CubaBrief: Democracies are successfully confronting COVID-19, and why the international community must remain wary of dictatorships

In these times of uncertainty the ability to have transparency and debate is critical to good public policy. One should not be surprised that the countries with the best response to the Wuhan Coronavirus (COVID-19) outbreak have been democracies with competent leadership, and with a deep understanding of the mendacity of the Chinese Communist dictatorship. National Public Radio’s (NPR) article “With Odds Against It, Taiwan Keeps Coronavirus Corralled” described how Taiwan did not fall for the assurances of the Chinese dictatorship, and began preparing a response in December 2019. According to NPR, ” Taiwan quickly launched and updated emergency measures as the outbreak grew in China’s Hubei province and then spread. Taiwan activated a response command center, sent a fact-finding team to China, imposed swift travel bans and quarantines. It even restricted the export of face masks.”

Science Magazine in their March 17th article “Coronavirus cases have dropped sharply in South Korea. What’s the secret to its success?” reported how this government avoided anti-democratic measures in successfully combating the pandemic, and their caution that this is not over. “South Korea is a democratic republic, we feel a lockdown is not a reasonable choice,” says Kim Woo-Joo, an infectious disease specialist at Korea University. South Korea’s success may hold lessons for other countries—and also a warning: Even after driving case numbers down, the country is braced for a resurgence.” 

Science Magazine also outlines the steps taken by South Korea that are a “success so far” involve  “the most expansive and well-organized testing program in the world, combined with extensive efforts to isolate infected people and trace and quarantine their contacts. South Korea has tested more than 270,000 people, which amounts to more than 5200 tests per million inhabitants—more than any other country except tiny Bahrain, according to the Worldometer website. The United States has so far carried out 74 tests per 1 million inhabitants, data from the U.S. Centers for Disease Control and Prevention show.”

Meanwhile, China claims to have the outbreak under control, North Korea denies having any cases, Cuba claims five cases while seeking tourism from Europe with false claims that the coronavirus cannot survive the sun and warm temperatures of the tropics, and Daniel Ortega in Nicaragua organized a mass rally titled “Love in the time of COVID-19” that goes against recommendations of social distancing.

In a democracy when the governing party messes up or engages in attempts to cover up what is actually happening there is a free press and political opposition to hold it accountable.  In China, North Korea, Cuba, and Nicaragua there are no such safeguards,  and things can get quite bad before it spills over to the rest of the world, as happened in the Wuhan coronavirus outbreak. Let us not forget that the 1986 Chernobyl accident in the USSR was covered up for days by the Soviets, despite a radioactive cloud circling the globe.

The regime in Cuba makes many claims that are not true. Paul Peterson of the Hoover Institution in The Wall Street Journal article “Cuba Is an Academic Fraud” exposes the dodgy statistics of the Castro dictatorship, their refusal to take part in international tests, that indicates that their educational claims are false.

Frank Calzon, former Executive Director of the Center for a Free Cuba in The Sun Sentinel warns of past coverups by the Castro regime of epidemics in Cuba, and that “flights between Florida and Cuba remain in place, even amid reports of coronavirus cases emerging on the island nation.”

The Wall Street Journal, March 16, 2020

Cuba Is an Academic Fraud

Few educational stats are available, and they are highly suspect.
Paul E. Peterson  March 16, 2020 
WALL STREET JOURNAL                       

Students in Havana, June 5, 2019. Photo: yander zamora/Shutterstock

Students in Havana, June 5, 2019. Photo: yander zamora/Shutterstock

Bernie Sanders has spent decades preparing to lose the Florida primary. In a 1985 interview, Vermont’s self-described socialist said of Fidel Castro that “he educated their kids.” He still praises the Communist regime’s “massive literacy program.”

Mr. Sanders is not alone in his admiration for Cuban education. In 2016 President Obama quoted himself as telling Raúl Castro, Fidel’s younger brother and successor: “You’ve made great progress in educating young people. Every child in Cuba gets a basic education.” Dan Domenech, executive director of the American Association of School Administrators, visited Havana in 2017 and exulted: “Cuba’s education system might as well be considered the ultimate wrap-around institution for children.” In 2007 Stanford’s Martin Carnoy published a book called “Cuba’s Academic Advantage.”

It’s all bunk—though it’s hard to prove, because Cuba refuses to participate in international tests such as the respected Program for International Student Assessment. The only external tests in which Cuba did participate were the 1997 and 2006 waves of the Latin American Laboratory for Assessment of the Quality of Education, sponsored by the United Nations Educational, Scientific and Cultural Organization and nicknamed Laboratorio. This was the main evidentiary basis for Mr. Carnoy’s book.

But the Cuban government supervised the administration of the Laboratorio tests, and the results strongly suggest it cheated. The median language-arts score for Cuban third-graders in 1997 was 343 points, compared with 264 in Argentina, 256 in Brazil and 229 in Mexico. If these scores are to be believed, the median child in Cuba learns by grade three what equivalent students elsewhere don’t learn until at least grade six.

In math, median Cuban third- and sixth-grade students scored 1.5 standard deviations higher than Chileans in 2006. (A standard deviation is about two years’ worth of learning.) Is Cuba a standout within Latin America, even though it won’t subject itself to comparison with developed countries? That seems unlikely. Chile performed only 0.9 standard deviation lower than high-flying Finland on the Program for International Student Assessment’s 2018 math test.

Belying Cuban students’ sky-high scores, they don’t seem to learn much from one grade to the next. In Argentina, Brazil, Chile and Mexico, fourth-graders scored 22 to 25 points higher than third-graders on the 1997 math test. In Cuba an additional year of schooling was good for only five points. Why? One possibility is that teachers corrected the answers so that many students in both grades received perfect or near-perfect scores.

Similarly suspicious is the narrow gap—only 0.05 standard deviation—between urban and rural schools in Cuba. In Mexico and Brazil urban schools do better by 0.62 and 0.66 standard deviations, respectively.

It’s unsurprising that a communist regime would falsify its own accomplishments. It’s dismaying that American politicians, educators and scholars would fall for it.

Mr. Peterson is a senior fellow at Stanford’s Hoover Institution, director of Harvard’s Program on Education Policy and Governance and a senior editor of Education Next, where an expanded version of this essay appears.

https://www.wsj.com/articles/cuba-is-an-academic-fraud-11584380234?mod=MorningEditorialReport&mod=djemMER_h

The Sun Sentinel, March 16, 2020

Trump should suspend U.S.-Cuba travel amid coronavirus outbreak | Opinion

By FRANK CALZÓN
SPECIAL TO THE SUN SENTINEL |
MAR 16, 2020

The latest measure against the coronavirus pandemic is the Trump administration’s announcement that it added the United Kingdom to the travel ban covering Europe, China and other countries.

But flights between Florida and Cuba remain in place, even amid reports of coronavirus cases emerging on the island nation.

The Miami Herald reported Monday that Cuba has four confirmed coronavirus cases, three Italian tourists from Lombardy and one Cuban. Another 259 people — 90 foreigners and 169 Cubans — are under medical observation.

Prospects are not good because, according to official government announcements, the shortages of soap, detergent and disinfectants will continue for at least two months, and there are sewage leaks into Havana’s streets and sidewalks due to lack of maintenance.

There have been protests in several neighborhoods where piles of garbage infected by rats, have not been collected for weeks.

In the past, the Cuban government authorities denied for many months that there were HIV/AIDs cases, and when a Cuban doctor told foreign journalists about a dengue outbreak he was sent to prison.

Be that as it may, HavanaTour told foreigners last week that they may come and stay on the island, that Cuba is ready to confront the epidemic, and that the sun is an antidote for the virus.

Last week, Miami-Dade Mayor Carlos Gimenez called on the Trump administration to cancel flights to Cuba, saying the Cuban government is not being transparent about the spread of the coronavirus.

The Trump administration should heed the advice of Gimenez and immediately suspend all travel to and from the U.S. and Cuba.

Frank Calzón is a former executive director of the Center for a Free Cuba.
https://www.sun-sentinel.com/opinion/commentary/fl-op-com-cuba-coronavirus-flights-havana-united-states-20200317-eqfvmd2df5cnbjn6rvqsbb4haq-story.html  

National Public Radio, March 13, 2020

The Coronavirus Crisis

With Odds Against It, Taiwan Keeps Coronavirus Corralled

March 13, 20205:19 PM ET

NPR Staff

People wear face masks to protect against the spread of the coronavirus as they pray at the Longshan Temple in Taipei, Taiwan, on Thursday. Taiwan has reported a relatively low number of cases of the virus despite its proximity to China, where the v…

People wear face masks to protect against the spread of the coronavirus as they pray at the Longshan Temple in Taipei, Taiwan, on Thursday. Taiwan has reported a relatively low number of cases of the virus despite its proximity to China, where the virus was first detected. Chiang Ying-ying/AP

The challenges that COVID-19 poses for governments around the world are formidable. For Taiwan, there have been additional hurdles.

Experts say the island’s response to the novel coronavirus has been remarkably effective so far, despite many serious challenges, starting with its close links to China, and may even hold lessons for others to follow.

“Taiwan is sort of a positive deviant,” said Jason Wang, a pediatrician who heads the Center for Policy, Outcomes and Prevention at the Stanford University medical school.

“It did really well when they were not expected to do so well.”

As of Friday, Taiwan has reported 50 confirmed cases of coronavirus, and one death, out of a population of around 23 million.

The island has seen a relatively low spread of the novel coronavirus despite its proximity and numerous links to China, where the virus was first detected and has infected more than 80,000 people. Taiwan has also had to contend with political pressure and possible misinformation from China.

In a paper this month in the Journal of the American Medical Association, or JAMA, Wang and two colleagues listed 124 actions that Taiwan’s authorities took starting in December when they sensed the looming threat — and the rest of the world seemed to be looking the other way.

Taiwan quickly launched and updated emergency measures as the outbreak grew in China’s Hubei province and then spread. Taiwan activated a response command center, sent a fact-finding team to China, imposed swift travel bans and quarantines. It even restricted the export of face masks.

Taiwan’s health-care system ranks among the best in the world. And it learned lessons from the experience of SARS 17 years ago, when it was the third worst hit territory after China and Hong Kong.

“They had basically prepared for the next crisis because after SARS people were so just shocked by the impact both to the people and the economy,” Wang said.

The “importation risk” for coronavirus was real for Taiwan.

Millions of people travel back and forth between China and the island each year. Last year, there were more than 5,700 flights per month, on average, between Taiwan and the mainland, according to Taiwan’s Ministry of Transportation and Communications. Nearly 11 million passenger journeys were made across the narrow Taiwan Strait by plane.

When the number of coronavirus cases started to spike in China in January, a study by Johns Hopkins University ranked Taiwan as one of the most at-risk locations.

‘Marginalize and exclude’

Proximity to China was only part of the challenge.

Beijing considers the self-ruled, democratic island a part of China and has vowed to unite it eventually with the mainland, by force if necessary.

On the global stage, the Chinese government has tried to squeeze TaiwanThe island only has a handful of diplomatic allies, and it’s not a member of the United Nations or the World Health Organization.

That has real-life implications during a disease outbreak, according to Richard Bush, a senior fellow at the Brookings Institution.

“Practically speaking, it means that certain types of information that WHO members get as a matter of course are not available to Taiwan — even though it does have cases, even though it has something to contribute when it comes to understanding and monitoring this disease,” he said.

The problem has been exacerbated by China’s distrust of Taiwan’s president, Tsai Ing-wen, whose Democratic Progressive Party has traditionally leaned toward independence for the island — a red line for Beijing.

Tsai’s predecessor, Ma Ying-jeou, was widely seen as more China-friendly, and the authorities in Beijing dangled more carrots in front of Taiwan during his administration. On the health front, Taiwan was allowed to attend the annual gathering of WHO members as an observer from 2009 to 2016 when he was president.

“Particularly because China doesn’t like the current president of Taiwan, Tsai Ing-wen, it is working particularly hard to marginalize and exclude it from all international governmental organizations in spite of the circumstances,” Bush said.

Taiwan hasn’t been completely boxed out during the coronavirus outbreak.

The WHO says it has been in communication with Taiwan on a technical level, although a spokesman declined to provide details when asked by NPR.

Taiwan’s government declined to comment on the challenges of tackling COVID-19 as a nonmember of the WHO.

In early February, Taiwanese scientists were allowed to attend — by videoconference — part of a WHO forum in Geneva on the coronavirus.

Rumors and “nonsense”

An additional challenge also emerged for Taiwan: disinformation.

As the virus spread in China in late January, a stream of rumors and fake news about Taiwan’s response to the outbreak began to appear on social media sites, including Facebook and Twitter, according to researchers who track the issue.

One of the first claimed that the outbreak was out of control in southern Taiwan and that trucks were being used to haul bodies to crematoriums, according to Summer Chen, editor-in-chief of Taiwan FactCheck Center, a group that ferrets out and debunks dodgy reports.

“At the time, the news looked to me like nonsense, or something that you’d never believe,” said Chen.

More reports followed.

A proliferation of misinformation in the runup to the presidential election on Jan. 11 helped raise awareness of the problem among the people of Taiwan, who Chen says are getting better at identifying and dealing with problematic online posts.

“I think most Taiwan people who read them would think they’re funny or fun, but when information is in large quantities, especially with society on alert already, I think it’s very malicious,” she said.

It’s unclear exactly who is behind the latest misinformation, but linguistic clues point to China, Chen and other researchers say.

Some of the posts used simplified Chinese characters or terminology that’s common on the mainland but not in Taiwan.

Nick Monaco, research director of the Digital Intelligence Lab at Institute for the Future, has analyzed many of the posts and says they appear to have come from “normal users online in China,” rather than the state.

But, he adds, the Chinese government has the ability to stop them — and it hasn’t.

“Disinformation campaigns online about coronavirus targeting Taiwan and targeting other countries, they are being permitted to … jump over the ‘Great Firewall’ and kind of propagate online, and I think that is very malicious,” Monaco said.

Neither China’s Foreign Ministry nor the information office of the State Council, or cabinet, had an immediate comment when NPR faxed them questions about the online activity and Taiwan’s exclusion from the WHO.

The net effect of Taiwan’s non-membership in the World Health Organization and the spread of virus-related disinformation targeting the island is hard to measure. But the risk of a wider spread of the virus is undoubtedly elevated, experts say.

“When you have an environment of restricted information on top of all those degrees of misinformation it makes decision-making difficult — both as an individual and as a government,” said Heidi Larson, who researches disinformation and vaccines at the London School of Hygiene & Tropical Medicine.

But against the odds, Taiwan has kept COVID-19 in check so far.

Stanford’s Wang and his colleagues will continue to track how Taiwan fares.

“We’re still in the middle of it. Probably it will take six months before we fully know,” he said.

https://www.npr.org/sections/goatsandsoda/2020/03/13/814709530/with-odds-against-it-taiwan-keeps-coronavirus-corralled

Science, March 17, 2020

Screen Shot 2020-03-17 at 6.03.17 PM.png

Coronavirus cases have dropped sharply in South Korea. What’s the secret to its success?

By Dennis Normile

Europe is now the epicenter of the COVID-19 pandemic. Case counts and deaths are soaring in Italy, Spain, France, and Germany, and many countries have imposed lockdowns and closed borders. Meanwhile, the United States, hampered by a fiasco with delayed and faulty test kits, is just guessing at its COVID-19 burden, though experts believe it is on the same trajectory as countries in Europe.

Amid these dire trends, South Korea has emerged as a sign of hope and a model to emulate. The country of 50 million appears to have greatly slowed its epidemic; it reported only 74 new cases today, down from 909 at its peak on 29 February. And it has done so without locking down entire cities or taking some of the other authoritarian measures that helped China bring its epidemic under control. “South Korea is a democratic republic, we feel a lockdown is not a reasonable choice,” says Kim Woo-Joo, an infectious disease specialist at Korea University. South Korea’s success may hold lessons for other countries—and also a warning: Even after driving case numbers down, the country is braced for a resurgence.

Behind its success so far has been the most expansive and well-organized testing program in the world, combined with extensive efforts to isolate infected people and trace and quarantine their contacts. South Korea has tested more than 270,000 people, which amounts to more than 5200 tests per million inhabitants—more than any other country except tiny Bahrain, according to the Worldometer website. The United States has so far carried out 74 tests per 1 million inhabitants, data from the U.S. Centers for Disease Control and Prevention show.

South Korea’s experience shows that “diagnostic capacity at scale is key to epidemic control,” says Raina MacIntyre, an emerging infectious disease scholar at the University of New South Wales, Sydney. “Contact tracing is also very influential in epidemic control, as is case isolation,” she says.

Yet whether the success will hold is unclear. New case numbers are declining largely because the herculean effort to investigate a massive cluster of more than 5000 cases—60% of the nation’s total—linked to the Shincheonji Church of Jesus, a secretive, messianic megachurch, is winding down. But because of that effort, “We have not looked hard in other parts of Korea,” says Oh Myoung-Don, an infectious disease specialist at Seoul National University.

New clusters are now appearing. Since last week, authorities have reported 129 new infections, most linked to a Seoul call center. “This could be the initiation of community spread,” through Seoul and its surrounding Gyeonggi province, Kim says. The region is home to 23 million people.

Lessons from MERS

South Korea learned the importance of preparedness the hard way. In 2015, a South Korean businessman came down with Middle East respiratory syndrome (MERS) after returning from a visit to three Middle Eastern countries. He was treated at three South Korean health facilities before he was diagnosed with MERS and isolated. By then, he had set off a chain of transmission that infected 186 and killed 36, including many patients hospitalized for other ailments, visitors, and hospital staff. Tracing, testing, and quarantining nearly 17,000 people quashed the outbreak after 2 months. The specter of a runaway epidemic alarmed the nation and dented the economy.

“That experience showed that laboratory testing is essential to control an emerging infectious disease,” Kim says. In addition, Oh says, “The MERS experience certainly helped us to improve hospital infection prevention and control.” So far, there are no reports of infections of COVID-19 among South Korean health care workers, he says.

Legislation enacted since then gave the government authority to collect mobile phone, credit card, and other data from those who test positive to reconstruct their recent whereabouts. That information, stripped of personal identifiers, is shared on social media apps that allow others to determine whether they may have crossed paths with an infected person.

After the novel coronavirus emerged in China, Korea Centers for Disease Control and Prevention (KCDC) raced to develop its tests and cooperated with diagnostic manufacturers to develop commercial test kits. The first test was approved on 7 February, when the country had just a few cases, and distributed to regional health centers. Just 11 days later, a 61-year-old woman, known as “Case 31,” tested positive. She had attended 9 and 16 February services at the Shincheonji megachurch in Daegu, about 240 kilometers southeast of Seoul, already feeling slightly ill. Upward of 500 attendees sit shoulder to shoulder on the floor of the church during 2-hour services, according to local news reports.

The country identified more than 2900 new cases just in the next 12 days, the vast majority Shincheonji members. On 29 February alone, KCDC reported more than 900 new cases, bringing the cumulative total to 3150 and making the outbreak the largest by far outside mainland China. The surge initially overwhelmed testing capabilities and KCDC’s 130 disease detectives couldn’t keep up, Kim says. Contact tracing efforts were concentrated on the Shincheonji cluster, in which 80% of those reporting respiratory symptoms proved positive, compared with only 10% in other clusters.

High-risk patients with underlying illnesses get priority for hospitalization, Chun says. Those with moderate symptoms are sent to repurposed corporate training facilities and spaces provided by public institutions, where they get basic medical support and observation. Those who recover and test negative twice are released. Close contacts and those with minimal symptoms whose family members are free of chronic diseases and who can measure their own temperatures are ordered to self-quarantine for 2 weeks. A local monitoring team calls twice daily to make sure the quarantined stay put and to ask about symptoms. Quarantine violators face up to 3 million won ($2500) fines. If a recent bill becomes law, the fine will go up to 10 million won and as much as a year in jail.

In spite of the efforts, the Daegu-Gyeongbuk region ran out of space for the seriously ill. Four people isolated at home, waiting for hospital beds, were rushed to emergency rooms when their conditions deteriorated, only to die there, according to local media.

Still, the numbers of new cases have dropped the past 2 weeks, aided by voluntary social distancing, both in the Daegu-Gyeongbuk region and nationwide. The government advised people to wear masks, wash their hands, avoid crowds and meetings, work remotely, and to join online religious services instead of going to churches. Those with fevers or respiratory illnesses are urged to stay home and watch their symptoms for 3 to 4 days. “People were shocked by the Shincheonji cluster,” Chun says, which boosted compliance. Less than 1 month after Case 31 emerged, “The cluster is coming under control,” Oh says.

Yet new clusters are emerging, and for 20% of confirmed cases, it’s unclear how they became infected, suggesting there is still undetected community spread. “As long as this uncertainty remains, we cannot say that the outbreak has peaked,” Chun says.

More data needed

The government hopes to control new clusters in the same way it confronted the one in Shincheonji. The national testing capacity has reached a staggering 15,000 tests per day. There are 43 drive-through testing stations nationwide, a concept now copied in the United States, Canada, and the United Kingdom. In the first week of March, the Ministry of the Interior also rolled out a smartphone app that can track the quarantined and collect data on symptoms.

Chun Byung-Chul, an epidemiologist at Korea University, says scientists are eager to see more epidemiological data. “We are literally stamping our feet,” Chun says. KCDC releases the basic counts of patients, their age and gender, and how many are linked to clusters. “That is not enough,” Chun says. He and others would like to study detailed individual patient data, which would enable epidemiologists to model the outbreak and determine the number of new infections triggered by each case, also known as the basic reproductive number or R0; the time from infection to the onset of symptoms; and whether early diagnosis improved patients’ outcomes. (South Korea has had 75 deaths so far, an unusually low mortality rate, although the fact that Shincheonji church members are mostly young may have contributed.) Chun says a group of epidemiologists and scientists has proposed partnering with KCDC to gather and share such information, “and we are waiting for their response.”

Kim says medical doctors are also planning to share details of the clinical features of COVID-19 cases in the country in forthcoming publications. “We hope our experience will help other countries control this COVID-19 outbreak.”

With reporting by Ahn Mi-Young in Seoul.

https://www.sciencemag.org/news/2020/03/coronavirus-cases-have-dropped-sharply-south-korea-whats-secret-its-success