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Why Did the Best Prepared Country in the World Fare So Poorly during COVID?

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  • Jennifer B. Nuzzo
  • Jorge R. Ledesma

Abstract

Though all countries struggled to respond to COVID-19, the United States' poor performance during the pandemic was unexpected. Despite having more pandemic preparedness capacities than other countries, the United States experienced more than one million COVID-19 deaths, which has contributed to historic declines in national life expectancy. Though some have raised questions as to whether preparedness capacities matter, data that appropriately address cross-country differences in age structure and surveillance approaches show that higher levels of national preparedness was associated with reduced mortality during the pandemic. The United States, however, stands out as a clear outlier in COVID-19 mortality comparisons with other highly prepared countries. We subsequently discuss and summarize the specific gaps in US pandemic preparedness that may have hampered COVID-19 responses in the country. Additional data and research are urgently needed to more accurately understand why the US did not make better use of its prepandemic advantages.

Suggested Citation

  • Jennifer B. Nuzzo & Jorge R. Ledesma, 2023. "Why Did the Best Prepared Country in the World Fare So Poorly during COVID?," Journal of Economic Perspectives, American Economic Association, vol. 37(4), pages 3-22, Fall.
    • Handle: RePEc:aea:jecper:v:37:y:2023:i:4:p:3-22
    DOI: 10.1257/jep.37.4.3
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    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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