Writing about responses to the COVID-19 pandemic at the end of 2020 was a bit like writing from the front about the outcome of a war during a major battle whose winner was not yet clear. It is therefore to the credit of the authors and editors of these two volumes that they read less like ancient history than informed assessments of a war’s trajectory at midpoint. This is essentially what they are, and the endgame of the war is still far from certain.
Historian Peter Baldwin’s title is explicit on this point. In an analysis that is organized around how public health strategies bring individual rights and the state’s efforts at collective protection into tension, if not conflict, he points out that pre-vaccine, “ancient preventive tactics” comprised the armamentarium of governments autocratic and democratic alike. Based on a less than systematic but meticulously documented catalog of responses, he concludes that neither regime type had performed better at the end of the first wave, highlighting the diversity of responses among superficially similar political architectures. Baldwin correctly points out the fallacy that science dictated policy responses: “politicians picked and chose among the possibilities science held out” (p. 18). Sometimes, as in the case of Donald Trump in the United States and Jair Bolsonaro in Brazil, it is already clear that they chose badly, if not malevolently. In other cases, this judgment cannot yet be made.
For example, although Baldwin concedes that “which tactics worked best will not be known for years” (p. 54), and his concluding chapter on “The State in a Post-Pandemic World” is commendably tentative, he spends many pages in chapter 3 (“The Politics of Prevention”) critiquing the “Mephistophelean bargain” (p. 68) of Sweden’s relatively laissez-faire early approach to the pandemic. However, The Economist estimated as of January 21, 2022 (“The Pandemic’s True Death Toll,” https://www.economist.com/graphic-detail/coronavirus-excess-deaths-estimates) that excess deaths from all causes in Sweden since the start of the pandemic, although substantially higher than in its Nordic neighbors, were comparable to the German figure, lower than France’s, and just over half as high as in Britain. All those countries locked down earlier and more aggressively, albeit in somewhat different ways. Estimates from the Institute for Health Metrics and Evaluation as of October 2021 (Haidong Wang, “Estimation of Total and Excess Mortality due to COVID-19,” https://www.healthdata.org/special-analysis/estimation-excess-mortality-due-covid-19-and-scalars-reported-covid-19-deaths; and data from H. Wang, personal communication) found less striking differences but a similar pattern. Truly meaningful comparisons will indeed not be feasible for years—perhaps for a generation, if we consider the longer-term indirect health impacts of such phenomena as increased inequality, reversals of progress toward the Sustainable Development Goals, and differential deterioration in learning outcomes associated with school closures.
This point is emphasized in the synthetic concluding chapter of the massive collection of country case studies assembled by political scientists Scott Greer and colleagues. Coronavirus Politics is more analytical and more explicitly hypothesis driven than Fighting the First Wave. The editors’ introduction focuses on the details of policy rather than on league tables of indicators such as excess mortality and on hypotheses related to regime type, the role of social policy, political institutions (majoritarianism and federalism), and public health capacity (chap. 1). Generic chapters on the World Health Organization’s response and on typologies of state response (governance, surveillance, coercion, and social policy) are followed by carefully documented case studies (like Baldwin’s book, drawing on a multilingual range of sources) of no fewer than 38 countries and the European Union. This in itself will ensure the reference value of the book for some time to come, as well as its importance as a starting point for investigation of later policy directions. Most of the case studies, structured around the editors’ initial hypotheses, were of middle- or high-income countries, because of limits to the availability of data from others—a problem that persists as we enter year three of the pandemic. Important case studies from outside the high-income world include those of Vietnam, India, Colombia, Malawi, and Tanzania.
The editors conclude from the case studies that the “most important finding … is the dependence of health policies on social policies” (p. 616), with countries like Germany and Denmark having used such policies to compensate for much of the damage done to livelihoods by lockdowns—in contrast to the approach of countries with fewer resources, some of which resorted to crude and coercive lockdowns that ultimately proved unsustainable. Greer and colleagues also emphasize the heterogeneity of authoritarian regimes, pointing out (again like Baldwin) that a wide variety of political institutions can be characterized as authoritarian, and that despite the intuitive plausibility of the hypothesis that authoritarian regimes were more effective in controlling the pandemic, responses have in fact been quite uneven. Furthermore, within the universe of formal democracies, “it is far from clear that the strong democratic leaders performed well” (p. 620), with Trump and Bolsonaro being cases in point.
Finally, they assess the importance of a robust public health infrastructure as surprisingly limited. This is a claim that those with firsthand experience of the weakening of that infrastructure at both national and local levels in the United Kingdom might question, although it appears to be borne out by the limited political strength of the Centers for Disease Control and Prevention (CDC) in the United States in the face of hostility from the pinnacle of the executive branch. In some cases, executive action actually undermined the public health infrastructure. For example, the Trump administration disbanded the global health security unit of the National Security Council in 2018, and Canada similarly shut down its Global Public Health Information Network in 2019. Indeed, the extent to which domestic public health capacity was weakened by design rather than inattention, in the face (for example) of a quarter-century of warnings by the prescient global health journalist Laurie Garrett, is an important topic for future comparative research. Greer and colleagues end their narrative just as the first vaccines become available, pointing to the need for future exploration of vaccine (un)availability. As Baldwin likewise concludes (p. 288), “So long as a critical mass has not been vaccinated, there will be no real security. The solution has to be global or not at all.”
The strongest parts of Fighting the First Wave are its descriptive chapters (chaps. 4, 5 and 9), which draw out the contrasting (and in some cases counterintuitive) styles of early national responses to the pandemic. The latter two chapters are eloquent about the inequitable impacts of lockdowns in poorer countries, notably those with large informal economies, and the “class divide” (chap. 9) that emerged based on the different individual choices that were available to individuals occupying different places in national distributions of income and occupation. Baldwin may be on less stable ground in trying to draw analogies between historical patterns of ascription of responsibility for disease and the specific challenges presented by the pandemic, by way of digressions on such topics as changing sexual mores and the size of the market for sex toys (chap. 7, p. 183). His attempt to connect pandemic responses with an increasingly individualized conception of public health, using factors like “an implicit behavioral pact with our doctors” (p. 195), is ultimately less than convincing. Indeed, this chapter and the one that follows, on the tension between moral suasion and enforcement of lockdowns and related restrictions, seem somewhat disconnected from the rest of the analysis.
One shortcoming of both books is a general lack of detailed engagement with political economy. As noted, inequality is foregrounded, but explaining generally rising pre-pandemic levels of inequality with reference to macrotrends such as globalization and financialization receives less attention. Austerity is properly front and center in the Coronavirus Politics chapters on the United Kingdom and, to a lesser extent, in discussions of Italy, Portugal and Spain, but it has been a much more widespread (and for some scholars more pernicious) phenomenon, going back in some cases to the last century’s conditionalities attached to loans from the Bretton Woods institutions. In their conclusion, Greer and colleagues indicate the need for more attention to political economy, but their focus is on vaccine availability rather than on larger contextual patterns. Future work could build on the characterization of COVID-19 as “neoliberal disease” (Matthew Sparke and Owain David Williams, “Neoliberal Disease: COVID-19, Co-Pathogenesis and Global Health Insecurities,” Environment and Planning A: Economy and Space, 2021). It should also foreground the political economy of a catastrophic underprovision of global public goods: neglecting “possibly the highest-return public investment ever” in vaccines and other preventive measures (Ruchir Agarwal and Gita Gopinath, A Proposal to End the COVID-19 Pandemic, International Monetary Fund Staff Discussion Note, 2021).
None of these observations should distract from the tremendous value that both books add to the rapidly expanding body of scholarship, the best of it anticipatory, on the pandemic and what comes afterward. Serious investigators will want them both at hand.
