We’ve found one factor that predicts which countries best survive Covid

‘Trust in other people is so important because many aspects of fighting a pandemic – such as social distancing – require collective action.’ Photograph: Maureen McLean/REX/Shutterstock

In 2019, the Global Health Security Index published a report ranking countries on their preparedness for pandemics. The US scored highest, followed by the UK. Two years later, both countries rank among those with the greatest loss of life from Covid. How could this be?

A large part of the answer is trust. Countries that looked good on paper in 2019, such as the US, UK, Spain and Slovenia, found they lacked this intangible but critical layer of defence. And this figure from our research over the past two years at the Oxford Covid-19 Government Response Tracker shows it in stark terms. On the left (see below) you can see that a higher global health security score in 2019 is not correlated with fewer deaths during the pandemic, at least among the countries whose health systems have a minimum threshold of capacity.