The Covid Resilience Ranking
The Best and Worst Places to Be in Covid: U.S. Sinks in Ranking
Winter and the long-anticipated rollout of coronavirus vaccines triggered some surprising shifts in Bloomberg’s Covid Resilience Ranking, a measure of the best places to be in the Covid-19 era.
Each month, we crunch the numbers to get a snapshot of where the virus is being handled the most effectively with the least social and economic disruption.
New Zealand—with its closed borders, vaccine deals and elimination of the virus in the community—remains No. 1 in December, with Taiwan edging into second place as the onset of cold weather challenges previously top-ranked places like Japan and South Korea.
The winter wave’s ferocity is testing their approach of trying to tame Covid-19 without locking down. Japan—No. 2 in November—Korea and Sweden have all fallen in the Ranking as people’s migration indoors fuels the virus’s spread, putting pressure on their long-standing strategies of suppressing the pathogen with minimal disruption. Lauded for its early focus on testing and cutting-edge contact tracing, Korea is trying to avoid imposing its toughest curbs yet.
Covid Resilience Ranking
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Read about the methodology behind the Bloomberg Covid Resilience Ranking here
Winter in the northern hemisphere has made a bad situation worse across Europe and the U.S., with the superpower plunging 19 spots despite the rapid authorization of two mRNA vaccines.
Mexico remains at No. 53, the last of the ranked economies. The country is closing the gap with other places as its positive testing rate falls and it lines up inoculations, but it’s still facing a rampant outbreak.
The Ranking scores economies of more than $200 billion on 10 key metrics: from growth in virus cases to the overall mortality rate and testing capabilities. The capacity of the local health-care system, the impact of virus-related restrictions like lockdowns on the economy, and freedom of movement are also taken into account.
Handling the Covid Era
For December, Bloomberg refreshed the Access to Covid Vaccines metric as more information emerges on order sizes, shifting from tracking the number of vaccine deals to the percentage of a population covered by agreements.
The U.K., the first country in the world to give emergency authorization to the Pfizer Inc.-BioNTech SE shot in early December, has still fallen two rungs from November. While its vaccine orders cover nearly 300% of the British population, distribution has only just begun and an unbridled outbreak has forced London and surrounding areas into an unprecedented lockdown through Christmas.
The U.S.’s steep drop in rank reflects the perils of a vaccine-reliant strategy. It has authorized two cutting-edge mRNA vaccines this month and hundreds of thousands of doses have been rolled out, but that is yet to translate to an easing of the devastation on the ground. The death toll has surged with one American dying every 41 seconds of Covid-19 over the past month, and hospitals near capacity in many states.
Also weighing on the U.S. is the fact its vaccine orders so far cover a smaller percentage of the country’s population than places like Canada and the European Union: 154%. Though the government says it will have enough supply for 20 million people by year-end, distribution across the 50 states looks uneven and it will be weeks before broader protection materializes in the population.
How quickly and effectively vaccination can stem the virus’s spread will be the key focus into January, when we’ll update the Covid Resilience Ranking again.
The Magic Formula?
The under-performance of some of the world’s most prominent democracies including the U.S. and India contrasted with the success of authoritarian countries like China and Vietnam has raised questions over whether democratic societies are cut out for tackling pandemics.
Bloomberg’s Covid Resilience Ranking tells a different story: democracies dominate the top 10 both this month and in November. Success in containing Covid-19 with the least disruption appears to rely less on being able to order people into submission and more on governments fostering a high degree of trust and societal compliance.
When citizens have faith in the authorities and their guidance, lockdowns may not be needed at all, as Japan, Korea—and to an extent, Sweden—showed through most of the year. Though fierce winter waves are definitely challenging those more open approaches now.
New Zealand emphasized communication from the start, with a four-level alert system that gave people a clear picture of how and why the government would act as the outbreak evolved.
Investment in public health infrastructure also matters. Undervalued in many places before 2020, systems for contact tracing, effective testing and health education bolstered the top performers, helping socialize hand-washing and the wearing of face masks. This has been key to avoiding economically crippling lockdowns, said Anthony Fauci, the U.S.’s top infectious diseases official.
Social cohesion has been a major differentiating factor in this pandemic, according to Alan Lopez, a laureate professor and director of the University of Melbourne’s global burden of disease group.
“If you look at Japanese society, the Scandinavian societies, there’s very little inequality and a lot of discipline in them,” said Lopez. “That would translate into a more cohesive response by the country and that’s why they’re up there at the top.”
Vaccine Advantage
The lack of an effective response to the virus’s spread in the U.S. has been one of the most stunning developments of the pandemic. The superpower leads the world in cases and deaths, and its reaction to the crisis has lagged from the start, from a shortage of medical equipment and PPE supplies, to the absence of coordination on testing and tracing efforts and the politicization of mask-wearing.
The administration of outgoing President Donald Trump has instead focused primarily on treatments and vaccines. Some $18 billion was allocated to vaccine developers to speed up their work in an initiative known as Operation Warp Speed, even as states asked for funding help to face the crisis.
Green Lights
This singular focus bolsters the U.S. in Bloomberg’s Covid Resilience Ranking, but there are concerns about supply, with the government confirming vaccine orders that would cover just 154% of the population, a smaller share than 21 other places on the Ranking.
Track the Coronavirus Vaccines That Will End the Pandemic here
Canada remains in front, ordering enough vaccines to inoculate more than five times its population. Both New Zealand and Australia have ordered enough shots to cover their populations more than twice over, besting top-ranked peer Taiwan, which has disclosed confirmed orders that cover only 26% of its population.
By tracking the percentage of people covered by vaccine orders, the new Access to Vaccines measure reflects the greater challenge before bigger countries like China, India and the U.S. While the two Asian giants have orders or production capacity of over two billion doses annually, that still leaves them at a disadvantage compared with smaller places.
Overall, the Access to Vaccines indicator underscores the enduring power of wealthier nations, even if some have otherwise failed at containing the virus. Smaller, developing economies with vaccine supply deals have largely scored them by offering to host clinical trials and to manufacture shots.
“Big countries have made sure they are the first in the queue, sometimes by extremely comprehensive measures,” Singapore Prime Minister Lee Hsien Loong said at the Bloomberg New Economy Forum in November. “I can understand that political urgency. I think it is a reality that they will get some of their way.”
The Poverty Trap
While they may have been wrong-footed by the insidious nature of the virus, advanced economies like Germany have seen their testing capacity and doctors’ ability to prevent Covid deaths improve over time.
These advantages don’t exist in Latin America, the region most devastated by the pandemic. It continues to populate the bottom half of Bloomberg’s Covid Resilience Ranking, with Mexico remaining last of the 53 places ranked, though its positive testing rate appears to be on a downward trajectory.
Argentina and Peru round out the bottom three, though Mexico has managed to cover more of its population with vaccine orders.
Brazil, with the world’s second largest Covid death toll, ranks 36th.
Like Trump, Brazilian President Jair Bolsonaro and Mexico’s Andres Manuel Lopez Obrador have repeatedly downplayed the coronavirus threat.
This “cavalier” leadership approach, plus a lack of social safety nets and strong public health systems, has worsened the crisis, said Cynthia Arnson, Latin American Program director at Washington D.C. think-tank the Wilson Center.
Latin America is the most urbanized region in the world, and much of the population live in crowded conditions where social distancing is difficult. The high proportion of people who rely on informal work and daily wages means that few are willing to stay home.
“The gross disparities between public and private health care have caught up with the region, as have other forms of inequality, including in education,” Arnson said.
Most countries in Latin America will be unable to return to pre-pandemic growth levels until 2023 and per capita income won’t recover until 2025, later than anywhere else, according to the International Monetary Fund.
Though attention has focused on the upheaval in developed countries, the pandemic’s hit to emerging economies is likely to be longer and more sustained. In India, decades of social and economic progress has been wiped out as children are taken out of school to work, and the discriminatory caste system rears its head again as jobs become scarce in the cities.
The pandemic will widen the gap between rich and poor nations, with as many as 150 million people pushed into extreme poverty by the end of next year.
In places like Sub-Saharan Africa, the crisis has a long tail.
“We’re seeing in Africa there’s a lot more deaths from the interruption of primary health care, including vaccination. That’s created a bigger toll than actually the coronavirus itself has,” said Bill Gates. “We need to build back in those countries and we need to get the innovation back underway. It’s, I would say, at least a three- or four-year setback for Africa.”