Fighting Covid-19: An Index of Government Effectiveness

May, 2020

Washington, Lincoln, Berlin – A useful measure of progress in the fight against the coronavirus pandemic is R, the reproduction rate of the virus.  An R above 1.0 indicates how fast the virus is spreading; an R below 1.0 shows how quickly it is diminishing.

A similar index could be created to compare the effectiveness and competence of government leadership against the virus, or L.  A high L, like a high R, would indicate a problem.

In the table below, a baseline of 1.0 is set for Germany's response to hold down both the numbers of Covid-19 cases and deaths, per 100,000 residents.  An overall L is the arithmetic average of two  L scores for cases and deaths.   Germany is used as the baseline because its response, early and decisive, is considered effective and illustrative of what was possible against the virus in mid- to large western democracies.

The top half of the table lists six other such countries for illustrative comparison.  Note that Austria is below 1.0 on all three measures.  France is comparable to Germany on cases, but not on deaths.  The UK has the worst L-average. The US is last in terms of cases but not deaths.  All calculations in the table are based on New York Times reporting until Memorial Day, 2020.


L-Cases
L-Deaths
L-Average
Germany
1.00
1.00
1.00
France
1.01
4.20
2.60
Netherlands
1.23
3.40
2.31
Austria
0.87
0.70
0.78
UK
1.83
5.60
3.71
Sweden
1.54
4.00
2.60
US
2.37
3.00
2.68




Maryland
3.66
3.80
3.73
Montgomery Cty
4.54
5.40
4.77
Nebraska
2.91
0.80
1.86
Douglas Cty
2.60
0.50
1.55
Lancaster Cty
1.60
0.30
0.97
Berlin
0.84
0.50
0.67

The bottom half of the table lists governments at the sub-national level.  Maryland is doing poorly, as is Maryland's Montgomery County, which is alarming as it is home to both NIH and FDA.  Nebraska's number of cases is high, but deaths are comparatively low.  Both Maryland and Nebraska are above the overall US case index.  Nebraska counties Douglas and Lancaster are both comparatively low in deaths, but Douglas County is in trouble for its number of cases.  Berlin is well below the overall German standard on both cases and deaths.

The L index could be used to calculate numbers of cases and deaths that were avoided by effective and competent government leadership and, conversely, those cases and deaths that could have been avoided with better government leadership.   Divide the L number into the raw number of cases or deaths for a baseline level of what might have happened.  For example, US deaths would be 100,000 deaths/3.00 = approximately 33,000.  In other words, about 67,000 deaths prior to Memorial Day were the consequence of government leadership shortcomings in the US.  This is consistent with earlier estimates made by Columbia University disease researchers, which put the number at 36,000 through May 3, 2020.  A historian of the 1918 pandemic judged the US response to the current pandemic as "incomprehensibly incoherent."

Observations for Three Capitals:

• Berlin has employed social distancing, stay-home orders, masking, testing, and contact tracing effectively, including enforcement measures.  Its local courts are busy dealing with cases of violations.  Berlin uses three measures to indicate progress against Covid-19:  R, new cases per capita, and health care capacity.  If the measures indicate trouble, controls are put back into place.  Berlin is reopening successfully at the moment. 

• The Maryland suburbs of Washington, DC, are still under stay-home, social distancing, and masking orders, but the first two have not seen any serious enforcement.  Testing supplies and contact tracing are inadequate.  Montgomery County is using CDC standards for reopening, but is not meeting them, as cases and deaths are going up.  The county's latest three-day average increases are 197 for cases and 6 for deaths.  The number of deaths is likely understated, as it does not include those who died with Covid-19 symptoms but were not tested. 

• Nebraska never implemented any stay-home orders, which has likely contributed to its high case index.  Omaha (in Douglas County) was identified today by the NYT as an emerging hotspot.  Nebraska Governor Ricketts has used only hospital capacity as the state's measure of success, not R or new case numbers.  The mayor of Lincoln, however, is using case numbers and vigorous contact tracing to mitigate virus spread, which may explain Lancaster County's comparative success, and why Lincoln may be able to reopen more successfully.  Or the county may simply be lucky, so far.