By Patrick Oppmann, CNN
Havana (CNN)Following widespread anti-government protests last month, the Cuban government is now receiving unprecedented criticism from health care workers who say officials botched the island’s response to the pandemic.
Symbols of the socialist health care system pioneered by Fidel Castro, doctors and nurses are usually praised as “heroes in white coats” by the island’s state-run media.

In recent years Cuban health care workers have also become a key generator of hard currency for the communist-run government, which sells their services to countries that need doctors.
But as Cuba deals with shortages of medicines and oxygen and hospitals are overwhelmed with surging coronavirus cases, tensions between the government and health care workers –who are required to work for the state– have boiled over.
During a visit in August to the hard-hit province of Cienfuegos, Prime Minister Manuel Marrero Cruz blamed health care workers’ lack of discipline and “errors” for the breakdown in medical services.
Marrero acknowledged residents had complained about a lack of medicines as well but said “they are less than the complaints of mistreatment, of neglect or that [doctors] don’t make visits. That’s incredible!”
The comments ignited a firestorm among health care workers who have borne the brunt of the pandemic in Cuba, often while having to purchase their own protective gear and explain to patients sick with Covid why hospitals have run out of basic medicines and beds.
The Cuban government blames the US embargo for breakdowns in the healthcare system, but critics point out that the same US economic sanctions do not prevent the government from investing in a string of shiny new hotels.
“We just ask that they tell the truth,” said Dr. Rosell Alberteris, in a video posted online. “We only demand the supplies to treat our patients with dignity and decorum.”
“We want to keep working, we want to keep saving lives,” said Dr. Daily Almaguer in the video. “We are not responsible for the sanitary collapse in our country.”
At least 39 health care workers have uploaded videos from Holguín, a city of nearly 300,000 people close to the small town where both Fidel and Raul Castro were born, complaining of abysmal conditions in hospitals overrun by Covid.
Some of the doctors recorded videos from inside their hospitals, talking barely in a whisper as they slammed their government’s failures.
More Cuban doctors and nurses on social media from all over the island have expressed their support for the online protest, which is all the more remarkable as the Cuban government on Tuesday announced draconian new measures that prohibited “fake news” and postings that damage the island’s “prestige.”
“We aren’t afraid of the pandemic, we are afraid of the government,” Dr. Rafael Alejandro Fuentes Sanchez said in another video posted online. “How they could interpret that we have come out to demand our rights and the people’s right to receive good medical attention.”
Cuba’s main newspaper, the Communist-party daily Granma said the health workers were being used in “new enemy campaigns” and being turned into spokespeople for an “anti-Cuban offensive.”
Cuban officials also looked to defuse the confrontation with their frontline workers as the island’s battered health care system confronts the most precarious moment of the pandemic to date.
“Every time it seems we are tired, exhausted, beaten from this long period of the pandemic,” wrote Cuban President Miguel Diaz-Canel on Twitter. “We think about how much our doctors and nurses have given.”
Officials have begun to bring back brigades of Cuban health care workers from postings abroad and admit that the situation is far worse than the island’s statistics let on.
Amidst a shortage in tests, Cuban Health Minister José Angel Portal Miranda told the state-run Invasor newspaper that only people who had a positive Covid result at the time of death are counted as having died of the coronavirus.
“Not all the fatalities are able to take or obtain a PCR result,” the newspaper concluded. “Death sometimes arrives first.”
Magdiel Jorge Castro told CNN his grandfather died on Wednesday after being sent home from the hospital in Holguín where he was unable to receive results from a Covid test he took days earlier. Oxygen had run out in the hospital.
Castro said his grandfather suffered from a fever and fatigue and that other members of his family are ill with Covid-like symptoms. After his grandfather’s death, Castro said his family struggled to bury him.
“The funeral services are collapsed. There aren’t any coffins,” Castro said. “My family was in despair to have a deceased person for 15 hours in their bed in the tropical heat. The funeral home said there were 16 cases like his, people without a place to be buried.”
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FDA grants full approval to Pfizer’s COVID-19 vaccine
The Food and Drug Administration (FDA) on Monday granted the Pfizer-BioNTech COVID-19 vaccine full approval in a highly anticipated move that’s expected to boost vaccinations and spark more mandates nationwide.
The federal agency reached the milestone of issuing the first complete authorization for a COVID-19 vaccine after an approximately three-month review of Pfizer and its German partner BioNTech’s application to the FDA for full approval.
The vaccine will be marketed as Comirnaty, with the full authorization applying to vaccine recipients age 16 and older.
Acting FDA Commissioner Janet Woodcock praised the authorization in a press briefing, saying it “holds the promise of altering the course of the pandemic in the United States.”
“This is an unprecedented timeline given the volume of review and the meticulous manner in which it was done,” she said. “But we want to underscore that our efforts to move as quickly as possible have in no way sacrifice scientific standards for the integrity of our process.”
Why it matters: With slightly more than half of the total U.S. population fully vaccinated, experts and Biden administration officials are hopeful the agency’s full approval will serve as a catalyst for vaccinations in the country.
Biden used the announcement to urge the unvaccinated to stop waiting and get the shots
The full FDA approval is a chance to step up the messaging, and President Biden quickly gave remarks after the move on Monday, calling on unvaccinated Americans who have been waiting to get the shots to get vaccinated “today.”
Biden called the FDA’s full approval for the vaccine from Pfizer and its German partner BioNTech earlier on Monday a “key milestone” in the fight against the virus, and said it takes away any final excuse for not getting vaccinated.
“After a strict process the FDA has reaffirmed its findings that the Pfizer COVID-19 vaccine is safe and effective and the FDA has given its full and final approval,” Biden said. “So let me say this loudly and clearly: If you’re one of the millions of Americans who said that they will not get the shot until it has full and final approval of the FDA, it has now happened.”=
And more people could now be mandated to get the shots through their employers
The full federal approval of the Pfizer-BioNTech vaccine on Monday immediately, as expected, led to new vaccination mandates by government entities, a development that suggests more could be coming.
Immediately after the Food and Drug Administration (FDA) gave full approval to the vaccine Monday, New York City announced that all public school teachers and staff will be required to get the shot. The Pentagon later confirmed that it would move forward with a vaccine mandate for military service members.
Biden administration officials believe that the private sector will follow suit.
“For businesses and universities that have been thinking about putting vaccine requirements in place in order to create safer spaces for people to work and learn, I think that this move from the FDA, when it comes, will actually help them to move forward with those kinds of plans,” Surgeon General Vivek Murthy told CNN on Sunday, prior to the FDA announcement.
A few dozen corporations, including Microsoft, Tyson Foods, Walt Disney and Netflix, announced vaccine requirements after the Biden administration mandated vaccinations for federal employees late last month.
More companies will implement their own vaccine requirements following the FDA decision, said Michelle Strowhiro, a lawyer at McDermott Will & Emery who advises businesses on COVID-19 employment issues.
Biden threw his support behind company vaccine requirements
Biden called on companies to mandate COVID-19 vaccines on Monday, voicing strong support for such requirements following the FDA’s full approval for Pfizer’s vaccine.
“Today I’m calling on more companies in the private sector to step up the vaccine requirements that’ll reach millions more people,” Biden said during an address. “If you’re a business leader, a nonprofit leader, a state or local leader, who has been waiting for full FDA approval to require vaccinations, I call on you now to do that.”
The president requested that business and government leaders follow in his footsteps after he previously ordered federal employees and onsite contractors to get vaccinated or endure regular COVID-19 testing. The administration has also directed troops, nursing home staff and workers at federal medical centers to get vaccinated.
“Do what I did last month: Require your employees to get vaccinated or face strict requirements,” he said in his plea to leaders.
“It only makes sense to require a vaccine to stop the spread of COVID-19,” he added.
NYC mandates COVID-19 vaccinations for all public school teachers, staff
All New York City public school teachers and staff will need to be vaccinated against COVID-19, the city announced Monday, shortly after the Food and Drug Administration gave final approval to the Pfizer vaccine.
Students in the country’s largest school district return to classes next month, and teachers and staff will need to have their first dose by Sept. 27. There is no alternative option for regular testing as some other districts have allowed.
Schools Chancellor Meisha Ross Porter called the policy “another layer of protection for our kids.”
Previously, teachers were subject to the same requirements as other city employees, which meant they would need to be vaccinated or face weekly testing. Currently, about 63 percent of school employees have already been vaccinated.
Labor reaction: Vaccine requirements have been a thorny issue among some labor unions and it’s unclear how the unions representing teachers and other staff will respond.
Mayor Bill de Blasio (D) said during a news conference that he will start bargaining with unions immediately over the specifics to make sure it is implemented fairly and equitably.
United Federation of Teachers President Michael Mulgrew in a statement said those details, like medical exemptions, may need to be worked out through arbitration if necessary.
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