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Book Review

COVID-19 and Governance: Crisis Reveals
Jan Nederveen Pieterse, Haeran Lim, Habibul Khondker (eds.)
London: Routledge, Taylor and Francis. 2021

This timely volume of country case studies sheds light on why some countries have done much better than others in combatting the virus. It considers two policy areas -- the control and movement of people (closing borders, quarantine, lockdowns, shifting to remote education and work) and control and movement of the virus (checkpoints, testing, contact tracing): termed the hammer and the dance in shorthand. Countries are broadly divided into two groups. One group includes governments adopting collective responsibility for providing universal healthcare, affordable mass transit, quality public education, discerning public broadcasting, social protection, and capable policing. The second group of governments leaves these service areas more to market forces and provides less funding for government services targeted to small, favored subgroups. The hypothesis is that governance systems that focus on collective responsibility, where universal public health and public services generally are held in high regard and institutionally embedded, are more effective in combatting COVID, while those that focus on individual responsibility are less effective. The evidence supports this, according to the authors. For example, governance systems practicing collective responsibility such as Uruguay, Argentine, Colombia, and Bolivia have done better in minimizing cases and deaths per million than those practicing individual responsibility such as Brazil, Chile, Peru, and Ecuador. NE Asian states also tend towards collective responsibility and have done well. Individual responsibility states tend to have high-income inequality, which is said to work against public health. Countries with federal systems may have subnational, collective responsibility jurisdictions that perform much better than the national average, such as the case of Kerala vis a vis India. There are many other governance permutations analyzed. 

While this framework helps in setting the stage, the authors resort too often to partisan fervor rather than evidence-based analysis, for example: “…unprotected precariat workers in neoliberal America”, “(Cuba’s) popular-democratic Revolution that impacted the continent”, “entrenching neoliberalism (in India)”, “Johnson’s Brexit campaign…populist tropes of fake anti-elitism”, and “(the pandemic is) an opportunity to boost China’s confidence in the socialist system with Chinese characteristics…”. 

The otherwise rich case studies would be more effective if supported by unbiased scrutiny and more empirical testing. Among many areas where more work is needed, four stand out. First, the fast-moving pandemic forces some evidence-based conclusions to be reconsidered. Among the developments occurring since December 2020, the date of key data points in the book is the spread of a much more infectious Delta Variant, the rollout of highly effective vaccines, and the change from Trump to Biden in the USA. Changes in country performance have been dramatic. The deaths per million in the USA were 3.8 times the rate in Germany in December 2020, but are down to 1.9 times today (September 2021). Argentina and Colombia are now doing worse than Ecuador and Chile.  The rates in Chile vs. Thailand declined from 906 times then to 8.8 times today. NE Asian countries are still doing better than peers elsewhere, but the differential is sharply declining. European countries with universal health care are as a group doing little better than the USA, even though the latter has a much smaller mandate for government-provided health care. What do these findings mean? 

A second area to be further explored is the differential performance of subnational units in federal systems. The chapter on India asserts that Kerala performs better than the country as a whole without providing data to prove it. Data are readily available in the USA: for example, the death rate adjusted for population in the worst-performing state of Mississippi is 7.6 times the rate in the best-performing state of Vermont. Is this due mainly to a more collective responsibility governance system at the state level in Vermont, or to vaccine hesitancy in Mississippi, or some other factors? 

A third area where more work could be done is to compare excess deaths between the pre-Covid period and today. The reason is that countries compile statistics differently: for example, some countries may not test patients for coronavirus before dying, thus excluding many COVID victims. In addition, many people may die of other causes due to hospitals being overcrowded due to the pandemic and medical staff being overworked. Using the measure of excess deaths, collective responsibility Bolivia has 1.2 times the number of excess deaths as individual responsibility Brazil. Russia has about 1.1 the number of Covid deaths per million of reasonably well-performing Switzerland, but 3.9 times the number of excess deaths (Economist 2021). Excess deaths in India may be over 11 times the number of reported COVID deaths. What do these differences say about COVID and governance? 

Finally, it would be important to look at other aspects of societies affected by the pandemic, and how governance arrangements may help to explain them. For example, the USA, where the COVID response is widely derided by many of the book’s authors, has had one of the best of all economic outcomes to date. Although the initial downturn was the worst since the Great Depression, the economic policy response has delivered excellent results. GDP is back to its pre-pandemic level, with well-timed, emergency monetary and fiscal measures. GDP growth is expected to be at least 6 percent in 2021, the fastest pace since 1984. The share of households in poverty is down from 10.5 percent before the pandemic to 9.1 percent today, a result of stimulus checks, food stamps, an eviction moratorium, and tax credits. How was the US able to achieve this, despite governance constraints including a populist regime in power until January 2021? More broadly, how should one balance the economic and social impacts of measures such as lockdowns in the USA and other jurisdictions to control the pandemic vs. the public health benefits of reducing infection and death?

Overall, the book raises many important issues, but much more careful, scholarly work is needed to better understand what worked, what didn't work, why, and the extent to which COVID measures that seem to work in one jurisdiction can be usefully replicated in others to help control this and future pandemics.

References

Economist 2021. Tracking covid-19 excess deaths across countries-- In many parts of the world, official death tolls undercount the total number of fatalities. Economist. https://www.economist.com/graphic-detail/coronavirus-excess-deaths-tracker

Ip, Greg. 2021 How the U.S. Nailed the Economic Response to Covid-19: America’s fiscal policy succeeded in pushing poverty in the opposite direction that usually occurs in recessions. Wall Street Journal. September 15. https://www.wsj.com/articles/how-the-u-s-nailed-the-economic-response-to-covid-19-11631714400

Clay Wescott, President, International Public Management Network and member of International Advisory Board at Centre for Governance Studies (CGS)