Abstract for: Why Similar COVID-19 Policies Resulted in Different Outcomes: a Global, Behavioral Perspective

In the first two years of the COVID-19 pandemic, despite implementing similar policies, countries varied widely in health outcomes, with per capita deaths varying by two orders of magnitude. Importantly, differences in factors like demographics, economic activity, and infection fatality rates are insufficient to explain such divergent outcomes. Furthermore, health outcomes were uncorrelated with the stringency of the policy responses. To explain this puzzle, we build on a previously validated model of pandemic evolution in which government policies and public behavioral change are determined by perceived risk of death in a community. Analyzing data from 131 countries (31 Dec 2019 to 31 Mar 2021), we find that the key explanatory factor of heterogeneous health outcomes is not policy responses per se, but variation in “responsiveness”. Responsiveness is a measure of risk sensitivity, representing the magnitude of perceived risk of mortality from disease that compels a community to respond and adopt policies to curb exponential growth in transmission. We further provide empirical evidence that responsiveness correlates with two cultural constructs that vary across countries, namely collectivism (as opposed to individualism) and risk avoidance. This analysis has major policy implications, pointing to the importance of incorporating behavioral factors in pandemic-related policy design.