As of April 2024, over 232,000 deaths in the United Kingdom have been linked to the SARS-CoV-2 pandemic. In New Zealand, however, this number falls to just under six thousand. Both countries implemented nationwide lockdowns, border closures and vaccination rollout programmes in an attempt to mitigate the spread of the coronavirus (with New Zealand's vaccination rollout comparatively sluggish throughout the first three financial quarters of 2021, such that public support for Jacinda Ardern’s Labour Party began to diminish) - rendering the vast disparity in the number of lives claimed near paradoxical. Globally, over seven million coronavirus-related deaths have been documented - a number which continues to grow by around a thousand each week. When examining the absolute number of recorded deaths, the United States of America has suffered the greatest loss, with over 1.2 million deaths attributed to the coronavirus - in what could be interpreted as a consequence of the repeated perpetuation of scientific misinformation by those in government, the inherent political fragmentation associated with the federal system and the politicisation of the pandemic by each of the two diametrically opposed political parties vying for leadership in the 2020 election. This catastrophic loss of life is a stark reminder of the importance of international and, where relevant, federal cooperation, serving to highlight how the hyperpoliticisation of social issues impairs the cohesion of leadership strategies - and could indirectly facilitate the death of hundreds of thousands of vulnerable constituents.

The healthcare system in the United States of America takes the form of a fragmented amalgamation of private medical facilities funded via out-of-pocket payments, government-subsidised healthcare provision initiatives such as Medicare and Medicaid and healthcare insurance coverage programmes typically associated with middle-class employment. Prior to the pandemic, around a tenth of American citizens had fallen between the metaphorical cracks of this patchwork, remaining completely uninsured. The experience of the coronavirus pandemic shared amongst these thirty three million people exists on a completely separate plane to that shared by the rest of the American population - as exemplified by the experience of Mandy Alderman, an uninsured American citizen who found herself feeling “irrelevant” and as though she “didn’t matter” when she was left unable to afford a visit to her primary care physician to procure antiviral treatment.

One hospital in Manhattan, the nationally-ranked Lenox Hill medical centre, publicised their coronavirus testing programme without any reference to the cost of this initiative - leaving one woman with a bill of over 3300 US dollars after a simple nasal swab test (a price estimated to be over thirty times the market value of the procedure). As reported by The New York Times, one family found themselves faced with a charge of almost 40,000 US dollars subsequent to twelve coronavirus tests - each of which was taken to meet a requirement imposed either by their employer or school. It is highly likely that the elevated, near-extortionate costs associated with testing and treatment programmes significantly reduced public willingness to adhere to governmental recommendations - increasing the number of people spreading the virus through their dissent. Contrary to the claims made by certain Republican pundits, suggesting that the implementation of universal healthcare coverage would result in an economic maelstrom, Yale Public Health research estimates that over a tenth of coronavirus-associated deaths and around 40 billion US dollars would have been saved had the United States made a nationwide switch to a more equitable healthcare system.

Additionally, the messaging surrounding personal protective measures and the nature of the pandemic itself grew increasingly dissonant as the months progressed - with certain states enforcing mask mandates and vaccination for essential medical workers, whilst others acted in contradiction to the guidance of the Biden administration and barred institutions from requesting proof of vaccination upon entry. In a press conference in April 2020, former President Donald Trump suggested that biomedical scientists should attempt to inject disinfectant into coronavirus patients as a means of “cleaning” the body - a statement accompanied by an 121% increase in accidental poisonings utilising household disinfectant as compared with April of the previous year . Additionally, Supreme Court Justice Rep. Marjorie Taylor Greene repeatedly perpetuated scientific misinformation, claiming that it was unsafe for children to receive the coronavirus vaccine, that vaccination programmes increased the population frequency of “turbo-cancers” and that SARS-CoV-2 posed no immediate danger posed to the general public - provided that they were 'non-obese' and under retirement age.

It would not be right to continue without acknowledging the inherent geographic advantage New Zealand leveraged throughout their pandemic mitigation strategy. As an island nation, it was considerably easier for the local government to enact strict border closures, preventing the inflow of pathogens carried by international travellers. On the other hand, the USA shares borders with both Canada and Mexico - with such a high level of illegal immigration (with around two million arrests of unauthorised immigrants just last year), former President Donald Trump felt compelled to build a physical wall along the Mexican-American border. Whilst this geographic advantage would prove significant in the success of Prime Minister Jacinda Ardern's pandemic strategies, one of the most significant differences between the outcome in the United States and that of New Zealand is the focus of the latter on elimination. In March of 2020, Ardern implemented a nationwide lockdown - closing all non-essential businesses and schools - when the total number of coronavirus cases spiked to just over a hundred. The administration’s long-term plan was not simply to lower the number of cases, but to completely eliminate the virus from the country. Additionally, Ardern hosted regular conferences accessible to her “team of five million” - maintaining transparency with her people by sharing the latest scientific information about the pandemic and coherently explaining the logical processes underpinning contemporary policymaking. This facilitated a sense of faith in her government which served to encourage prosocial activity (e.g. via adherence to mask mandates and social distancing measures). Furthermore, the healthcare system in New Zealand is both centralised and equitable - and therefore the care received by all the country's residents was of a consistent standard, reducing the number of untreated coronavirus sufferers present in the population and, therein, the number of hosts through which the virus could be transmitted.

In terms of success in mitigating the spread of the coronavirus, the United Kingdom’s approach falls squarely between those of New Zealand and the United States - boasting one of the worst death tolls in Europe, but remaining roughly mediocre when contemplated with reference to the global context. Contemporary Prime Minister Boris Johnson initially pursued a controversial 'herd immunity' approach, with the intention to allow the virus to ‘run through’ the healthy majority of the population so as to protect those most vulnerable, before initiating a border lockdown, followed by a nationwide lockdown in late March. This delay in the imposition of more stringent measures allowed for the rapid emergence of outbreaks throughout the country. During the initial months of the pandemic, the British healthcare system was overwhelmed - with temporary ('Nightingale') hospitals being hosted in conference buildings to provide more beds for those in need, and 'thousands' of non-coronavirus patients passing away as a consequence of the inaccessibility of timely treatment. That said, the centralised approach to policy and universal healthcare coverage provided by the National Health Service (NHS) ensured the effectiveness of mitigation policy, once implemented. For those who might not be otherwise able to access medical care, testing, treatment and vaccination remained free of charge - alleviating nervousness about reporting cases and therein improving the accuracy of tracing data. The messaging perpetuated by British governments was largely consistent - with a widespread 'hands, face, space' public information campaign pushed throughout the winter in an attempt to increase adherence to mitigation measures.

Once the approaches of the United States, the United Kingdom and New Zealand have been compared, this global dissonance in coronavirus mitigation strategy begs the question of what might have happened during the pandemic if some kind of international cohesion in policy had been possible. How different might the case count be? The death toll? We might gain better insight into these ‘what-ifs’ should the next pandemic be approached with improved global cooperation.

Mandatory Resources 🦠

A Bloomberg Opinion Piece: Comparing Seven Global Pandemic Response Strategies

A Pandemic Policy Simulator: Coronavirus in Czechia

An IFP Article: "Indoor Air Quality Is the Next Great Public Health Challenge”