Earlier in the fall, I was asked to lead a discussion on the coronavirus pandemic among faculty associated with the Center of International Financial Services and Markets of the Zarb School of Business in my old academic home, Hofstra University. Given the scope of the Center, I proposed to focus on questions with an international perspective.
Admittedly, the discussion was based more on information gleaned from news reports than on hard evidence. But still the questions themselves were worth considering as a starting point. The following were the questions we discussed.
Did the structure of health care systems (national vs. private) and health insurance (universal vs. optional) matter? Broadly speaking, the answer appears to be no. Countries with diverse systems in the delivery of health care and health insurance suffered devastating surges in coronavirus cases and deaths. This was true for Europe with its emphasis on national health care and universal insurance as it was in the US where health care is mostly private and insurance, even after the Affordable Care Act (commonly known as Obama care), is not universal. There was, however, one area where the structure of the health care system made a difference: in the production of more or less equitable outcomes. The lack of universal health insurance and less emphasis on public health policies in the US have left significant numbers of Americans, especially minorities and poorer people, with severe co-morbidities that resulted in greater frequency of severe Covid-19 symptoms and deaths among these groups.
Did a national vs. a regional response matter? Most countries in Europe, Asia, as well as Canada adopted a national strategy in designing methods and tactics with respect to testing and tracing, wearing masks and practicing social distancing, and imposing restrictions, including lockdowns. These countries managed to contain the first wave better than the case was in the US where president Trump left this task to the states. When the second wave came, we again observed that countries following a national policy were more successful in reining the pandemic. An area where the type of the policy, national vs. regional, mattered a lot was in regards to opening schools. Although a difficult and challenging feat, countries with a national policy provided a more consistent and coordinated approach, most often favoring in-person classes, than countries with regional approaches, like the US. Countries that opened their schools proved to have made a more judicious use of the evidence that the infection rate is extremely low among the young. They also seemed to appreciate more the role of socialization in the cognitive and emotional growth of children. A cacophony of special and political interest voices bungled this issue in the US. As a result, the US may pay a significant deficit in this regard for many years to come.
Did the individualistic vs. the socio-centric culture of a country mattered? Asian countries with their greater emphasis on the interests of society vs. those of the individual were better able to mobilize their populations to abide by government guidelines. Interestingly, if we look across countries with a common cultural background, in this case an Anglo-Saxon culture, we can see that the display of individualistic attitudes, which run strong in this culture, was not uniform. In Canada, Australia, and New Zealand, the people displayed a greater compliance with state mandates than in the US and the UK. Especially in the US, the zeal to exercise individual rights, often driven by political preferences, made the coordination of responses to the pandemic exceedingly challenging and in some states outright ineffectual with devastating results health-wise.
Did trust in the authorities matter? Needless to say, that trust in the government and the medical and scientific community is extremely important for an effective response to any health crisis. It was an unfortunate coincidence the pandemic hit the US during an election year. The toxic political discourse coupled with the unusually low trust in government made the public’s cooperation with federal and state authorities extremely fraught. On top of that, there was a proliferation of conspiracy theories that drove dangerous wedges in any attempt to coral public support for any policy response to the pandemic. We don’t need to make any international comparison to conclude that mistrust played an enormous part in the health calamity experienced in the US.
An important point that emerged in the discussion was the role of policy and leadership. Policy tools and effectiveness are, of course, impacted by culture, institutions, and availability of resources. But coherence, steadiness, and execution can matter even more. Countries, like China, South Korea, New Zealand and Germany to mention some, responded with well-thought out and well-executed policies. Again, the US was a laggard in this respect. Choice of policies also matters. A case in point is the experience of the Nordic countries which share a lot in culture and institutions. Norway, Denmark and Finland formulated and executed more aggressive policies. Sweden opted for a weak policy stance and paid a heavier price. Leadership has to do with the clarity and steadiness of message, resoluteness, and leading by example. None of that happened in the US. If anything, the US leadership provided fodder for counterproductive behavior that exacerbated the negative health outcomes.
How different countries responded to the pandemic had serious implications for the meaning of “failed state” and, hence the brand image of a country. Small countries, like New Zealand, buttressed their image as competent and successful countries, whereas the US lost significant brand capital. We can also say that soft power, like public trust and policy design and execution, proved to be superior to hard power measured by military and economic power.
Finally, if there is a common international theme in fighting the pandemic, it is, first, the compassion and sacrifice of the health care givers, and, second, the speed and ingenuity with which the scientific community across the globe responded to produce the vaccines needed to inoculate us against the coronavirus.
Disclaimer: The opinions expressed in this post do not necessarily reflect those of the Center, the Zarb School of Business, or Hofstra University.
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