In January 2020 the Cuban government launched a rapid and comprehensive multisectoral response to the threat posed by SARS-CoV-2. This response built upon the strengths of the nation’s public health infrastructure, including an expansive health professional workforce experienced with prior epidemics (e.g., dengue, HIV, and Ebola). It also revealed the challenges posed by the vulnerabilities of aging and weak municipal infrastructures. Deteriorating housing, poor airflow, and sweltering heat undermined adherence to lockdown measures, putting those over age sixty—an increasingly large proportion of Cuba’s population—at particular risk. I discuss challenges posed by a rapidly graying population, vulnerabilities and increasing inequality stemming from Raul Castro’s 2009 economic reforms, and the island’s struggle to address its precarious housing stock to highlight the severe difficulties sheltering in place posed for the most vulnerable: elderly Cubans living without family support. The COVID-19 pandemic crisis has underscored the multiple forms infrastructure—including pipes, energy grids, and social networks—takes on the island, and the implications infrastructural strain and weakness have for maintenance of the socialist state and its continued provision of universal health care, housing, and nutrition.

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