Coping with Covid: public health responses - the trade-off that didn't exist

In tackling the Covid pandemic most governments assumed that they faced a trade-off between public health and economic performance. The more restrictions they imposed on public health grounds, the worse they believed economic performance would be. The trade-off concept proved false. Countries in the Western Pacific region (including Australia, Japan and South Korea) that had suffered during the SARS epidemic were alone in following the WHO’s advice, based on SARS experience. That advice was to clamp down hard on epidemic outbreaks and get case numbers down close to zero before opening up the economy. This worked. The Western Pacific countries recorded the lowest death rates from Covid and suffered the smallest falls in GDP in 2020-21. Other countries got their policy sequences wrong; they repeatedly re-opened their economies when Covid case numbers remained substantial. That said, there were interesting regime differences. Public compliance with Covid restrictions was related to ‘trust in government’ and ‘trust in fellow citizens’. Trust levels were highest in social democratic Scandinavia, which despite a highly voluntarist approach to complying with Covid restrictions in Sweden, still had lower death rates than other regimes.