Cuba's successful containment of COVID-19 through door-to-door screening of every home in the country, shows how 'shoe-leather' epidemiology could have averted the dramatic failure of the UK's response to the pandemic. In Cuba there have been 2,173 confirmed cases and 83 deaths, with no reported deaths throughout the first week in June.
The term 'shoe leather' epidemiology, where much of the work is carried out on foot in the community, was first demonstrated during the Soho cholera epidemic in 1854.
Writing in the Journal of the Royal Society of Medicine, Professor John Ashton describes how, when China first reported the emerging epidemic in Wuhan in January 2020, Cuba promptly drew up a cross-government contingency plan. When the first cases of the virus were confirmed in the country among three tourists from Italy on 11 March, the plan was immediately put into action.
Screening was carried out in Cuba by tens of thousands of family doctors, nurses and medical students on foot, with testing, tracing and quarantining of suspected cases in state-run isolation centres for 14 days.
Prof Ashton said: "Cuba has long been renowned for its ability to turn in world beating health statistics while continuing to struggle economically. With a health system grounded in public health and primary care, the country invests heavily in producing health workers who are primarily trained to work in the community. Their efforts with COVID-19 have been outstanding."
He added: "Cuba was one of the first countries to send health workers to support the control of the epidemic in Wuhan, back in January, just one example of its unrivalled commitment to international solidarity in humanitarian disasters."