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For a long time Cubans were proud of their health-care system, and justifiably so. Between 2000 and 2020 the small communist-run island outspent most other countries in Latin America and the Caribbean. Life expectancy is higher than in the United States. Cuba has qualified doctors and nurses to spare. When covid-19 first struck, Cuba sent some of its medics to countries struggling with their initial wave of patients. An impressive 89% of Cuba’s population is now fully vaccinated with its homegrown covid jabs—which boasts efficacy rates of up to 92.4% after three doses. But according to The Economist‘s excess mortality tracker, Cuba has one of the highest estimated death tolls from the pandemic, relative to its size. Where did it go wrong?
Officially, by August 2022 covid had killed 8,529 of Cuba’s 11m people. But our model estimates that the true toll could be far higher. Excess mortality—the gap between how many people have died in a given period, regardless of cause, and how many deaths would normally have been expected—suggests that up to 62,000 Cubans may have died as a result of the pandemic. That 600% increase over the official toll is probably the result of inadequate testing and other problems. It is possible that officials underreported the deaths, too.
Cuba’s estimated tally of excess deaths per 100,000 people is 550. This revised death toll would place it among the 20 worst countries in the world. It would also make Cuba an outlier in the region: the average across the Americas is 368.
Its aging population—almost 20% of Cubans are over 60, more than anywhere else in the region—made Cuba especially vulnerable to covid. But other factors were avoidable. Budget cuts and a shortage of essential supplies were taking a toll even before the pandemic. After the outbreak hospitals quickly became overwhelmed; oxygen, personal protective equipment and medicines ran short. And although plenty of Cubans are now vaccinated, the country was slow off the mark. Deaths peaked as late as August 2021, during the Delta wave. In that month only around 35% of Cubans had received a full course of covid vaccinations, compared with 64% of Britons and 54% of Americans. The pandemic has brought to light something Cubans have known for some time, but that officials wanted to keep under wraps: the country’s health-care system is not what it used to be. ️