Thread by @TomBollyky, Countries without government trust have performed badly in #COVID19, even when you [...]

Countries without government trust have performed badly in #COVID19, even when you account for differences in population age and size, and the timing of the pandemic

New analysis in @ForeignAffairs via @samckiernan, Sawyer Crosby @IHME_UW, and me 1/
https://www.foreignaffairs.com/articles/united-states/2020-10-23/coronavirus-fighting-requires-trust

“Government exists to protect us from each other,” Reagan once said, but goes “beyond its limits . . . in deciding to protect us from ourselves”

When applied to pandemics, Reagan was wrong & so are policymakers, in esp. in US, who have adopted this view https://www.foreignaffairs.com/articles/united-states/2020-10-23/coronavirus-fighting-requires-trust

Fighting a Pandemic Requires Trust

The success of public health efforts depends on the trust between governments and their people.

https://www.foreignaffairs.com/articles/united-states/2020-10-23/coronavirus-fighting-requires-trust

Confronted w/novel contagious virus, for which there's no effective treatment & no preexisting immunity, the only way to protect citizens from one another is by convincing them to protect themselves

Esp. in free societies that depends on trust between government and its people

We saw this Ebola in West Africa 4/ https://www.nejm.org/doi/full/10.1056/NEJMp1409859

Ebola Virus Disease in West Africa — No Early End to the Outbreak | NEJM

Perspective from The New England Journal of Medicine — Ebola Virus Disease in West Africa — No Early End to the Outbreak

https://www.nejm.org/doi/full/10.1056/NEJMp1409859

And with Ebola in the DRC 5/ https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30063-5/fulltext#seccestitle140

Institutional trust and misinformation in the response to the 2018–19 Ebola outbreak in North Kivu,...

The findings underscore the practical implications of mistrust and misinformation for outbreak control. These factors are associated with low compliance with messages of social and behavioural change...

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30063-5/fulltext#seccestitle140

And with H1N1 & SARS too 6/
https://www.foreignaffairs.com/articles/united-states/2020-10-23/coronavirus-fighting-requires-trust

Government trust assumes an outsize role when threat is new to a population that does not already perceive itself as vulnerable 7/

https://www.foreignaffairs.com/articles/united-states/2020-10-23/coronavirus-fighting-requires-trust

In #COVID19, many of successful nations have direct experience with past coronavirus outbreaks, such as SARS or MERS, or recent history high level of endemic infectious disease

An already high risk perception relies less on government to convey risk 8/ https://www.foreignaffairs.com/articles/united-states/2020-10-23/coronavirus-fighting-requires-trust

Fighting a Pandemic Requires Trust

The success of public health efforts depends on the trust between governments and their people.

https://www.foreignaffairs.com/articles/united-states/2020-10-23/coronavirus-fighting-requires-trust

For everyone else, public trust an the honest, full appraisal of risk from government & its leaders clearly matters 9/

https://www.foreignaffairs.com/articles/united-states/2020-10-23/coronavirus-fighting-requires-trust

The good news is that can be earned in crisis

A government builds & maintains that trust by issuing science-based advice and timely, honest assessment of risk

Again, we saw with Ebola 10/
https://www.foreignaffairs.com/articles/united-states/2020-10-23/coronavirus-fighting-requires-trust

The US government has long known this, which is why this statement existed in USG 2006 pandemic plan 11/

https://georgewbush-whitehouse.archives.gov/homeland/pandemic-influenza-implementation.html

Past surveys had found most trusted sources of information in a health crisis were @CDCgov officials, followed by state and local public health officials, with elected officials typically least trusted 12/
https://www.liebertpub.com/doi/10.1089/bsp.2012.0048

And, yet, White House kept @CDCgov from briefing the public, took away its responsibilities related to data, and watered down its recommendations 13/ https://www.propublica.org/article/inside-the-fall-of-the-cdc

Inside the Fall of the CDC

How the world’s greatest public health organization was brought to its knees by a virus, the president and the capitulation of its own leaders, causing damage that could last much longer than the…

https://www.propublica.org/article/inside-the-fall-of-the-cdc

And, President Trump was retweeting things like this from his twitter account 14/

The result, I am very sad to say, speak for themselves 15/15

https://www.foreignaffairs.com/articles/united-states/2020-10-23/coronavirus-fighting-requires-trust

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