What I saw in Little Cayman was not SCTLD (they claimed it was not present in Little or Brac - only around Grand Cayman (though hard to believe that given proximity) - it was bleaching due to persistent high water temps.
I dove GC one year ago, before the high temps of this past summer. Everything was already dead.
It isn’t a singular issue. It isn’t solely bleaching, or solely SCTLD. There are a multitude of factors, including high plant nutrients and phosphates in the water, due to fertilizers, treated waste and untreated waste. Lionfish can devastate the algae eaters on the reef in a matter of weeks. Algae on the reef blooms and there’s no remedy for that because the small algae eater fish are gone.
Haiti has over 12 million inhabitants and not one working sewage treatment plant.
Hurricanes and severe storms, poor diver skills, overfishing, plastics and pollution, probably most importantly, the loss of mangroves due to development all mix together to put pressure on an already fragile ecosystem.
The Caymans are only one example of this problem. It is epidemic across the Caribbean