First let's look at a chart from yesterday-- a dozen big countries with the total number of COVID cases, the number of new COVID cases yesterday and how many COVID cases they've had per million residents:
USA- 28,897,718 (+71,054) 86,973 cases per million residents
India- 11,029,326 (+13,463) 7,942 cases per million residents
Brazil- 10,260,621 (+63,090) 48,050 cases per million residents
Russia- 4,189,153 (+11,823) 28,698 cases per million residents
UK- 4,134,639 (+8,489) 60,699 cases per million residents
France- 3,629,981 (+20,064) 55,531 cases per million residents
Italy- 2,832,162 (+13,314) 46,887 cases per million residents
Germany- 2,405,263 (+5,763) 28,648 cases per million residents
Mexico- 2,043,632 (+2,252) 15,743 cases per million residents
Japan- 426,456 (+859) 3,379 cases per million residents
China- 89,582 (+10) 62 cases per million residents
Remember when we first started hearing about it when a big epidemic broken out in Wuhan, China. Looking back on that, it didn't really spread that much. Sometime last spring, I asked my doctor, who does a lot of research in China, why the rate of spread had all but died in China and was accelerating rapidly in Europe and especially the U.S. She told me that the Chinese authorities were telling people to go shopping for several weeks worth food and then when they got home, they nailed their doors shut. No one could go out; Period. Sounded draconian at the time, didn't it?
Last night, just after the U.S. reached the gruesome 500,000 deaths total, NPR published a piece my medical reporter Fran Kritz, Do "Tight" Cultures Fare Better In The Pandemic Than "Loose" Cultures?. She wrote that numbers like that weren't inevitable. "Data from Johns Hopkins University," she wrote, "shows that some countries have had few cases and fewer deaths per capita. The U.S. has had 152 deaths per 100,000 people, for example, versus .03 in Burundi and .04 in Taiwan. There are many reasons for these differences among countries, but a study in the Lancet Planetary Health published last month suggests that a key factor may be cultural. "
The study looks at "loose" nations-- those with relaxed social norms and fewer rules and restrictions-- and "tight" nations, those with stricter rules and restrictions and harsher disciplinary measures. And it found that "loose" nations had five times more cases (7,132 cases per million people versus 1,428 per million) and over eight times more deaths from COVID-19 (183 deaths per million people versus 21 per million) than "tight" countries during the first ten months of the pandemic.
Michele Gelfand, the lead author of the study and a professor at the University of Maryland who specializes in cross cultural psychology, previously published work on tight- and loose- rules nations in Science and in a 2018 book, Rule Makers, Rule Breakers: How Tight and Loose Cultures Wire Our World.
Gelfand says her past research suggested that tight cultures may be better equipped to respond to a global pandemic than loose cultures because their citizens may be more willing to cooperate with rules, and that the pandemic "is the first time we have been able to examine how countries around the world respond to the same collective threat simultaneously."
For the Lancet article, the researchers examined data from 57 countries in the fall of 2020 using the online database "Our World in Data," which provides daily updates on COVID-19 cases and deaths. They paired this information with previous research classifying each of the countries on a scale of cultural tightness or looseness. Results revealed that nations categorized as looser-- like the U.S., Brazil and Spain-- experienced significantly more cases and deaths from COVID-19 by October 2020 than countries like South Korea, Taiwan and Singapore, which have much tighter cultures.
NPR talks to Gelfand about the findings and about how understanding the concepts of "looser" and "tighter" nations might lead to measures that help prevent COVID-19 cases and deaths as the pandemic continues.
How did your past research bring you to your current findings about the pandemic?
One of the things I've been looking at for many years is how strictly cultures abide by social norms. All cultures have social norms that are kind of unwritten rules for social behavior. We don't face backward in elevators. We don't start singing loudly in movie theaters. And we behave this way because it helps us to coordinate with other human beings, to help our societies function. [Norms] are really the glue that keep us together.
One thing we learned during our earlier work is that some cultures abide by social norms quite strictly. And these differences are not random. Tight cultures tend to have had a lot of threat in their histories from Mother Nature, like disasters, famine and pathogen outbreaks, and non-natural threats such as invasions on their territory. And the idea is when you have a lot of collective threat you need strict rules. They help people coordinate and predict each other's behavior. So, in a sense, you can think about it from an evolutionary perspective that following rules helps us to survive chaos and crisis.
Can you change a culture to make it tighter?
Yes, but you need leadership to tell you this is a really dangerous situation. And you need people from the bottom up being willing to sacrifice some of the freedom for rules to keep the whole country safe. And that's what's happening in New Zealand, where they had few cases and few deaths per million, and where they're really very egalitarian. My interpretation is that people said look, "We all have to follow the rules to keep people safe."
Can you give us some examples of how tight and loose cultures operate when there's not a pandemic going on?
Tight cultures have a lot of order and discipline-- they have a lot less crime and more monitoring of [citizens'] behavior and [more] security personnel and police per capita. Loose cultures struggle with order.
Loose cultures corner the market on openness toward people from different races and religion and are far more creative in terms of idea generation and ability to think outside the box. Tight cultures struggle with openness.
Do you think it's possible to tighten up as needed?
Yeah, absolutely. I mean I would call that ambidexterity-- the ability to tighten up when there's an objective threat and to loosen up when the threat is diminished. People who don't like the idea of tightening would need to understand that this is temporary and the quicker we tighten the quicker it will reduce the threat and the quicker we can get back to our freedom-loving behavior.
I imagine people are worried, though, about long-term consequences of tightening up.
We shouldn't confuse authoritarianism with tightness.
Following rules in terms of wearing masks and social distancing will help get us back faster to opening up the economy and to saving our freedom. And we can also look to other cultures that have been able to open up with greater success, like Taiwan for example. Increased self-regulation and [abidance of] physical distancing, wearing masks and avoiding large crowds allowed the country to keep both the infection and mortality rates low without shutting down the economy entirely. We need to think of this as being situation-specific in terms of following certain types of rules.
It requires using cultural intelligence to understand when we deploy tightness and when we deploy looseness. And my optimistic view is that we're going to learn how to communicate about threats better, how to nudge people to follow rules, so that people understand the danger but also feel empowered to deal with it.
[In the U.S., for example, we] need to have national unity to cope with collective threat so that we are prepared as a nation to come together like we have in the past during other collected threats, such as after September 11.
Last week, Foreign Policy published an essay by Laurie Garrett, a Pulitzer Prize winning science writer and a former senior fellow for global health at the Council on Foreign Relations, <https://foreignpolicy.com/2021/02/18/trump-is-guilty-of-pandemicide/>Trump Is Guilty of Pandemicide</>. Trump may have authoritarian tendencies but in terms of the pandemic, he and his government were as loose as a goose. She advocates "holding Donald Trump accountable for the failure" of the U.S. to protect itself from the pandemic. "There is vast evidence," she wrote, "of Trump’s negligence during the pandemic’s third wave. Had I been a member of the House of Representatives during the body’s impeachment deliberations, I would have added to Trump’s indictment the crime of pandemicide, naming him as responsible for most of the COVID-19 deaths that transpired while he, the nation’s leader, was preoccupied with damning Joe Biden’s election victory. Trump’s failure to, as he vowed in his oath of office, 'faithfully execute the office of president of the United States' promulgated a scale of lives lost exceeding anything experienced in the country since the Civil War, 160 years ago.
[T]hough there is striking evidence that the policies of the four-year Trump administration vastly worsened life expectancy and mortality rates in the United States, contributing to 461,000 excess deaths in 2018 alone, these are matters of callous, ill-considered policies and brutal budget cuts, preceding the virus’s arrival to U.S. shores.
Pandemicide is not the outcome of ill-advised, ignorant, or outright stupid budget actions and health messages. I do not even level the charge over Trump’s denunciation of mask use and opposition to temporary business and school closures to halt the spread of SARS-CoV-2, encouraging people to “liberate” states that were implementing tough lockdown regulations.
Rather, the path of pandemicide was paved in pursuit of the president’s reelection and his relentless, all-consuming post-election campaign to refute his opponent’s victory, claiming election fraud and even theft. Despite the summer surge in COVID-19 infections nationwide, Trump abandoned virtual campaigning in favor of crowded, largely maskless gatherings of his supporters, knowingly risking that each rally would become a superspreader event. According to a study by Stanford University, 18 campaign rallies held between June 20 and Sept. 22, 2020, spawned in excess of 30,000 COVID-19 cases, likely leading to more than 700 deaths. During the same time period, half of Trump’s campaign rallies were followed by COVID-19 surges in the counties in which they took place. While Biden’s campaign rallies were largely virtual or held in parking areas with participants in their vehicles, Trump’s tightly packed, mostly mask-free throngs increased in both number and frequency, further spreading the virus and causing the U.S. government’s top COVID-19 response expert, Anthony Fauci, to warn that the president was “asking for trouble.”
Even after Trump and the first lady contracted COVID-19, compelling emergency treatment that included, in Trump’s case, hospitalization at Walter Reed National Military Medical Center and round-the-clock treatment from an army of physicians and nurses, the president refused to regularly don a mask. On the day of his hospital admission, Oct. 2, the United States had cumulatively logged more than 200,000 deaths to COVID-19—an undercount, as are all U.S. COVID-19 numbers, but an official data point that would more than double by the Jan. 20 inauguration of Biden. According to a new Lancet Commission report compiled by an international team of august scientists and public health leaders, some 40 percent of America’s COVID-19 death toll during the Trump administration was needless, meaning it could have been averted with available nonmedical interventions.
By the time the election took place, Trump had ignored the pandemic, not attending a single COVID-19 White House meeting for at least five months, since late May. Behind the scenes in the fall, the Trump administration lobbied Congress vigorously to block the movement of funds to states for vaccine rollout efforts, leaving them unable to efficiently execute mass immunizations.
And going forward from election night, on Nov. 3, to the inauguration on Jan. 20, Trump was fully fixated on overturning Biden’s victory. He ceased speaking to the press on Dec. 8, held no public events after Nov. 4, and made his final public appearance at a Dec. 12 football game. According to White House schedules, Trump had few official meetings for days, left Washington for Mar-a-Lago on Dec. 23, and did not resurface until New Year’s Eve, when he delivered a video address to the nation celebrating Food and Drug Administration emergency approval of SARS-CoV-2 vaccines. On Jan. 6, the president delivered his now infamous speech to supporters, exhorting them to march down Pennsylvania Avenue to the Capitol. From Jan. 7 until he moved out of the White House on the morning of Jan. 20, Trump made few public remarks, frustrated by his loss of access to social media. As his much-touted Operation Warp Speed sputtered, unable to speed vaccines into the arms of Americans, Trump was silent. And the White House became COVID-19 central, with chief of staff Mark Meadows, four other White House staff, Secretary of Housing and Urban Affairs Ben Carson, and David Bossie, Trump’s designated leader of efforts to challenge the election, all infected. In line with the president’s mantra that COVID-19 wasn’t all that serious—“Don’t let it take over your lives”—none of these individuals regularly wore protective face masks in the White House or on the election-counting trail.
So, I level the charge of pandemicide against Trump for his failure to say or do anything to halt the soaring burden of infection and death across the United States from Election Day to his departure from office. During a period when experts inside his government warned that holiday travel and interactions over Thanksgiving, Christmas, and New Year’s could lead to massive spread of the virus, and states clamored for aid to disseminate vaccines, Trump was mum.
He ignored the pandemic on Nov. 3, when 92,000 people were newly infected, bringing the nation’s cumulative total to 9.4 million and its death toll to 225,000.
He remained taciturn as more than 1 million Americans per day, over the four-day Thanksgiving weekend, flew on commercial planes and millions more traveled by other means to visit families, despite stay-at-home pleas from the Centers for Disease Control and Prevention. By Nov. 30, more than 13.5 million Americans had tested positive for COVID-19, and 259,000 had died.
As Christmas approached, public health leaders again pleaded for Americans to resist temptation, stay home, and avoid family gatherings. By Dec. 22, 18 million Americans had acquired COVID-19, and 314,000 had died from it. But the president was silent, and, again, millions of Americans traveled and celebrated with friends and families.
As the new year neared, on Dec. 31, the total case count was almost 20 million, with 336,000 deaths. And still, Trump was silent.
As his insurrection mob gathered on Capitol Hill, the case tally topped 21 million, with 352,000 deaths.
And by the time Trump boarded Marine One for his final helicopter ride at taxpayer expense, en route to Mar-a-Lago, 24 million Americans had tested positive with SARS-CoV-2, killing nearly 400,000 of them.
Between the election and the inauguration, the number of infected Americans more than doubled, skyrocketing from 9.4 million cases to 24 million—adding some 15 million cases, on Trump’s watch, when he was fixated on overturning Biden’s victory and AWOL on the pandemic front.
And in his absence from pandemic duty—his duty to protect the American people—172,000 Americans died, nearly doubling the mortality toll since Election Day.
Republicans have, of course, decided that Trump cannot be impeached now that he is a private citizen. As a matter of formality, then, my call is moot. But let history record that no sitting U.S. president—since April 30, 1789, when George Washington took the first oath on the balcony of Federal Hall on Wall Street in New York City—has willfully allowed such preventable carnage to unfold on the American people.
Let history record that Donald Trump is guilty of the crime of pandemicide.