the 5% everyone touts.

Randolph - I'm sure that the farmers could look after themselves, at least for a while. But although you could live off the land fairly well, fuel to farm with be more difficult to come by, and the electricity grid (as you point out) will become more difficult to maintain. And of course 500 tons of spuds may have limited appeal after 6 months or so...

The point I was making with regard to Cuba is that the Cubans already have relatively limited inbound supplies. Their imports have risen substantially in recent years http://www.indexmundi.com/cuba/imports.html, with oil, food, machinary and chemical being major imports, but its still just over $9 billion (although their exports are just under $3billion, the gap possibly being filled by a mix of remittences and tourist earnings), but they are not exactly living it up. Living with an embargo for so many years, particularly since the withdrawal of Soviet support, has meant that Cuba learnt to really tightened its belt. If there is mass deflation of the world economy, then the US (with its massive trade and budget deficit) will fare even worse.

Perhaps we should stop trying to argue who will come out worst in the flu pandemic game, and instead discuss what should be done to protect us all, both from the pandemic itself, and the effect it will have on daily life. The positive approach is that there may be things that Cuba and the US can learn from each other. If we don't all hang togeather...

Cuba's problem could end in probably one or two heartbeats. One of Fidel's stopping and possibly a bullet ending his brothers within a few hours of that. The assertion that UHC is better with less in Cuba is pretty much a crock. The families in Miami of the people in Cuba have to constantly fly their relatives to Mexico City, Guatemala and Venezuela for treatment that the government cant afford. Many round robin back into Miami on humanitarian visa's afterwards.

And I wonder why they still try the boats in the middle of the night if things are so rosey?

PLEASE READ THIS LINK BELOW! It states plainly the facts of the Mass. damned near mandatory healthcare UHC they implemented in the state. Healthcare is now rationed because the system is already going into the red, and there are not enough doctors to go around. Slam dunk on why UHC doesnt work, it wont and is nothing more than government just stealing money for nothing.

http://online.wsj.com/article/SB118532549004277031.html

Randy: The Mass plan relies on health insurance companies, a fatal flaw. But you can't blame the doctor shortage on the plan which hasn't even started yet. The other flaw is that they are too chicken to raise taxes. You get what you pay for and we don't pay for much and get even less. Take some of the money away from the bloated military budget ($400 million a day for the Iraq debacle!) and we wouldn't be going bankrupt because of the neocons and their Republican henchmen. The Cuban health care system is an achievement. There are many other reason why people want to leave Cuba. Life is hard there because of the embargo and the government is repressive. But that's not relevant to the health care system.