Bits of the answer were obvious, of course. Covid-19 selectively kills the elderly, and poor countries with high birth rates have a very low proportion of elderly people. They can’t die in droves if they just aren’t there.
There’s also the issue of under-counting, which you would expect to be worse in countries with poor or no public health service, but the phenomenon extends even into middle-income countries like Russia.
Russian Deputy Prime Minister Tatiana Golikova revealed recently that ‘excess deaths’ in 2020 were three times bigger than the number who had ‘Covid’ on their death certificates – but that 80% of the excess were also probably Covid deaths. If so, then Russia’s death rate was almost as bad as the United States.
But even compared to other rich counties with the same age profile, the UK and the US performed terribly in ‘deaths per million’, which is the best measure since it is not distorted by population size. The United States has had 1,555 Covid deaths per million people. Canada has had 573 deaths per million, barely a third as many per capita.
As for the United Kingdom, it has had 1,781 deaths per million, even worse than the US – whereas Germany has had only 824. In fact, the US and the UK together account for four-fifths of all Covid deaths in the ten worst-performing countries.
So what is going on here? Is speaking English bad for your health? Three-quarters of Canadians speak English, so probably not.
Does God punish countries that elect lying, narcissistic populists as leaders? Perhaps, but I’d prefer a more evidence-based answer, and at last we have one. Maybe.
Michele Gelfand, a cultural psychologist at the University of Maryland, may have the key that unlocks the puzzle. At the very least, she has great timing.
In her 2018 book ‘Rule Makers, Rule Breakers: How Tight and Loose Cultures Wire Our World’, Gelfand proposed that some national cultures embrace discipline while others glorify rule-breaking. That may sound like your usual social-scientist-desperate-for-a-fresh-angle re-framing national stereotypes as statistical fact, but she may be on to something about Covid death rates.
Her latest research was published in ‘Lancet Planetary Health’, a leading epidemiological journal, late last month. Using her established categories of ‘tight’ societies (willing to abide strictly by social norms, e.g. Singapore, Japan, China, Austria) versus ‘loose’ ones (more permissive about rule-breaking, e.g. the US, the UK, Israel, Italy), she compared Covid case rates and death rates.
The results were quite striking. The ‘loose’ cultures on average had five times the infection rate of the ‘tight’ ones, and eight times the death rate. If you compare the most libertarian with the most conformist, say the United States vs. Japan, then the contrast is astounding: about 25 times as many American cases and deaths per million.
What conclusions can we draw from this? Well, it suggests that the role of individual leaders like Donald Trump and Boris Johnson in shaping disastrous national Covid outcomes was probably not decisive. The outcomes would probably have been pretty bad even if less irresponsible leaders had been in charge.
Secondly, as Gelfand points out, the human cost that countries pay for being ‘loose’ in times of crisis may be compensated by the advantages they gain in creativity and innovation in better times (although it would be tactless to make this argument to the victims).
But there is something wrong with Gelfand’s explanation for why countries become or remain ‘tight’ or ‘loose’. She argues that “communities with histories of chronic threat – whether natural disasters, infectious diseases, famines or invasions – develop stricter rules that ensure order and cohesion.” That would make sense, but history says it’s really not that simple.
How did Israel – the Holocaust, six wars in the past 75 years, most of the population descended from refugees – end up among the carefree, permissive countries? And by the way, it really doesn’t have a very high death rate (614 per million).
Shouldn’t the Eastern European countries (world wars, civil wars, foreign occupation, waves of refugees) be among the ‘tightest’ societies in the world? Yet seven of the fifteen countries with the highest death rates in the world are among the former Communist countries of Eastern Europe – places like Hungary, Bulgaria, the Czech Republic and Slovenia, all with over 1,450 deaths per million.
There’s probably a lot more hard-wiring involved in determining where a culture ends up in terms of ‘tight’ or ‘loose’. And by the way, we would all love to know: why did the United States Navy pay for this research?