Confidence in public institutions is critical in containing the COVID‐19 pandemic

This paper investigates the relative importance of confidence in public institutions to explain cross‐country differences in the severity of the coronavirus disease 2019 (COVID‐19) pandemic. We find that a 1 SD increase (e.g., the actual difference between the United States and Finland) in confidence is associated with 56.3% fewer predicted deaths per million inhabitants. Confidence in public institutions is one of the most important predictors of deaths attributed to COVID‐19, compared to country‐level measures of health risks, the health system, demographics, economic and political development, and social capital. We show for the first time that confidence in public institutions encompasses more than just the unobserved quality of health or public services in general. If confidence only included the perceived quality, it would be associated with other health and social outcomes such as breast cancer recovery rates or imprisonment as well, but this is not the case. Moreover, our results indicate that fighting a pandemic requires citizens to cooperate with their governments, and willingness to cooperate relies on confidence in public institutions. Key points There is substantial heterogeneity in COVID‐19 prevalence and deaths across countries. We employ regression and machine learning methods to identify the most critical predictors of deaths attributed to the pandemic. We find that confidence in public institutions is one of the most important predictors of deaths attributed to COVID‐19. Our results suggest that effective policy implementation during pandemics relies on confidence in public institutions. 摘要:本文调查了“对公共机构的信心”的相对重要性，以解释不同国家在2019冠状病毒病(COVID‐19)大流行严重程度方面的差异。我们发现，信心每增加一个标准差（例如，美国和芬兰之间的实际差异），每百万居民的预测死亡人数则减少56.3%。与国家层面的健康风险衡量、卫生系统、人口统计、经济和政治发展、以及社会资本相比，对公共机构的信心是COVID‐19死亡人数的最重要预测因素之一。我们首次表明，对公共机构的信心与乳腺癌康复率或监禁无关，这表明它并不能替代性衡量某些未观察到的健康质量或一般公共服务。我们的结果表明，抗击大流行需要公民与政府合作，而合作意愿取决于对公共机构的信心。 Resumen Este artículo investiga la importancia relativa de la confianza en las instituciones públicas para explicar las diferencias entre países en la gravedad de la pandemia de COVID‐19. Encontramos que un aumento de una desviación estándar (p. ej., la diferencia real entre EE. UU. y Finlandia) en la confianza se asocia con un 56,3% menos de muertes previstas por millón de habitantes. La confianza en las instituciones públicas es uno de los predictores más importantes de muertes atribuidas a la COVID‐19, en comparación con las medidas de riesgo para la salud a nivel de