June 9, 2021

“Trump was a comorbidity,” one of the public-health heroes of Michael Lewis’s book The Premonition tells him. It is a memorable line — and a boldly contrarian one. As he delved into the story of the Covid-19 pandemic in the United States, writes Lewis, “it became clear that Trump’s approach to government management was only a part of the story, and maybe not even the bigger part.”

This is not the mainstream view, to say the least, which is that the pandemic was especially disastrous in the United States precisely because the president was an incompetent populist. The same narrative was central to the way much of the British media covered the pandemic, at least until vaccines saved the day and the prime minister. Even so, it was notable that the parts of Dominic Cummings testimony that attracted the most attention were his criticisms of Boris Johnson as “unfit for the job” of prime minister, “smashing from one side of the aisle to the other,” like a rogue shopping trolley. The New York Times summary was that Cummings had “accused the British prime minister of incompetence that caused tens of thousands of extra Covid deaths”.

For liberal journalists and editors who already had an aversion to populist leaders, the temptation to pin the blame on them for last year’s high excess mortality has been irresistible. We can see the same narrative in Brazil, where Jair Bolsonaro is the populist with blood on his hands, and in India, where Narendra Modi gets the same treatment from his political opponents.

An example of where this assumption of populist guilt can lead even the most experienced writer was James Fallows’s article “The 3 Weeks That Changed Everything,” published in The Atlantic last June. According to Fallows, the poor performance of the United States in response to the spread of the novel coronavirus had one, and only one, explanation: the incompetence of the “person at the top of the system”. He quoted an unnamed “veteran of the intelligence world”— one of “some 30 scientists, health experts, and past and current government officials” he spoke to — who summed up his argument neatly: “Our system has a single point of failure: an irrational president.”

Fallows at no point asked himself why so many scientists, experts and government officials might be so eager to pin the blame on Trump. He was too pleased with the analogy between Trump and the pilot of an aircraft. Hundreds of thousands of Americans died prematurely, he concluded, because the pilot was tweeting when he should have been responding to an approaching storm.

You can find versions of the same piece about most if not all of the populist leaders. “Jair Bolsonaro apparently intended to lead the country to herd immunity by natural infection, whatever the consequences,” meaning that he “effectively planned for at least 1.4 million deaths in Brazil,” according to Vanessa Barbara in the New York Times. “In a series of stunningly reckless decisions,” wrote Sumit Ganguly in the Washington Post, Narendra Modi “invited the second wave that is now crushing the country”. This “colossal failure of policymaking” reflected Modi’s “general callousness, crass electoral considerations, and sheer ineptitude.”

The generalisation follows easily: populism kills. “Strikingly,” noted the Christian Science Monitor in April, “the top five slots in [the] mortality rankings all belong to countries run by populists when the pandemic began — the U.S., Brazil, Mexico, India, and Britain.” In the words of Yascha Mounk of the Council on Foreign Relations: “If you look around the world today, it becomes painfully clear that those countries that are ruled by populists have paid an especially heavy toll in economic damage, case load, and mortality.” Not only the Mexican president, Andres Manuel Lopez Obrador (AMLO), fits the narrative; so too do the leaders of Bolivia, Ecuador and the Philippines.

The necessary counterargument is not that these populist leaders did a good job and need defending. They all did terribly, with Bolsonaro only just edging out Trump for the number of unbelievably stupid, wildly irresponsible things he did. (The redeeming feature of Trump’s response was Operation Warp Speed, which unquestionably laid the foundation for this year’s very successful vaccination campaign. Bolsonaro’s government managed to bungle vaccine procurement, too.)

Yet to conclude from the populists’ countless sins that the countries in question would have fared much better under different leaders is to draw a dangerously erroneous inference. It would lead you to conclude that, by replacing Trump with Joe Biden, American voters have solved the problem that caused so much illness and death last year; and that Brazilian, Indian and Mexican voters can solve their problems in the same manner when their populists come up for reelection.

There are three flaws to this reasoning, leaving aside the point (made by Brett Meyer in a smart paper for the Tony Blair Institute) that not all populist leaders downplayed the threat posed by the pandemic, while a significant number favoured stringency over laxity. The first is that it is not clear that the countries run by populists did fare decidedly worse than other countries, at least in terms of excess mortality — the best measure of how a country has fared in the Plague Year. The second flaw is that, on close inspection, the mistakes that caused the bulk of premature deaths during the pandemic cannot easily be attributed to presidential or prime ministerial decisions. More often than not, the mistakes were made further down the chain of command, by public health officials and scientific advisers who profoundly misjudged the problem they were facing. Thirdly, and finally, the counterfactuals of better outcomes with different leaders do not stand up to close scrutiny.

Let’s begin with excess mortality data. One study of 32 countries in 2020, which calculated excess age-standardised mortality, arrived at the following worst ten (in terms of mortality per 100,000: Bulgaria came first, followed by Poland, Chile, the United States, Slovenia, Belgium, Czechia, Spain, England and Wales, and Scotland. One might argue that the governments of Bulgaria, Czechia, Poland and Slovenia were led by populists, along with the U.S. and England; but Chile, Belgium, Spain and Scotland?

Or consider the latest excess mortality figures from the Financial Times, which go up to 5 May. The UK and the U.S. are in the middle of the table with excess mortality of, respectively, 17% and 18% above the baseline. Bolsonaro’s Brazil is worse (34%) and AMLO’s Mexico worse still (55%). But excess mortality has been even higher in Peru (123%), Ecuador (67%), Bolivia (56%), Armenia (43%) and Azerbaijan (42%). The problem in each of these countries was not a powerful populist leader.

In Peru, to give just one example, it is Congress that wields the power, so much so that it has brought down three of the country’s last four presidents, including Martín Vizcarra, who was impeached twice last year and finally forced to resign despite an approval rating above 60%. In the case of Ecuador, too, Lenín Moreno did not conform to the populist stereotype last year. In Bolivia, the pandemic struck after the populist Evo Morales had been ousted from power.

In any case, the idea that presidents are to pandemics what pilots are to severe turbulence or engine failure is, to the historian’s eye, deeply misleading. The reality is that the man or woman at the top is struggling to manage multiple government agencies with “stakes” in public health, to say nothing of state or provincial governments.

In practice, as any serious student of modern government knows, the critical decisions in a public health crisis are not made at the top: it is the scientific advisers and principals of the relevant agencies who must decide on the seriousness of the threat and the policy response to recommend. A president or prime minister becomes involved only if there is a fundamental disagreement within the relevant group of expert and officials, or between the Cabinet-level principals. If there is a consensus in favour of a “herd immunity” strategy, as appears to have been the case in London in the first two and half months of 2020, then a prime minister is highly unlikely to overrule that consensus, regardless of whether he is being distracted by a book deadline, a disgruntled girlfriend, or an outsized interior décor bill.

Anyone listening closely to Cummings’s testimony last month, or reading the long Twitter thread which preceded it, will understand that he was not in fact laying the blame for last year’s debacle on Boris Johnson. “Critical as I am of the PM in all sorts of ways,” Cummings wrote, “it’s vital to understand the disaster was not just his fault.” On the contrary, the entire system failed: not just the elected politicians, but the civil servants and the public health experts—all fell “disastrously short of the standards that the public has a right to expect.”

In other words, Boris was a comorbidity. To some extent, the same may also be true of Bolsonaro, Modi and AMLO.

Perhaps the best way to show the weakness of the populist pandemic hypothesis is to contemplate the counterfactuals. If, thanks to some kink in the space-time continuum, Joe Biden had been inaugurated in January 2020, would U.S. excess mortality have been significantly lower? It is easy to claim, as an eminent TV anchor said to me the other day, that it would have been, because Biden and his administration would have “followed the science.”

Yet Ron Klain, Joe Biden’s chief of staff, acknowledged in 2019 that, if the swine flu that struck the U.S. in 2009 had been as deadly as COVID-19, President Barack Obama’s administration would not have done much better: “We did every possible thing wrong. And … 60 million Americans got H1N1 in that period of time. And it’s just purely a fortuity that this isn’t one of the great mass casualty events in American history. Had nothing to do with us doing anything right. Just had to do with luck.”

And how did the Obama administration do when faced with an opioid epidemic? More than 365,000 Americans died of drug overdoses between 2009 and 2016. Each year saw more deaths than the year before. The most affected age groups were those between 25 and 54, for whom the overdose rates in 2016 were between 34 and 35 per 100,000. For that reason, the total of life years lost may well have exceeded those lost to COVID, albeit over a longer period of time. Yet I have never read an article blaming the opioid epidemic on “pilot error.”

To repeat, I am not here to defend Boris, Trump et al. I am merely arguing that is too easy — and also downright misleading — to lay all the blame for the excess mortality of 2020-21 on populist leaders, though their erratic leadership undoubtedly added some percentage to the body count. What happened in most Western countries, regardless of whether they were led by a populist, a liberal or a technocrat, was a systemic failure of the public health bureaucracy. There were pandemic preparedness plans; they simply did not work. Testing capacity was not built swiftly enough; contact tracing was barely attempted; quarantines were not enforced; the vulnerable (especially in elderly care homes) were not protected but exposed.

These were the costliest mistakes in terms of loss of life, and it is not plausible that presidents or prime ministers were personally to blame for any of them. The most parsimonious interpretation is that the public health systems in Taiwan and South Korean learned from the experience of SARS and MERS, while ours did not.

To conclude that getting rid of the populists at the top will ensure that we do better when the next disaster strikes is not merely a delusion. It guarantees that, on both sides of the Atlantic, we shall fail to identify where the real points of failure have been and to do something about them, as soon as we possibly can, in every domain of our manifestly dysfunctional systems of government.

That, I think, was what Dominic Cummings was trying to tell us. “The official plan was disastrously misconceived,” he wrote, “DHSC/CABOFF did not understand this or why, & a PlanB had to be bodged amid total & utter chaos.”

This was because Plan A — to go for herd immunity rather than suppress the virus — “was supposed to be ‘world class’ but turned out to be part disaster, part non-existent. … If we’d had the right preparations + competent people in charge, we would probably have avoided lockdown1, *definitely* no need for lockdowns 2&3. Given the plan was AWOL/disaster + awful decisions delayed everything, lockdown1 became necessary.”

According to one poll, 75% of Britons do not trust what Cummings had to say about the government’s handling of the crisis. This is unfortunate, because what we were presented with last month was a rare, unfiltered glimpse into the reality of life in the corridors of power when a full-blown national emergency strikes. If you think it would have gone much better with David Cameron, Theresa May or (imagine it) Jeremy Corbyn in No. 10, then I have a pandemic preparedness plan to sell you.

In any case, the Cummings critique of the British state has never really been about the personality of the prime minister. His question for years has been: “How does the deep institutional wiring of the parties/civil service program destructive behaviour by putting the wrong ppl in wrong jobs with destructive incentives?” Why are “SW1 incentives … ~all about rewarding *process + fake signals*”? These are the right questions to ask, and a similar set of questions could and should be asked about the Washington Beltway.

The irony is that, back in 2016 and 2017, people voted in populist leaders in large measure because they felt frustrated by the dysfunctional inertia of the “deep state,” whether in Whitehall, Washington, Brasilia, or (for that matter) Brussels. The events of the past 16 months have proved that, as was obvious at the outset, the populists were not a real solution to that problem. But the pandemic has also shown us the deadly consequences of leaving the problem unsolved — which is precisely what we shall do if we conclude that the premature deaths were all the populists’ fault.

Niall Ferguson’s new book DOOM: The Politics of Catastrophe has just been published by Penguin Press.