Containing the Contagion: Determinants of Government Response to the First Wave of the COVID-19 Pandemic in Europe

Abstract

The COVID-19 Pandemic has spared no country in the world, causing almost three million deaths in its first year. Countries had to react quickly to reduce an exponential rise in deaths and avoid healthcare system collapse. Yet governments were unprepared for and responded very differently to iterations of the same virus. This thesis investigates what factors determined national variation of first-wave policy response to the COVID-19 pandemic in European countries, and what led to response effectiveness. I create a theoretical framework that explains differences in response effectiveness, a measure which depends on both intensity (the stringency of the measures) and quality (how competently the response was executed). Combined, these two elements create a response that varied in its effectiveness in containing cases and deaths. To address this three-dimensional outcome, I use a mixed methods approach: quantitative analysis explores the determinants of variations in response intensity in 29 European nations, while qualitative analysis examines how the determinants affect variations in response quality in three case studies of Sweden, Italy, and Germany. I hypothesize that four groups of factors (Governmental, Political, Societal and Economic) will be significant in explaining (1) national variations in response intensity, (2) national variations in response quality, and will interact to determine (3) response effectiveness. To test my hypothesis, I first use fixed-effects linear regression with time series controls to measure how my set of factors influences response intensity in the first wave. After having identified the direction and the significance of the variables, I complement my findings with three qualitative case studies of Sweden, Italy and Germany, that consider the quality of the response. These countries had very distinct experiences during the COVID-19 pandemic. In Sweden, a laissez faire response led to very high rates of cases and deaths. Italy also had high case counts and deaths, despite its very stringent policies. In Germany, a moderately intense response was instead successful at containing cases and deaths. In all three cases, effectiveness depended on the quality as well as the intensity of the response. Overall, I argue that these four groups of factors explain variation in response intensity and quality, and that they interact to determine an effective response. Among them, (1) decentralization with strong intergovernmental coordination and central guidance, with reliance on few but communicative scientific experts, (2) strong leadership with low pressure from the opposition, (3) high trust, and (4) a strong economy that is able to quickly increase healthcare capacity, combine to determine an effective response: one which best couples intensity with quality to avoid high numbers of cases and deaths. In light of my findings, I propose policy recommendations to national governments and political leaders to strengthen the Governmental, Political, Societal and Economic mechanisms that can help achieve an effective outcome in future public health crises.