Democracy makes responding to disease impossible

The narrative of Chinese success and US failure has led to concern that COVID-19 represents bad news about the value, and future, of democratic governance (Diamond 2020). Initial studies have already been conducted showing a correlation between democracy and worse outbreaks as well as less effective policy responses (Cepaluni, Dorsch, and Branyiczki 2020). Pandemic response is different from much of population health—with effective responses requiring the ability to act quickly, implement effectively, and gain public compliance. With the exception of HIV (see Lieberman 2009), disease outbreaks and political institutions have been understudied in comparative politics—with much of the literature focused on infant mortality or life expectancy, long-running trends that have far different mechanisms from a pandemic. Here, the accountability mechanisms that help democracies perform better may not be as beneficial. Political leaders with short time horizons may have relatively weak incentives to invest in pandemic preparedness and response (Dionne 2010; Healy and Malhotra 2009). And some of the benefits of associational networks and civil society can be shut down in the face of an emergency—facing, for example, stay-at-home orders. Democracies also have the added challenge of managing competing political factions and institutions, some of whom may have political incentives to undermine response. Once the outbreak broke into the public and Beijing was moved to act, China was able to quickly shut down the Wuhan market, shut down the movement of tens of millions of people, screen and isolate the sick, and even build two hospitals in a matter of days. Singapore is another autocracy that has gained praise for its quick response. The United States, on the other hand, has struggled to respond. The Trump administration focused on travel bans to keep the “foreign” virus out rather than on mobilizing public health capacities to detect and respond—a message that aligns with the Trump administration’s election-year anti-immigrant and anti-China political frame. The president’s incentive structure has been clear, as his administration has tried to label COVID-19 the “Wuhan Virus,” continuing a trade war with China, the largest producer of medical goods needed by the United States. Perhaps these incentives were clearest in early March when Trump resisted allowing a cruise ship with COVID-19 cases to dock because “I don’t need to have the numbers double because of one ship” (White House 2020).