A comparison of 2020 health policy responses to the COVID-19 pandemic in Canada, Ireland, the United Kingdom and the United States of America

Abstract

This paper compares health policy responses to COVID-19 in Canada, Ireland, the United Kingdom and United States of America (US) from January to November 2020, with the aim of facilitating cross-country learning. Evidence is taken from the COVID-19 Health System Response Monitor, a joint initiative of the European Observatory on Health Systems and Policies, the WHO Regional Office for Europe, and the European Commission, which has documented country responses to COVID-19 using a structured template completed by country experts. We show all countries faced common challenges during the pandemic, including difficulties in scaling-up testing capacity, implementing timely and appropriate containment measures amid much uncertainty and overcoming shortages of health and social care workers, personal protective equipment and other medical technologies. Country responses to address these issues were similar in many ways, but dissimilar in others, reflecting differences in health system organization and financing, political leadership and governance structures. In the US, lack of universal health coverage have created barriers to accessing care, while political pushback against scientific leadership has likely undermined the crisis response. Our findings highlight the importance of consistent messaging and alignment between health experts and political leadership to increase the level of compliance with public health measures, alongside the need to invest in health infrastructure and training and retaining an adequate domestic health workforce. Building on innovations in care delivery seen during the pandemic, including increased use of digital technology, can also help inform development of more resilient health systems longer-term.

Keywords: COVID-19; Europe; Government; North America; Public health; Workforce.

Fig. 1

Confirmed COVID-19 cases and deaths in Canada, Ireland, the UK and the US. Note: Note: Direct comparison between countries should be treated with caution as each country has different testing capacity, availability and criteria, may measure and report confirmed cases and deaths differently, and reliability of data may also vary.

Fig. 2

Google Community Mobility Trends: Visits to retail and recreation venues and public transport stations in North Atlantic Countries February –November 2020. Notes: Change in visitor numbers is measured relative to a baseline day; a baseline day is the median value from the 5-week period between Jan 3rd and Feb 6th 2020. This index is smoothed to the rolling 7-day average. Source: Ritchie , Google COVID-19 Community Mobility Trends (2020).