Political regime, data transparency, and COVID-19 death cases

Democratic quality and excess mortality during the COVID-19 pandemic

The aim of this study is to analyse the relationship between democratic quality and excess mortality produced in the year 2020 before COVID-19 vaccinations were generalised. Using cross-sectional data from 80 countries on five continents, multiple linear regression models between excess mortality, the general democracy index and its disaggregation into five categories: electoral process and pluralism, government functioning, political participation, political culture and civil liberties were estimated. The analysis also considered, public health spending per capita, overweight inhabitants, the average temperature of the country, population over 65 years of age, The KOF Globalisation Index, and the Gross National Income per capita as control variables. It was possible to establish a strong inverse association between excess mortality per million inhabitants and the general democracy index and four of its five categories. There was a particularly strong relationship between excess mortality and the political culture dimension (-326.50, p < 0.001). The results suggest that the higher the democratic quality of the political institutions of a State and particularly of their political culture the more improved the response and management of the pandemic was in preventing deaths and protecting their citizens more effectively. Conversely, countries with lower democracy index values have higher excess mortality. Quality democratic political institutions provide more effective public health policies in the face of the COVID-19 pandemic.

ChatGPT and Corporations of Mega-journals Jeopardize the Norms That Underpin Academic Publishing

Those who participate in and contribute to academic publishing are affected by its evolution. Funding bodies, academic institutions, researchers and peer-reviewers, junior scholars, freelance language editors, language-editing services, and journal editors are to enforce and uphold the ethical norms on which academic publishing is founded. Deviating from such norms will challenge and threaten the scholarly reputation, academic careers, and institutional standing; reduce the publishers' true impacts; squander public funding; and erode the public trust to the academic enterprise. Rigorous review is paramount because peer-review norms guarantee that scientific findings are scrutinized before being publicized. Volunteer peer-reviewers and guest journal editors devote an immense amount of unremunerated time to reviewing papers, voluntarily serving the scientific community, and benefiting the publishers. Some mega-journals are motivated to mass-produce publications and attract the funded projects instead of maintaining the scientific rigor. The rapid development of mega-journals may diminish some traditional journals by outcompeting their impacts. Artificial intelligence (AI) tools/algorithms such as ChatGPT may be misused to contribute to the mass-production of publications which may have not been rigorously revised or peer-reviewed. Maintaining norms that guarantee scientific rigor and academic integrity enable the academic community to overcome the new challenges such as mega-journals and AI tools.

COVID-19 and democracy: a scoping review

BACKGROUND

The resilience of democracy is tested under exogenous shocks such as crises. The COVID-19 pandemic has recently tested the resilience of democratic institutions and practices around the world.

AIM

The purpose of this article is to scope the early research literature that discusses democracy and the COVID-19 pandemic. We review scientific journal articles published during the first two years of the pandemic. We ask three research questions in scoping this body of literature: (1) what are the key topic areas of all published research that associates itself with both democracy and COVID-19, (2) what kinds of conceptual and theoretical contributions has research literature that more specifically discusses democracy under the pandemic produced, and (3) what are the impacts of democracy to the pandemic and vice versa according to empirical research?

METHODS

The scoping review methodology draws on systematic literature search strategies, computational methods, and manual coding. The systematic Web of Science search produced 586 articles for which we conducted a Correlated Topic Model. After technical and manual screening, we identified 94 journal articles that were manually coded.

RESULTS

The early research on democracy and the COVID-19 pandemic offers a versatile body of scholarship. The topic modeling shows that the scholarship discusses issues of crises, governance, rights, society, epidemiology, politics, electorate, technology, and media. The body of papers with conceptual and theoretical contributions has offered new insights on the difficulties, possibilities, and means to maintain democracy under a pandemic. Empirical research on democracy's impact on the COVID-19 pandemic and vice versa varies in terms of methodology, geographical scope, and scientific contributions according to the direction of influence studied. Democracy appears to have a significant impact on some aspects of policy responses and epidemiological characteristics of the pandemic. In most parts of the world, the scope, franchise, and authenticity of democracy narrowed down due to the pandemic, albeit in most cases only temporarily.

CONCLUSIONS

A significant number of papers show that the pandemic has accentuated democratic backsliding but is unlikely to have undermined established democracies that have proved resilient in face of the pandemic. But empirical research has also made visible some weak signals of antidemocratic tendencies that may become more accentuated in the longer run.

SEIR models in the light of Critical Realism - A critique of exaggerated claims about the effectiveness of Covid 19 vaccinations

In a recent modeling study Watson et al. (Lancet Infect Dis 2022;3099:1-10) claim that Covid-19 vaccinations have helped to prevent roughly 14-20 million deaths in 2021. This conclusion is based on an epidemiological susceptible-exposed-infectious-recovered (SEIR) model trained on partially simulated data and yielding a reproduction number distribution which was then applied to a counterfactual scenario in which the efficacy of vaccinations was removed. Drawing on the meta-theory of Critical Realism, we point out several caveats of this model and caution against believing in its predictions. We argue that the absence of vaccinations would have significantly changed the causal tendencies of the system being modelled, yielding a different reproduction number than obtained from training the model on actually observed data. Furthermore, the model omits many important causal factors. Therefore this model, similar to many previous SEIR models, has oversimplified the complex interplay between biomedical, social and cultural dimensions of health and should not be used to guide public health policy. In order to predict the future in epidemic situations more accurately, continuously optimized dynamic causal models which can include the not directly tangible, yet real causal mechanisms affecting public health appear to be a promising alternative to SEIR-type models.

Good democratic governance can combat COVID-19 - excess mortality analysis

Some studies claim that democracy is in crisis during the current pandemic while authoritarian countries better combat COVID-19 because they face no tradeoff between freedom and health. These claims, however, are usually supported by unreliable reported data; furthermore, they often overlook an important variation in government effectiveness that is likely to interact with different political regimes. In this paper, I use as the dependent variable more reliable data, excess mortality, which is available for 152 countries, and analyze the interaction effect between regime type and government effectiveness. The results reveal that democratic countries with higher government effectiveness are likely to reduce excess mortality. Democratic countries thus need not give up freedom; they need to improve government effectiveness to combat COVID-19.

COVID-19 vaccine equity in doldrums: Good governance deficits

This paper explores whether inequities in access to COVID-19 vaccines can be attributed to governance deficits, particularly for developing and emerging countries where poor governance is widespread, but also for developed countries, where governments' performance fell short of expectations. These shared performance deficits beg questions about the impact of governance quality as well as the interplay of ethics in governance when life-or-death decisions must be made. It also explores the impact of COVID-19 on development, especially in the areas of poverty and employment. The findings of the paper show that there is a positive correlation between vaccine equity and good governance, meaning that countries with higher scores in governance rankings have more access to vaccines and have vaccinated most of their populations. Similarly, countries with relatively lower scores in governance rankings have poor access to and distribution of vaccines and have only covered a limited number of their people. The paper further points to disastrous societal impacts of COVID-19 vaccine inequity on poverty and employment, which have hindered global development.

Country-Level Governance Indicators as Predictors of COVID-19 Morbidity, Mortality, and Vaccination Coverage: An Exploratory Global Analysis

As the COVID-19 pandemic continues to affect all countries across the globe, this study seeks to investigate the relationship between nations' governance, COVID-19 national data, and nation-level COVID-19 vaccination coverage. National-level governance indicators (corruption index, voice and accountability, political stability, and absence of violence/terrorism), officially reported COVID-19 national data (cases, death, and tests per one million population), and COVID-19 vaccination coverage was considered for this study to predict COVID-19 morbidity and mortality. Results indicate a strong relationship between nations' governance and officially reported COVID-19 data. Countries were grouped into three clusters using only the governance data: politically stable countries, average countries or "less corrupt countries," and corrupt countries or "more corrupt countries." The clusters were then tested for significant differences in reporting various aspects of the COVID-19 data. According to multinomial regression, countries in the cluster of politically stable nations reported significantly more deaths, tests per one million, total cases per one million, and higher vaccination coverage compared with nations both in the clusters of corrupt countries and average countries. The countries in the cluster of average nations reported more tests per one million and higher vaccination coverage than countries in the cluster of corrupt nations. Countries included in the corrupt cluster reported a lower death rate and morbidity, particularly compared with the politically stable nations cluster, a trend that can be attributed to poor governance and inaccurate COVID-19 data reporting. The epidemic evaluation indices of the COVID-19 cases demonstrate that the pandemic is still evolving on a global level.

Does ‘Data fudging’ explain the autocratic advantage? Evidence from the gap between Official Covid-19 mortality and excess mortality

Governments can underreport Covid-19 mortality to make their performance appear more successful than it is. Autocracies are more likely to ‘fudge’ these data since many autocratic regimes restrict media freedom and thus can prevent domestic media from reporting evidence of undercounting deaths. Autocracies also enjoy greater leverage over reporting health authorities to either fudge data or adopt restrictive definitions of what constitutes Covid-19 mortality. Controlling for other factors that explain official Covid-19 mortality, excess mortality and the difference between the two, our results suggest that any apparent ‘autocratic advantage’ in fighting the pandemic is likely to only exist in official Covid-19 mortality. Analyzing the gap between excess mortality and official Covid-19 mortality we find that autocracies on average have a larger gap between official Covid-19 mortality data and excess mortality data, which points towards ‘autocratic data fudging’ of their official Covid-19 mortality statistics.

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Autocracies have greater incentives and opportunity to underreport Covid-19 mortality.

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Excess mortality provides a check on the reliability of official Covid-19 mortality.

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Autocracies seemingly experience lower official Covid-19 mortality rates.

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Autocracies exhibit a larger gap between excess and reported Covid-19 mortality.

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More autocratic countries are more likely to ‘fudge’ their Covid-19 mortality data.

Identifying factors associated with COVID-19 related deaths during the first wave of the pandemic in Europe

Aim

To clarify the high variability in COVID-19-related deaths during the first wave of the pandemic, we conducted a modeling study using publicly available data.

Materials and methods

We used 13 population- and country-specific variables to predict the number of population-standardized COVID-19-related deaths in 43 European countries using generalized linear models: the test-standardized number of SARS-CoV-2-cases, population density, life expectancy, severity of governmental responses, influenza-vaccination coverage in the elderly, vitamin D status, smoking and diabetes prevalence, cardiovascular disease death rate, number of hospital beds, gross domestic product, human development index and percentage of people older than 65 years.

Results

We found that test-standardized number of SARS-CoV-2-cases and flu vaccination coverage in the elderly were the most important predictors, together with vitamin D status, gross domestic product, population density and government response severity explaining roughly two-thirds of the variation in COVID-19 related deaths. The latter variable was positively, but only weakly associated with the outcome, i.e., deaths were higher in countries with more severe government response. Higher flu vaccination coverage and low vitamin D status were associated with more COVID-19 related deaths. Most other predictors appeared to be negligible.

Conclusion

Adequate vitamin D levels are important, while flu-vaccination in the elderly and stronger government response were putative aggravating factors of COVID-19 related deaths. These results may inform protection strategies against future infectious disease outbreaks.

Association between democratic governance and excess mortality during the COVID-19 pandemic: an observational study

BACKGROUND

Excess mortality has been used to assess the overall health impact of COVID-19 across countries. Democracies aim to build trust in government and enable checks and balances on decision making, which may be useful in a pandemic. But during the pandemic, they have been criticised as being hesitant to enforce restrictive public health measures.

METHODS

Through linking open-access datasets we constructed univariable and multivariable linear regression models investigating the association between country V-Dem Liberal Democracy Indices (LDI), representing strength of democratic governance and excess mortality rates, from January 2020 to September 2021. We adjusted for several important confounders and conducted a range of sensitivity analyses to assess the robustness of our findings.

RESULTS

Across 78 countries, 4.19 million deaths million excess deaths were recorded. On multivariable regression, a one-point increase in V-Dem LDI was associated with a decrease in excess mortality of 2.18 per 100 000 (p=0.004), after accounting for age, gender, wealth and universal health coverage. This association was only partially attenuated by COVID-19 vaccination rates and remained robust in all sensitivity analyses.

CONCLUSIONS

Democratic governance may have played an important role in mitigating the overall health impact of COVID-19 across countries. This study strengthens the case to broaden the scope of traditional pandemic risk assessment and discussions on preparedness.

Government Reactions, Citizens' Responses, and COVID-19 around the World

We analyze the relationship between different dimensions of the quality of the political system and the outcome of the COVID-19 pandemic. Data are retrieved from open-access databases for 98 countries. We apply a multivariable regression model to identify the relationship between various factors likely to affect the number of COVID-19 deaths, in addition to different dimensions of the quality of the political system. We find that the high quality of the electoral process in a country is associated with more COVID-19 deaths, while good political culture is associated with fewer deaths. As expected, we also find that trust in government and experiences with pandemics in the past is negatively related to COVID-19 deaths. Finally, a high GDP per capita is significantly associated with more COVID-19 deaths. Our findings illustrate that rapid, effective, and comprehensive government measures can protect society from the spread of a virus, but citizen compliance is also essential to policy success.

Cross-country evidence on the role of national governance in boosting COVID-19 vaccination

Background

Frequent mutations of the COVID-19 virus, such as the Delta and Omicron variants, have prolonged the pandemic. Rich countries have approved the booster shots (3^rd doses) of vaccine, but this causes further delay of vaccination in developing countries. This raises the risk of further mutations, which may lower the efficacy of currently available vaccines. As herd immunity by universal vaccination is essential to end the pandemic, the COVID-19 Vaccine Global Access (COVAX) facility has been established to provide developing countries with subsidized vaccines. However, a critical issue is that the developing countries also need to effectively deploy vaccines to citizens. Although this argument suggests positive effects of good national governance on vaccination coverage, to the best of our knowledge, there is no cross-country evidence on the role of national governance in increasing the coverage of COVID-19 vaccines among citizens. The goal of this study was to examine the association between the national governance and vaccination coverage among developing countries.

Methods

Using cross-country data, an ordinary least squares regression was conducted to examine the association between the national governance index and three outcomes: (1) the number of days until the administration of the first dose in the country since December 2019, (2) the number of doses per 100 citizens as of the end of July 2021, and (3) the selection of approved vaccine manufacturers. The results were compared between the model including all countries and the model excluding the member countries of Organisation for Economic Co-operation and Development (OECD).

Results

A one standard deviation increase in the national governance index was associated with 9.1 days (95%CI: -15.76, -2.43) earlier administration of vaccines in the country, and a 12.1 dose increase (95%CI: 4.76, 19.34) per 100 citizens. These associations were larger in the non-OECD sample. The results also indicated the role of governance in the selection of the administered vaccines.

Conclusion

The provision of subsidized vaccines alone is not sufficient to control the spread of infection in developing countries; logistical and administrative support should also be offered, especially in countries with poor governance.

Trial registration

Not applicable

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12985-5.

A Spatial Analysis of COVID-19 in African Countries: Evaluating the Effects of Socio-Economic Vulnerabilities and Neighbouring

The ongoing highly contagious coronavirus disease 2019 (COVID-19) pandemic, which started in Wuhan, China, in December 2019, has now become a global public health problem. Using publicly available data from the COVID-19 data repository of Our World in Data, we aimed to investigate the influences of spatial socio-economic vulnerabilities and neighbourliness on the COVID-19 burden in African countries. We analyzed the first wave (January-September 2020) and second wave (October 2020 to May 2021) of the COVID-19 pandemic using spatial statistics regression models. As of 31 May 2021, there was a total of 4,748,948 confirmed COVID-19 cases, with an average, median, and range per country of 101,041, 26,963, and 2191 to 1,665,617, respectively. We found that COVID-19 prevalence in an Africa country was highly dependent on those of neighbouring Africa countries as well as its economic wealth, transparency, and proportion of the population aged 65 or older (p-value < 0.05). Our finding regarding the high COVID-19 burden in countries with better transparency and higher economic wealth is surprising and counterintuitive. We believe this is a reflection on the differences in COVID-19 testing capacity, which is mostly higher in more developed countries, or data modification by less transparent governments. Country-wide integrated COVID suppression strategies such as limiting human mobility from more urbanized to less urbanized countries, as well as an understanding of a county's social-economic characteristics, could prepare a country to promptly and effectively respond to future outbreaks of highly contagious viral infections such as COVID-19.