Two years ago at this time, we were all in lockdown due to a mysterious new virus first discovered in the United States at a Seattle area nursing home. There was very little information at the time. We didn’t know much about how it spread or even how dangerous it was. Going into the lockdown, most of us believed, or at least hoped, that a few weeks of shared sacrifice would stamp it out and we could return to our normal lives. The stamp out did not happen and it became increasingly clear that the virus did not affect everyone equally. Fissures developed in support for and compliance with social distancing measures, including between the President and his own public health experts.
An infectious disease became a partisan issue. In Seattle, you’d be ashamed to not wear a mask. In Spokane or Coeur d'Alene, you might be ashamed to wear one. A similar pattern for vaccines followed. A large segment of the population refuses vaccines that are proven to be both highly effective and safe. It’s not like these are decisions are without consequences. Current hospitalizations and deaths related to COVID are overwhelmingly among the unvaccinated. Tens of thousands of American deaths were completely avoidable. How did this happen?
A recent article published in The Lancet by a multidisciplinary UW research team that includes faculty and graduate students from the Department of Political Science points to one troubling explanation: Trust, or more precisely a lack of it. The article describes a sophisticated statistical study that attempts to predict and explain COVID infection and death rates across 177 countries. Many country differences matter, such as the general health of the population, or the quality of a nation’s public health care system. But what was particularly remarkable were the large effects of citizens’ trust in government and in each other.
Other things equal, the countries with the highest levels of trust had substantially lower rates of infection and death. Overall, the study estimated that if government trust in every country was as high as that of Denmark or South Korea, global infections would be an estimated 12.9% lower. If everyone's interpersonal trust was as high as that of Denmark or South Korea, global infections would be an estimated 40.3% lower.
How are government and interpersonal trust related to COVID infection and death rates? The most plausible explanation is quite simple: Policy recommendations only work if they are followed. The US is on the lower end of the spectrum in terms of government and interpersonal trust, and our infections and deaths are substantially higher than what would otherwise be expected.
A recent Gallup study notes that people’s sense of community attachment is strongly related to their sense of whether their political worldviews match that of the community. We can probably expect the downward decline in trust to continue as the United States continues to become more politically polarized. As Frank Newport of the Gallup notes, "Any functioning society needs to develop and maintain its social institutions -- the widely agreed-upon ways in which society handles the core functions necessary for survival. But that agreement appears to be waning. Partisans on both sides increasingly see institutions in the U.S. not as beneficial and necessary, but as part of an effort by the other side to gain advantage and to perpetuate its power and philosophical positions."
This is clearly troubling for our ability to address a wide range of public policy issues that depend on citizen compliance. In discussing the Lancet article, New York Time Columnist Ezra Klein made an astute observation about policy implementation that probably applies well beyond the coronavirus pandemic:
We erred this time by believing ourselves not just more capable, but also more united, than ultimately proved true. Now that we know the truth about ourselves, and the havoc our divisions will wreak on any pandemic response, the problem we need to solve becomes clearer.
What does good pandemic policy look like for a low-trust, high-dysfunction society?