A Note on Long-Run Persistence of Public Health Outcomes in Pandemics

Peter Zhixian Lin, Christopher M. Meissner

NBER Working Paper No. 27119
Issued in May 2020, Revised in June 2020
NBER Program(s):Development of the American Economy, Health Economics

Covid-19 is the single largest threat to global public health since the Spanish Influenza pandemic of 1918-20. Was the world better prepared in 2020 than it was in 1918? After a century of public health and basic science research, pandemic response and mortality outcomes should be better than in 1918-20. We ask whether mortality from historical pandemics has any predictive content for mortality in the ongoing Covid-19 pandemic. We find a strong persistence in public health performance in the early days of the Covid-19 pandemic. Places that performed poorly in terms of mortality in 1918 were more likely to have higher mortality today. This is true across countries and across a sample of US cities. Experience with SARS is associated with lower mortality today. Distrust of expert advice, lack of cooperation at many levels, over-confidence, and health care supply shortages have likely promoted higher mortality today as in the past.

Acknowledgments

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Document Object Identifier (DOI): 10.3386/w27119