An analysis of the policy responses to the COVID-19 pandemic in France, Belgium, and Canada

Abstract

Objectives: This paper presents an overview and comparative analysis of the epidemiological situation and the policy responses in France, Belgium, and Canada during the early stages of the 2020 Covid-19 pandemic (Feb.-Aug. 2020). These three countries are compared because they represent a spectrum of different governance structures while also being OECD nations that are similar in many other respects.

Methods: A rapid review of primary data from the three countries was conducted. Data was collected from official government documents whenever possible, supplemented by information from international databases and local media reports. The data was then analysed to identify common patterns as well as significant divergences across the three countries, especially in the areas of health policy and technology use.

Results: France, Belgium and Canada faced differing epidemiological situations during the Covid-19 pandemic, and the wide variety of policy actions taken appears to be linked to existing governance and healthcare structures. The varying degrees of federalism and regional autonomy across the three countries highlight the different constraints faced by national policy-makers within different governance models.

Conclusions: The actions taken by all three countries appear to have been largely dictated by existing health system capacity, with increasing federalism associated with more fragmented strategies and less coordination across jurisdictions. However, the implications of certain policies related to economic resilience and health system capacity cannot yet be fully evaluated and may even prove to have net negative impacts into the future.

Keywords: Covid-19; Health; Pandemic; Policy.

Fig. 1

Heat map showing the regional distribution of Covid-19 hospitalizations in France (As of 09/08) (France did not report number of cases by region) .

Fig. 2

Heat map showing the regional distribution of Covid-19 cases in Canada (as of 09/08) .

Fig. 3

Heat map showing the regional distribution of Covid-19 cases in Belgium (As of 09/08) .

Fig. 4

Comparison of the trends of new daily Covid-19 cases (per 100 000 population) across France, Belgium, Ontario, Québec, B.C. and Canada (7 day rolling Average) , , , , , .

Fig. 5

Trends in total ICU capacity used by Covid-19 patients in France, Belgium, Ontario, Québec and British Columbia (B.C.) (including increases to capacity over time; national-level data for Canada is not available) ,,,,.

Fig. 6

Trends in case fatality rate for all Covid-19 cases in France, Belgium, Ontario, Québec, B.C. and Canada , , , , , .

Fig. 7

Cumulative mortality trends per 100 000 population in France, Belgium, Ontario, Québec, B.C. and Canada ,,,,,.

Fig. 8

Proportion of Covid-19 cases and deaths affecting males in France, Belgium and Canada ,,.

Fig. 9

Timeline of economic and virus containment policies in France contrasted with trends in daily new Covid-19 cases per 100 000 (Minimal, Medium, Severe, Uncategorized) .

Fig. 10

Timeline of economic and virus containment policies in Belgium contrasted with trends in daily new Covid-19 cases per 100 000 (Minimal, Medium, Severe, Uncategorized) .

Fig. 11

Timeline of economic and virus containment policies in Canada contrasted with trends in daily new Covid-19 cases per 100 000 (Minimal, Medium, Severe, Uncategorized) ,,,.

Fig. 12

Trends in the number of daily Covid-19 tests performed in France, Belgium, Ontario, Québec, B.C. and Canada (7 day rolling average) ,,,,,.