World Happiness Report 2023 57 ever more difficult the application of a COVID-19 elimination strategy. Omicron led in 2022 to a convergence of death rates, as shown in Panel A of Figure 2.5. Although policy stringency was reduced58 or removed in all countries, and health authorities largely stopped measuring and reporting the number of infections, death rates were held in check by vaccines and treatments that reduced the frequency of serious illness and deaths. Previous research covering the first 15 months of the pandemic found that among 15 countries with diverse strategies, the eliminator countries achieved these lower death rates with no net cost in terms of mental health. This was attributed to the timeliness and careful direction of policies resulting in the eliminator countries, on average, requiring less stringent policies.59 Given the Omicron-induced prevalence of community transmission everywhere in 2022, what can be said about the eventual net national and global benefits of an elimination strategy? Panel B of Figure 2.5 shows that the members of the WHOWPR and the near-eliminator Nordic countries (excluding Sweden) had cumulative COVID-19 deaths for 2020 through 2022 that were significantly below those among the other countries of Western Europe and the rest of the world. If elimination strategies had been quickly enough implemented everywhere, then the genie might have been put back in the bottle and the virus kept out of general circulation. That was the lesson from SARS, where the virus was removed from circulation, and both infections and deaths went quickly to zero. The eliminator countries helped to reduce the space for variants to develop. This global benefit depended on country size, with China as the largest eliminator.60 But there was clearly enough community spread in the rest of the world to enable the development of variants so transmissible as to make an elimination strategy infeasible everywhere. Now there is a fully global field for the evolution of still further variants, with possibly declining virulence,61 improved and more widely used vaccines62 and treatments, better ventilation, Table 2.3: Regressions to explain COVID-19 deaths per 100,000 population COVID-19 death rate per 100k One country one vote Population-weighted (1) (2) (3) (4) Variables 2020-21 Std. coef. 2022 Std. coef. 2020-21 Std. coef. 2022 Std. coef. Institutional trust (2017-19) -220.8*** -0.321 -44.67*** -0.228 -279.3*** -0.458 -71.65*** -0.461 (38.83) (11.54) (39.24) (12.44) Country is an island -39.99** -0.120 -4.898 -0.052 26.25 0.078 6.498 0.076 (15.51) (5.824) (19.53) (4.314) WHOWPR member -77.91*** -0.165 15.72 0.117 -110.8*** -0.479 -14.05* -0.238 (29.77) (13.18) (14.48) (7.632) Risk adjusted age profile -33.35*** -0.526 -9.865*** -0.547 -37.27*** -0.564 -9.707*** -0.576 (3.773) (1.235) (4.540) (2.269) Exposure to infections in other countries (at Mar 31, 2020) 30.97*** 0.295 7.196*** 0.241 21.57** 0.159 4.570 0.132 (8.477) (2.587) (9.467) (3.452) Gini for income inequality (0-100) 3.192*** 0.224 0.223 0.055 4.524*** 0.307 0.177 0.047 (0.758) (0.282) (1.045) (0.335) Constant 107.2** 48.86*** 87.22 58.27*** (43.54) (14.00) (60.46) (15.80) Number of countries 154 154 154 154 R-squared 0.611 0.564 0.747 0.633 Adj. R-squared 0.595 0.546 0.736 0.618 Notes: Robust standard errors are reported in parentheses. ***, **, and * indicate significance at the 1, 5, and 10 percent levels respectively.
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