Global study pinpoints "authoritarian advantage" in managing COVID-19 threat

Published:09 July 2020

CQU social and health psychologist Dr Olav Muurlink.

Global health experts have been quick to identify conditions that make an individual particularly vulnerable to COVID-19, but now a CQUniversity researcher has analysed some of the factors that make a whole nation vulnerable.

New research by CQU academic Associate Professor Olav Muurlink, conducted with an international team of researchers, shows key spending outcomes like nurses and hospital beds per population was linked to lower death rates than total per capita health care spending overall.

The study, published in Frontiers of Public Health this week, is also the first analysis to consider the impacts of public freedoms, and show countries with a dominant centralised government had an “authoritarian advantage” in flattening the infection curve.

“When we factored in variables that previous research has suggested might critical in predicting death rates, such as population density and comorbidities, what stood out was that even holding these factors into account, health care capacity was a key factor in decreasing COVID-19 deaths,” Dr Muurlink said.

The research team analysed modelled the outcomes via a health care capacity index, and Brisbane-based Dr Muurlink said that data to 30 April showed one particularly contrary relationships: wealthier countries had higher death rates, even taking into account other factors.

“This could be due to the study being a relatively early analysis – for instance I know from my work in Bangladesh that, up until fairly recently, in that country COVID was being talked about as a ‘rich person’s disease’, associated with flying in planes.”

The researcher team analysed data from countries that had confirmed at least 1000 cases of COVID-19, and also found higher population density did not translate to higher fatality rates across the 86 nations included.

Dr Muurlink attributes this anomaly to the ability of nations to effectively lockdown populations, and said civic freedom is not necessarily compatible with handling a pandemic.

“The CIVICUS Civil Society Index (CSI) looks how free citizens are free to do things like demonstrate in public places, and how closely information is controlled by the government – and  I wanted to look at whether in crises like these, societies could be better off with more authoritarian leadership.”

Dr Muurlink says the study provides challenging evidence that there are trade-offs to be made, in terms of public freedoms.

“The CSI ranks societies from ‘closed’ to ‘open’ in five categories, and as societies become more closed, there is a tendency for both case numbers and deaths to reduce,” said Dr Muurlink.

“There is an understanding in the literature that there is an “authoritarian advantage” in public health crises, but this pandemic has a long way to go - exactly how that advantage will play out is going to be interesting.”

“Like all complex problems, where social, cultural, and political factors interact with background factors like population density and national health care capacity, coming up with clean, straightforward answers is always going to be tricky.”

Healthcare Capacity, Health Expenditure, and Civil Society as Predictors of COVID-19 Case Fatalities: A Global Analysis is available to read in Frontiers of Public Health journal here.