As the director of the World Health Organization pleaded more than a year ago for leaders to act swiftly to arrest a quickly-worsening health crisis, he also stressed that the fate of the virus was in their hands.
“We’re deeply concerned both by the alarming levels of spread and severity and by the alarming levels of inaction,” Director-General Tedros Adhanom said in a news conference March 11, the day the organization officially declared the COVID-19 outbreak a pandemic. “All countries can still change the course of this pandemic,” if they put resources toward detecting, testing for, and tracing cases of COVID-19, as well as mobilizing their citizens to respond to the virus, he said.
The following weeks would prove to be a crucial test for world leaders and their governments to respond effectively to the novel coronavirus. Across the world, the rhetoric they used to convey the level of threat to the public varied drastically.
Denmark’s Prime Minister Mette Frederiksen announced on March 11 that the country’s borders would be temporarily closed, saying the government was “painfully aware that this will have severe consequences” on businesses and families, but felt it was the necessary response to take in light of the crisis. In New Zealand, Prime Minister Jacinda Ardern urged residents to go home after imposing what she called the most significant lockdown in the country’s history, warning them to “act now or risk the virus taking hold as it has elsewhere.” After Germany announced strict lockdown measures, Chancellor Angela Merkel warned the guidance was not optional: “These are not recommendations by the state,” she said. “They are rules that have to be followed in our collective interest.”
But not all leaders conveyed the same urgency in their message to the public. In China, state officials delayed releasing vital information about the disease in January, in turn hampering the WHO’s ability to respond effectively. Even after the novel coronavirus had been declared a “public health crisis” by the WHO, in Brazil, President Jair Bolsonaro described it “like a little flu or a little cold.” As top Iranian health officials tried to cover up some of the first deaths that occurred from the disease, the country’s health minister fell ill with the coronavirus at a news conference. In Washington, President Donald Trump also downplayed the severity of the virus, comparing it to the flu, and repeatedly promised that the country would “be open for business again,” even as public health experts cautioned that his message would give Americans a false sense of hope. Mexico’s president Manuel Lopez Obrador focused primarily on preserving the country’s economy, encouraging residents at one point to eat out at restaurants. In a video posted to his Facebook page, he told Mexicans to frequent local businesses rather than take health precautions, saying, “If you’re able and have the means to do so, continue taking your family out to eat … because that strengthens the economy.”
Experts who study crisis and leadership say while some aspects of the pandemic transcend any one person’s power, a few key themes have emerged from countries that have contained the virus and kept public trust: a clear messaging campaign absent of false hope or misinformation, as well as the prioritization of science over politics.
More than a year into the pandemic, some parts of the world seem to have finally turned a corner on the virus. A number of vaccines have been approved for use globally. Yet new, more aggressive variants of COVID-19 still pose a major threat, and are driving a new infection surge in countries such as India, Canada and Brazil. Leaders’ handling of vaccine distribution, as well as the spreading of these new variants, continues to attract public scrutiny. President Joe Biden entered office with a mandate to get the coronavirus under control, and the efficacy of the administration’s response could significantly shape his legacy. In countries like Brazil, where the death toll is continuing to climb, some public health experts argue inept leadership has cost countless lives.
“We tend to not think about leadership as being the most important thing in terms of pandemic response,” said Dr. Laura Kahn, a physician and research scholar at Princeton’s Woodrow Wilson School who has studied leadership during public health crises. “But the main thing that this pandemic has shown us is that it is absolutely critical.”
Effective leaders drew upon past experience, prioritized science in messaging
Michele Gelfand, a cross-cultural psychologist at the University of Maryland who has been studying cultural differences that have shaped the pandemic response, said that countries that have experienced more chronic threats throughout their history tend to be more adept at following restrictions in response to events such as a pandemic. This might explain why a number of East Asian countries — where the 2003 SARS pandemic is a recent memory and mask-wearing is a cultural norm — have been more effective at containing COVID-19.
Such was the case in countries like Taiwan, which had the third-highest death tally from SARS and took aggressive, and ultimately successful, steps to control COVID-19 in light of lessons learned from the 2003 pandemic. South Korea effectively contained the virus by developing a widespread testing and contact tracing program, having learned about the importance of early diagnosis during the 2015 MERS outbreak.
Gelfand added that while some countries had a natural advantage responding to the coronavirus because their public had dealt with other pandemics recently, the influence of political leaders cannot be discounted. “Leadership goes hand-in-hand with culture,” she said. “Any cultural shift can happen from the bottom-up, but has to be coordinated. When leaders minimize the threat, it goes along with the loose response.”
New Zealand Prime Minister Jacinda Ardern has been widely credited with spurring the necessary response from her constituents during the pandemic. When the country entered the strictest lockdown in its modern history last March, her government pursued an “enormous communication effort to try to mobilize collective adherence to these incredibly restrictive measures,” said Suze Wilson, a professor at New Zealand’s Massey School of Management who studied Ardern’s leadership style during the pandemic.
“It was so well communicated that people just got it,” Wilson said of New Zealand’s COVID-19 messaging campaign, which is called “Unite against COVID-19.” She described Ardern as “calm, focused, practical, and decisive” in her daily briefings and Facebook lives to the public, and said she was particularly good at using metaphors and framing — such as encouraging people to stay within their quarantine “bubble” — to explain what was needed to stop the spread of COVID-19 at a time when very little was known about it.
Ardern also worked closely with the country’s chief public health officer and deferred questions about science and research to him. She avoided criticizing, undermining or speculating about the virus, which Wilson said was “profoundly important” in managing the response, too: “If you ignore the science, from a strategy perspective, you’re putting yourself and your people in a very dangerous position.”
Although New Zealand had advantages in controlling the virus from the start due to its geographic isolation and population of only about 5 million, many still point to Ardern as an example of effective leadership. New Zealand was able to reopen last June after there were no new reported cases for 18 days, and although it has had to shut down two other times since — most recently in February to contain the spread of a more contagious UK variant — overall cases remain low, and the death toll, at 26 people, is dramatically lower than the thousands of deaths seen in other countries.
Voters recognized Ardern for leading an effective COVID-19 response: Her reelection victory in October marked the best performance her Labour party had seen in 50 years.
Not all leaders have been as visible as Ardern in their coronavirus response. But other governments have had similar success in thwarting the spread of the coronavirus by prioritizing science in their messaging to the public. In Vietnam, where the authoritarian government instituted mass quarantines and social distancing measures to tamp down COVID-19 spread early on, the health ministry put out a song about the importance of handwashing that went viral. Taiwan’s robust contact tracing and strict quarantine enforcement measures have been credited as a major contributor to the country’s successful fight against COVID-19, but the digital ministry’s viral, humorous campaigns advocating the importance of social distancing and mask-wearing likely helped, too. And in Senegal, musician Youssou N’dour released a song encouraging citizens to stay at home and wash their hands. Graffiti artists painted murals promoting similar public health measures.
Some government responses that have helped contain the coronavirus have trampled human rights in the process. In China, the outbreak has been contained, but in large part because of a sophisticated surveillance system that is helping keep the virus in check for now, but could pose a longer term threat to privacy and human rights, experts say. South Korea also used surveillance technology liberally in its successful COVID-19 response, as did India, which is nonetheless facing a new surge in infections.
But it’s clear that when leaders do not take public health crises seriously, it becomes much harder to convince citizens to do so, too. Kahn said varying responses to the pandemic have underscored that the competency of a leader during a public health crisis “can be a matter between life and death.”
When political leadership faltered, the public suffered
Despite leaders’ efforts to push a “wartime” response to the virus, the COVID-19 pandemic has proved an elusive threat, and citizens have suffered at the hands of their governments for a variety of different reasons.
“It helps to have an enemy to galvanize the nation,” Kahn said. “And the enemy in this case was invisible and it was all around us. So that’s a bigger challenge than fighting your political foe in another country.”
In Italy, a strained health care system was unable to accommodate the high number of people who fell ill during the first months of the virus, many of whom were elderly. Belgium has one of the highest COVID-19 death rates in the world, which a number of experts have blamed on the country’s fiercely divided political system. More recently the Czech Republic has struggled to contain a new, highly contagious coronavirus variant after members of parliament refused a request to extend the country’s state of emergency.
And a number of world leaders used their platforms to boost misinformation and give false hope about the virus, resulting in devastating consequences for the public, experts argue.
“I never got the sense that the Trump administration was really focused or prioritized the idea of having a clear messaging campaign aimed at the homefront,” said James Kimble, a communication professor at Seton Hall University who specializes in studying domestic propaganda. Kimble wrote a column in the Washington Post last year about the lessons that could be gleaned from World War II in mobilizing the public against the coronavirus.
While the former U.S. president initially fashioned himself as a “wartime” leader, urging the public to “sacrifice together” to combat the virus, he was reluctant to institute a national lockdown and repeatedly flouted advice from the country’s top infectious disease experts. In responding to the crisis he pitted public health against the economy, saying, “the cure cannot be worse than the problem.” He promoted hydroxychloroquine as an effective treatment for COVID-19 despite the fact that its benefits remain unproven, and in one highly publicized moment, suggested during a news conference that exposing patients to UV light and disinfectant could help treat the coronavirus, something that has never been verified by science. As their understanding of the virus grew, scientists at the CDC recommended the public wear masks to stop the spread of the virus, revising an earlier recommendation that masks were not necessary. But Trump was reluctant to embrace that message, waiting months to acknowledge it could be helpful in curbing the virus’ spread, and often appeared at his own political rallies without one. The president later told the public not to be “afraid of COVID” after contracting it himself in October, even as thousands of Americans continued to die from the virus each day, often without access to the advanced experimental treatments the president received.
Former White House response coordinator Deborah Birx recently told CNN that she believes hundreds of thousands of lives could have been “mitigated or decreased substantially” if the Trump administration had encouraged the public to take necessary safety measures earlier in the pandemic. The former president responded to both Birx and Dr. Anthony Fauci’s criticism of his administration’s response, calling them “two self-promoters trying to reinvent history to cover for their bad instincts and faulty recommendations.”
Trump was not alone in misleading the public about the severity and scope of the virus. He had counterparts in British Prime Minister Boris Johnson, who first reassured Brits that the country would be back to normal within 12 weeks, a goal the country hasn’t achieved nearly a year later, as Britain isn’t expected to fully reopen until June. Less than a month later, the prime minister came down with the coronavirus himself, and ended up in the ICU. Johnson later rolled out “moonshot” testing plans with quotas that experts said the government did not have the capacity to meet. The country at one point had the highest daily death tolls in the world, partly, some experts believe, because Johnson allowed families to travel and gather together during the holidays before instituting another lockdown.
Like Trump, Brazil’s President Jair Bolsonaro denied the severity of the virus even after contracting it himself, and promoted unproven treatments for COVID-19, such as hydroxychloroquine. He has shunned wearing masks in public, leading to similar politicization of a simple public health recommendation. The health ministry missed an opportunity to order 70 million doses of the Pfizer vaccine back in August, insisting it would produce vaccines locally, but pace has not kept up with demand. And Bolsonaro has continuously expressed skepticism about the efficacy of the COVID-19 vaccine, warning Brazilians back in December that they could “turn into a crocodile” if they were inoculated.
“[Bolsonaro] himself is the first one to disseminate misinformation,” said Marcia Castro, who chairs the global health and population department at Harvard’s T.H. Chan School of Public Health and advises its Brazil studies program. On top of that, she said, “the government never set up a communication framework or campaign so they can convey the right information to the population.” One of the most visible social media campaigns that Bolsonaro’s office put out — titled “Brazil Can’t Stop” — advocated for businesses to re-open and an end to social distancing, flying in the face of recommendations by the country’s own health department.
Kimble said that he believes that “a messaging campaign that’s clear, understandable, resonates with the public … has every potential to save countless lives.” But during the time that the leaders of countries like the U.S., UK and Brazil failed to deliver a strong, unified message about the virus, hundreds of thousands of people perished.
The public takes note of how leaders respond
International polling indicates that citizens have been observant of the way their leaders responded to the virus. A study by IPSOS Mori published last August found that leaders of the U.S., UK, Italy and Australia all experienced what the study’s co-author Will Jennings called a “rally-around-the-flag” boost in ratings during the first few months of the pandemic, but soon saw a decline in trust as the situation in their countries worsened. The only leader of that group who had experienced a rise in approval ratings as of June was Australian Prime Minister Scott Morrison, likely because Australia has done comparatively better at containing the virus.
“What we tended to find was that the leaders of the countries where the pandemic had gone worse in terms of deaths and cases were the [countries] where leaders were rated most poorly,” Jennings, a political science professor said, adding he believed these figures suggested that “the public are rational,” and “they respond to real objective performance.” In other words, “citizens are making judgments that reflect their particular context of how the pandemic is being managed in different countries.”
In Trump’s loss to Joe Biden in November, which occurred after the coronavirus had killed more than 200,000 Americans, the pandemic was the top issue on voters’ minds, according to an AP Votecast survey.
Since reaching a peak in January, coronavirus cases have begun to fall in both the U.S. and the UK, and the countries are now among the world’s top leaders in vaccinations.
Kahn said she found the changes instituted by President Biden — including signing a national mask mandate on federal property and public transportation, as well as speeding up production of PPE and vaccines — have been “vitally important in containing the pandemic.” Last month Biden announced that at least 90 percent of the U.S. population would be eligible for vaccination by April 19, but this came on the same day as a stark warning from CDC director Rochelle Walensky, who said she had a feeling of “impending doom” amid a spike in cases in certain parts of the country.
And the current situation in Brazil is worsening, serving as a stark warning of what other countries could face as more contagious COVID-19 variants continue to spread and potentially become dominant. Deaths are escalating and nearly all the states’ intensive care units are near or at capacity, prompting experts to warn that the health care system is “close to collapse”. Rather than changing his tone on vaccinations, Bolsonaro has started to push for an experimental nasal spray being developed in Israel as a possible treatment for COVID-19. In response to the recent deaths connected to the new variants, his message to citizens was to “stop whining.” During a recent Cabinet reshuffle Bolsonaro ousted three commanders of the country’s armed forces, suggesting he’s grown even more isolated in his haphazard response to the virus.
As COVID-19 cases rise elsewhere in Latin America, too, top officials are facing further scrutiny. In Peru, two ministers resigned after it was revealed after it was revealed that 500 government officials — including the country’s president Martin Vizcarra — took advantage of their positions to receive COVID-19 vaccines in February. With a week to go until the country’s general elections on April 11, Peru recently hit its highest level of single day deaths from the virus thus far.
Kahn says she hopes such behavior from powerful leaders will make voters think more carefully about how elected officials would respond to a public health crisis when they head to the polls in the future. “You don’t want a government that is just winging it,” she said. “The stakes are too high. And really, it makes the difference between lives saved and lives lost.”