The COVID-19 pandemic has challenged governments around the world. It has also challenged conventional wisdom and empirical understandings in the comparative politics and policy of health. Three major questions present themselves: First, some of the countries considered to be the most prepared—having the greatest capacity for outbreak response—have failed to respond effectively to the pandemic. How should our understanding of capacity shift in light of COVID-19, and how can we incorporate political capacity into thinking about pandemic preparedness? Second, several of the mechanisms through which democracy has been shown to be beneficial for health have not traveled well to explain the performance of governments in this pandemic. Is there an authoritarian advantage in disease response? Third, after decades in which coercive public health measures have increasingly been considered counterproductive, COVID-19 has inspired widespread embrace of rigid lockdowns, isolation, and quarantine enforced by police. Will these measures prove effective in the long run and reshape public health thinking? This article explores some of these questions with emerging examples, even amid the pandemic when it is too soon to draw conclusions.
Most countries have implemented restrictions on mobility to prevent the spread of Coronavirus disease-19 (COVID-19), entailing considerable societal costs but, at least initially, based on limited evidence of effectiveness. We asked whether mobility restrictions were associated with changes in the occurrence of COVID-19 in 34 OECD countries plus Singapore and Taiwan. Our data sources were the Google Global Mobility Data Source, which reports different types of mobility, and COVID-19 cases retrieved from the dataset curated by Our World in Data. Beginning at each country’s 100th case, and incorporating a 14-day lag to account for the delay between exposure and illness, we examined the association between changes in mobility (with January 3 to February 6, 2020 as baseline) and the ratio of the number of newly confirmed cases on a given day to the total number of cases over the past 14 days from the index day (the potentially infective ‘pool’ in that population), per million population, using LOESS regression and logit regression. In two-thirds of examined countries, reductions of up to 40% in commuting mobility (to workplaces, transit stations, retailers, and recreation) were associated with decreased cases, especially early in the pandemic. Once both mobility and incidence had been brought down, further restrictions provided little additional benefit. These findings point to the importance of acting early and decisively in a pandemic.
Although COVID-19 cases are declining rapidly in the US, they have reached record highs in low-and middleincome countries (LMICs). The nucleus of the pandemic has shifted decidedly to the global south. The South-East Asia region and Latin America now represent 75% of global weekly deaths. 1 On June 22, the Latin America region reported more than 1 million weekly new cases and 30 000 new deaths. Latin America has the highest deaths per capita, where deaths in countries such as Brazil, Argentina, Mexico, and Peru have reached 177 to 564 per hundred thousand. 1 The Africa region has had increasing numbers of cases, with Uganda and Zambia experiencing 10 000 and 17 000 new weekly cases, respectively. Increasingly, the pandemic is where the vaccines are not.Approximately 1.2% of the global vaccine supply has been received by low-income countries and just 14% by lower-middle-income countries, which account for nearly 40% of the world's population. 2 In contrast, more than half the US adult population is fully vaccinated, including most health workers and individuals from vulnerable populations. Yet sub-Saharan Africa has doses to cover only an estimated 18% of health workers and older individuals. South Asia has not vaccinated all priority groups, and vaccine supplies would fully vaccinate just 9% of the total population.Vaccine inequity is driven by insufficient supply and unfair allocation. Powerful high-income countries prepurchased sufficient doses for their entire populations, sometimes twice the number needed. In contrast, COVAX, a global initiative to procure and equitably allocate vaccines, failed to secure enough doses even for its modest goal of covering 20% of lower-income country populations this year. 3 Pfizer, for example, agreed to sell COVAX only 40 million doses, and had delivered just over 1 million by mid-May. 4 On June 13, the G7 countries pledged to share 1 billion vaccine doses, half of which would come from the US. But this represents only a fraction of the approximately 11 billion doses needed to vaccinate the world. Support for LMICs to enable them to produce vaccines for their populations and significantly more donations are necessary to vastly increase supplies and ensure equity. The US and allied governments could take several steps to overcome barriers to vaccinating the world.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.