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For a long one Cubans were once proud of their health care system, and rightfully so. Between 2000 and 2020, the small communist-run island outpaced 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 hit, Cuba sent some of her doctors in countries struggling with their initial wave of patients. An impressive 89% of Cuba’s population is now fully vaccinated with it jabs grown for covid— which boast efficacy rates of up to 92.4% after three doses. But according to The EconomistS ‘ 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 11 million inhabitants. But our model estimates that the true number could be much higher. Excess mortality – the gap between the number of people who have died in a given period, regardless of cause, and how many deaths would normally be expected – suggests that as many as 62,000 Cubans may have died as a result of the pandemic. This 600% increase over the official rate is probably the result of inadequate testing and other problems. Officials may have underreported deaths as well.
Cuba’s estimated number of excess deaths per 100,000 people is 550. This revised death toll would place it among the 20 worst countries in the world. That would also make Cuba an outlier in the region: the average across the Americas is 368.
Its aging population – nearly 20% of Cubans are over 60, more than anywhere else in the region – made Cuba particularly vulnerable to Covid. But other factors were avoidable. Budget cuts and shortages of essential supplies were taking a toll even before the pandemic. After the outbreak, hospitals were quickly overwhelmed; oxygen, personal protective equipment and medicine ran out. And although many Cubans are now vaccinated, the country was slow. Deaths peaked by August 2021, during the Delta wave. In that month only about 35% of Cubans had received a full course of Covid vaccination, compared to 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 secret: the country’s health care system is not what it used to be. ■