Covid – 19: Does Governance Matter?

When the Covid – 19 pandemic finally ends, a generation of students of public health and public policy will have data to evaluate the approaches taken by different governments in terms of their effectiveness at identifying the virus, controlling its spread, and treating its victims.

Early experience suggests that countries that diligently traced cases and tested widely (Korea, Singapore, Hong Kong, Taiwan) were most successful at controlling its spread.

Another possible comparison is between Canada and the US. The US has 9 times Canada’s population but, as of today, 17 times as many cases (18,500 versus 1078). The disease is spreading exponentially in both countries, but faster in the US. The major concentrations in the US have been in places that have been geographically close to Canada (Washington and New York states), which implicitly controls for climate. The US imposed a ban on travel from China, the original source of the virus, which Canada did not do.

I would hypothesize that the big difference between the two countries is governance, particularly in the area of public health. Canada has a much higher level of trust in the national government (62 percent answering the question “do you have confidence in the national government” in the affirmative in Canada, compared to 30 percent in the US in a global Gallup Poll conducted in 2016). Canada’s single-payer health insurance system makes testing and treatment available to all. Prime Minister Trudeau and his ministers operate from a position of respect for science and scientists, unlike President Trump and many of his political appointees. Canada has conservative-leaning media, but nothing like Fox News, endlessly repeating the president’s initial attempts to minimize the seriousness of Covid – 19. Canada’s public health agencies, at all levels of government, appear to have been faster in their response to the pandemic than those of the US.

As a citizen of the world, I hope and pray the US is successful in bringing the pandemic under control within its borders as soon as possible. As a social scientist, I think it is important to determine whether Canada’s stronger system of health insurance, more evidence-based policy-making at the federal level, and greater trust in government by its citizens, lead to better outcomes.


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