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Do Authoritarian or Democratic Countries Handle Pandemics Better?

A mix of factors have shaped every country’s response to the coronavirus pandemic, but the stakes for the democratic model are high.

Published on March 31, 2020

China has declared victory over the new coronavirus and begun to close its temporary hospitals. Singapore’s coronavirus chief wept while thanking healthcare workers for their efforts. Meanwhile, Spanish officials have requisitioned an ice rink as a makeshift morgue, and nurses in the United States are begging for hand-sewn masks. The stark contrasts raise a pointed question about governance: Are authoritarian countries doing a better job than democratic ones in arresting the coronavirus?

China is certainly engaged in an English-language propaganda campaign to depict its response as an effective deployment of high-tech authoritarianism that rapidly contained the virus and bought the world time. It’s buttressing the message by sending medical equipment and experts to other countries, and spreading a false story that the illness originated as U.S. military bioterrorism. Mounting a propaganda campaign of his own, President Donald Trump issued guidelines to slap the pandemic with a “Made in China” label and blame China’s authoritarianism and censorship for early delays that allowed a potentially containable virus to infect the world.

Despite attempts by politicians to use the crisis to tout their favored political model, the record so far does not show a strong correlation between efficacy and regime type. While some autocracies have performed well, like Singapore, others have done very poorly, like Iran. Similarly, some democracies have stumbled, like Italy and the United States, while others have performed admirably, like South Korea and Taiwan. The disease has not yet ravaged developing countries, making it impossible to include poorer autocracies and democracies in the comparison.

The Evidence So Far

Three factors appear to have a greater bearing on a country’s success than its type of regime.

Lessons Learned From the SARS Epidemic

Taiwan, South Korea, Hong Kong, and Singapore differ in their governance systems, but all took away key lessons from SARS: They developed speedy tests soon after the coronavirus began spreading and undertook broad testing to get one step ahead of the virus. All had laws in effect or to invoke during emergencies that allowed extraordinary tracking of where individuals infected with the coronavirus had been, and they relaxed privacy protections to spread that information widely and alert people to be tested. They then relied on heavily enforced quarantines to corral the outbreak. Canada, the one country outside Asia to have a major SARS outbreak, engaged in similar coronavirus preparation and mass testing.

Legitimate Political Systems

When Hong Kong’s chief executive attempted the same strategy as some of Hong Kong’s neighbors, she faced striking nurses and violent opposition to quarantine. What differentiated Hong Kong from other SARS veterans? Its government is distrusted by nearly 60 percent of the population.

The success of governmental social control depends more on voluntary compliance than on government enforcement. In the Cold War era, totalitarian systems were known for their neighborhood spies, gulags, apparatchik bureaucrats, and centralized, highly ideological states where citizens distrusted their government and one another. But today, trust no longer breaks down clearly by government type.

According to surveys by Edelman, China is far and away the country most trusted by its population, Singapore ranks sixth, and South Korea has risen to tenth place under its current leadership. Governments with high levels of trust can effectively maintain onerous lockdowns. Equally important, trust enabled some countries to convince their citizens to allow mass testing and quarantine before the virus’s effects were widely seen, allowing them to stop the spread early.

Conversely, Iran’s government has long been troubled by crises of illegitimacy—one reason why religious leaders in Qom refused to close holy pilgrimage sites and many Iranians ignored warnings to stay home and continued to spread the disease.

But many democracies—dogged by polarization, inequality, and a sense of failed promise—also face low citizen trust. Italians’ trust in their government hovers near that of Hong Kong. Thus, even as police charge tens of thousands of people for breaking lockdown, movement in Lombardy has continued at about 40 percent of normal levels, according to cell phone data. Many European democracies have faced declining trust since the 2008 financial crisis, with Spain, France, and the UK rating particularly low in a Gallup study. In the United States, Pew polling finds that trust in the government has plunged from 75 percent of the population in the 1960s to a near-historic low of 17 percent today. While more people trust government medical advice, Gallup has found that over a third of Italians and nearly 30 percent of Americans don’t. Unsurprisingly, many people in both countries ignored early advice to practice social distancing.

In the United States, polarization affects views of legitimacy. Observance of measures such as handwashing broke down along starkly partisan lines as Trump downplayed the virus and offered advice in conflict with that of medical experts. As state governments—which enjoy greater trust levels—step into the breach, they implement widely differing public health approaches that mirror the red-blue electoral map, turning the United States into fifty case studies in governance.

Another aspect of legitimacy is the extent to which governments play politics with a pandemic to buttress their rule. In typical authoritarian fashion, Iran and China both hid the extent of the crisis from the world and their own publics. China forced an early whistleblowing doctor to recant and refused help from the World Health Organization; Iran grandstanded by sending masks to help Wuhan just a few weeks before it would secretly build mass graves at home. Yet in authoritarian Singapore, the prime minister’s excellent risk communication and transparency have been credited with quickly stopping people from hoarding goods by letting them know what to expect. Meanwhile, the U.S. government politicized the crisis, minimizing its seriousness and under-testing, possibly to avoid numbers that would be politically damaging in an election year.

State Capability

A government’s capacity—its ability to intervene competently in arenas from communication and health provision to quarantine maintenance and equipment manufacturing—is only loosely related to its GDP or overall type of political regime. Some poorer countries have highly educated populations and stronger than average systems of health and enforcement. Authoritarian, lower-middle-income Vietnam, for instance, was able to carry out a similar strategy, with similar success, to that of wealthier, more democratic South Korea.

The United States is underperforming relative to its wealth. The unusual percentage of political appointees in its national civil service means that, at its wealthiest and best-resourced level of government, the response has been hampered by politics and ideology, as well as bureaucratic red tape and rigidity. One consequence is that it can take a week to receive the results of coronavirus diagnostic tests in the United States, while Japan has developed a fifteen-minute test and Singapore can produce test results in three hours. Meanwhile, who gets tested, how fast those tests are processed, and with how much meticulousness contacts are traced and corralled—the crucial steps that allow countries to avoid general lockdown—are all conducted by local health departments. Local resources and education vary widely, and some areas resemble far poorer and less capable countries. In early March, for example, Vietnam was carrying out vastly greater numbers of tests, both per capita and on an absolute basis, than the United States.

Science Requires Responses, Not Ideologies

While it is relatively easy to determine what characteristics make for an effective pandemic response, it’s difficult to determine whether any given strategy is more authoritarian or democratic. For instance, the lax privacy rules that allow South Korea to combine the credit card, CCTV, and GPS tracking data of people who have the virus, and then publicize the results to trace possible contacts, feel Orwellian to those in the West. Yet mass tracing, testing, and quarantine have allowed some countries to avoid the long-term forced lockdowns and military patrols that make democratic Italy, Spain, and France feel as if they are under martial law.

China forced 800,000 people into quarantine, and its use of stadiums as mass isolation areas was chillingly reminiscent of Chilean concentration camps under former president Augusto Pinochet. Yet China has claimed that the people in these temporary hospital facilities were closely monitored and received speedy help, enabling the country to end emergency measures within weeks. Such policies would likely be a relief to many Italians dying in their homes or U.S. businesses facing long-term closure.

The laws of science have a logic that belies ideology. China’s tough measures forcing businesses and schools to close, locking off Hubei Province, and keeping its 50 million citizens homebound was reported by the Washington Post under the headline “China’s coronavirus lockdown—brought to you by authoritarianism.” But then Italy imposed similar rules on 60 million Italians, over 100 million Americans were told to shelter in place, and India called for the largest shutdown in history for its 1.3 billion people. Singapore’s criminal penalties for breaking quarantine and China’s temperature-checking apps and phone-reading drones appeared to capitalize on their high-capacity authoritarianism. But those measures are not dissimilar to South Korea’s digital tracking app, and criminal penalties for breaking quarantine also apply in a multitude of democratic countries, including Italy and the United States.

Authoritarian and democratic governments both have mixed records when it comes to pandemic response. But China’s early start in fighting back the scourge, its economic wherewithal, and its desire to rise globally suggest that it will not let the pandemic go to waste. Authoritarians are certainly in the lead in using the crisis to double down on autocracy in other areas of their governance: witness Russian President Vladimir Putin’s use of the virus to grab more power, Prime Minister Viktor Orbán’s attempt to rule by decree in Hungary, and China’s denial of food access to Uighur citizens already facing massive repression. If developed democracies cannot pull together to stop the spread of the virus, manufacture the goods the world needs to fight it, and make plans to jumpstart the global economy, China will do so. On the other end of this crisis, the result could be a decisive global shift toward its authoritarian model.

Carnegie does not take institutional positions on public policy issues; the views represented herein are those of the author(s) and do not necessarily reflect the views of Carnegie, its staff, or its trustees.