To those who obsessively followed the COVID-19 websites these past eleven months (including me), one thing demanded an explanation above all: why were the worst death rates per million in the richest, most developed countries, and in the United States and the United Kingdom most of all?
Bits of the answer were obvious, of course. COVID-19 selectively kills the elderly, and poor countries with high birth rates have a very low proportion of elderly people. They can’t die in droves if they aren’t there.
There’s also the issue of under-counting, which you would expect to be worse in countries with poor or no public health service, but the phenomenon extends even into middle-income countries such as Russia.
But even compared to other rich countries with the same age profile, the UK and the U.S. performed terribly in deaths per million. The United States has had 1,555 COVID deaths per million people. Canada has had 573 deaths per million, barely a third as many per capita.
As for the United Kingdom, it has had 1,781 deaths per million, even worse than the U.S., whereas Germany has had only 824. In fact, the U.S. and the UK together account for four-fifths of all COVID deaths in the ten worst-performing countries.
So, what is going on here? Is speaking English bad for your health? Three-quarters of Canadians speak English, so probably not.
Michele Gelfand, a cultural psychologist at the University of Maryland, may have the key that unlocks the puzzle. At the very least, she has great timing.
In her 2018 book Rule Makers, Rule Breakers: How Tight and Loose Cultures Wire Our World, Gelfand proposes that some national cultures embrace discipline while others glorify rule-breaking. That may sound like a social scientist desperate for a fresh angle re-framing national stereotypes as statistical fact, but she may be on to something about COVID death rates.
Her latest research was published in Lancet Planetary Health, a leading epidemiological journal, late last month. Using her established categories of “tight” societies (willing to abide strictly by social norms, such as Singapore, Japan, China, Austria) versus “loose” ones (more permissive about rule-breaking, such as the U.S., the UK, Israel, Italy), she compared COVID case rates and death rates.
The results are striking. The loose cultures, on average, had five times the infection rate of the tight ones, and eight times the death rate. If you compare the most libertarian with the most conformist, say the United States versus Japan, the contrast is astounding: about 25 times as many American cases and deaths per million.
What conclusions can we draw from this? Well, it suggests that the role of individual leaders such as former U.S. president Donald Trump and UK Prime Minister Boris Johnson in shaping disastrous national COVID outcomes probably was not decisive. The outcomes probably would have been pretty bad even if less irresponsible leaders had been in charge.
But there is something wrong with Gelfand’s explanation for why countries become or remain tight or loose. She argues that “communities with histories of chronic threat – whether natural disasters, infectious diseases, famines or invasions – develop stricter rules that ensure order and cohesion.” That would make sense, but history says it’s really not that simple.
How did Israel – the Holocaust, six wars in the past 75 years, most of the population descended from refugees – end up among the carefree, permissive countries? And by the way, it really doesn’t have a very high death rate (614 per million).
Shouldn’t the Eastern European countries (world wars, civil wars, foreign occupation, waves of refugees) be among the tightest societies in the world? Yet seven of the fifteen countries with the highest death rates in the world are among the former Communist countries of Eastern Europe, places such as Hungary, Bulgaria, the Czech Republic and Slovenia, all with more than 1,450 deaths per million.
There’s probably a lot more hard-wiring involved in determining where a culture ends up in terms of conformity to social norms. And by the way, we would all love to know: Why did the United States Navy pay for this research?
Gwynne Dyer is an independent journalist based in London, England.