Key to COVID-19 success: Not states but societies

Afew months after COVID-19 burst onto the world stage, it seemed clear why some countries were doing well and others poorly. Places that had strong, effective governments — China, Taiwan, Singapore, the United Arab Emirates, Germany — suffered few deaths from the virus. Places with weak leadership and bureaucracies that were dysfunctional — the United States, Britain, Italy, Chile, Brazil — did poorly.

But now, one year into the pandemic, the situation is somewhat more complicated. Many European countries that had gotten the virus under control have now seen sharp spikes in cases. Some countries that were pummeled by the virus have done very well with vaccinations. How to make sense of these new facts?

It remains true that the single strongest ingredient to successfully handling the pandemic has been strong and effective governmental institutions, particularly in the public health domain. But it turns out, that’s not enough. In addition to the state, we have to look at society.

Michele Gelfand, a cultural psychologist at the University of Maryland, has long argued that a key distinction among countries is whether they have “tight” or “loose” cultures. Tight cultures like China tend to be highly respectful of rules and norms; loose ones like the United States tend to defy and break them. In a January 2021 paper in the Lancet Planetary Health, she and several colleagues studied 57 countries and concluded that loose countries had five times the rate of COVID cases and nine times the rate of COVID deaths as tight countries.

Ms. Gelfand points out that this distinction between rule-observant societies vs. rule-breaking ones was first observed by Herodotus and has been noted by many anthropologists and scholars over the centuries. But she has tried to study the phenomenon systematically and determine the consequences of these cultural traits. In March 2020, as the pandemic was growing, she presciently warned that loose cultures were likely to have a hard time unless they managed to “tighten up.”

The numbers speak for themselves. When looking at cumulative deaths per million among large countries, loose cultures such as Britain, the United States, Brazil and Mexico have been some of the worst performers. Tight cultures such as those in East Asia — China, Japan, Taiwan, Singapore, Vietnam — have all maintained very low rates of COVID cases, hospitalizations and deaths.

Ms. Gelfand wisely does not claim that these cultural differences are rooted in some innate differences between East and West but rather are a rational product of historical realities. Societies that have faced chronic threats — war, invasion, famine, plagues — tend to develop tight cultures in which following rules becomes a mode of survival. Think of Taiwan, constantly under the threat of Chinese military intervention, vs. the United States, sheltered by two vast oceans and two benign neighbors. Places that have been secure and prosperous for a long time tend to become more lax about observing norms.

This distinction between state and society sheds much light on Europe. In many European countries, such as Germany and France, the state functions well. As a result, they were able to crush the curve after the first wave. But eventually people got “weary” of following the rules (in Emmanuel Macron’s phrase). In France, social distancing broke down during the country’s August vacation period. In Germany, people decided to gather for festivities a few months later. The result — COVID spikes.

The vaccine rollout highlights another dimension of this phenomenon. Some of the loosest countries, which fared poorly in managing the pandemic through measures such as social distancing — the United States, Britain, Israel, Chile — were the most innovative and dynamic at developing, procuring and distributing the vaccine. The very traits that made it hard to follow social distancing rules were ones that helped generate the solution to the problem — and now they are benefiting from that creativity, risk-taking and rule-breaking.

Ms. Gelfand told me that this is not a case of one trait being better than the other. “Whether you are a country, a company or even a family, sometimes you want to be tight, sometimes loose. The key is, do you know how to move from one side of the spectrum to the other.” She points out that New Zealand, generally considered a loose country, tightened up when confronting COVID. Greece, under the leadership of an extremely able prime minister, did the same. “The goal should be,” she said, “to be ambidextrous — tight or loose, depending on the problem we face.”