Lack of trust helped fuel the Covid-19 pandemic


Low levels of government and social trust, as well as higher levels of government corruption, are strongly correlated with higher Covid-19 infection rates around the world.

According to a new peer-reviewed study published today in The Lancetother indicators, including indices of pandemic preparedness, democracy, income inequality, universal health care and hospital capacity, did not show a significant relationship with Covid-19 infection rates. 19 or infection mortality rates.

Covid-19 has been called an ‘epidemiological mystery’, with higher death rates in many wealthy countries with greater health care resources than poor countries, and deaths varying widely even among nearby countries. geographically.

A matter of trust

The study of 177 countries, conducted by a team of researchers from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine and the Council on Foreign Relations (CFR), found that the wide variation between countries in Covid -19 infection rates cannot be explained by many oft-cited factors in politics (e.g. democracy and populism), state capacity (e.g. effectiveness of the government), health care (e.g. hospital beds or universal health coverage) or social factors (e.g. economic inequality or trust in science). The results suggest that if all societies had trust in government at least as high as Denmark, which is in the 75th percentile, the world would have seen 13% fewer infections. If social trust (trust in others) reached the same level, the effect would be even greater: 40% fewer infections worldwide.

“Many factors that influence Covid-19 outcomes, such as seasonality, age structure and population density, are not in the hands of policy makers,” said CFR’s Global Health Program Director, Thomas J. Bollyky, lead author of the study.

“Trust is an area where governments can move the needle, and the fact that it trumps traditional measures of health care capacity and pandemic preparedness should be a wake-up call for all of us as we face the ongoing Covid-19 pandemic and the threat of future disease outbreaks.

High levels of government and social trust as well as lower government corruption were all associated with higher vaccination coverage. Lower levels of government corruption have been associated with reductions in mobility during the pandemic, suggesting greater compliance with social distancing rules.

Promote better health

The results also suggest that promoting better health, such as lower body mass index and lower smoking rates, can help prevent illness and death in future pandemics.

The researchers analyzed a dozen indices of pandemic preparedness, seven indicators of health care capacity and ten additional demographic, social and political conditions, and adjusted for many known biological factors of infection such as age and seasonal effects. Ranking high on core health system capacities and pandemic preparedness measures has not only been insufficient to succeed in this pandemic, but it has also been unnecessary. Countries like the Philippines and the Dominican Republic, which rank relatively low on pandemic preparedness and health care access and quality, have maintained low rates of infections and deaths throughout the study period, while other higher-ranked countries, including the United States and France, faced much worse outcomes for infections and deaths.

“Trust can be encouraged by governments during a crisis,” said Erin Hulland, researcher at IHME and co-first author of the study. “Clear risk communication and community engagement strategies have helped build trust in other outbreaks, even in post-conflict West African countries during the Ebola outbreak. We hope that these findings can be leveraged to increase support for strategies that can improve trust and build resilience against future threats.

The data from this analysis can be downloaded from the Global Health Data Exchange.


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