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. 2020 Apr 24;6(2):e19218.
doi: 10.2196/19218.

Regulation and Trust: 3-Month Follow-up Study on COVID-19 Mortality in 25 European Countries

Atte Oksanen  1 , Markus Kaakinen  2 , Rita Latikka  1 , Iina Savolainen  1 , Nina Savela  1 , Aki Koivula  3
Affiliations

Regulation and Trust: 3-Month Follow-up Study on COVID-19 Mortality in 25 European Countries

Atte Oksanen et al. JMIR Public Health Surveill. .

Abstract

Background: The outbreak of the coronavirus disease (COVID-19) has dramatically changed societies in 2020. Since the end of February, Europe has been hit particularly hard by COVID-19, but there are major country differences in both the spread of the virus and measures taken to stop the virus. Social psychological factors such as institutional trust could be important in understanding the development of the epidemic.

Objective: The aim of this study was to examine country variations of COVID-19 mortality in Europe by analyzing social risk factors explaining the spread of the disease, restrictions and control measures, and institutional trust.

Methods: The present study was based on a background analysis of European Social Survey data on 25 European countries (N=47,802). Multilevel mixed effects linear regression models focused on 84 days of the COVID-19 epidemic (January 22 to April 14, 2020) and modelled the daily COVID-19 mortality. Analysis focused on the impact of social relations, restrictions, and institutional trust within each country.

Results: The spread of the COVID-19 epidemic has been fast everywhere, but the findings revealed significant differences between countries in COVID-19 mortality. Perceived sociability predicted higher COVID-19 mortality. Major differences between the 25 countries were found in reaction times to the crisis. Late reaction to the crisis predicted later mortality figures. Institutional trust was associated with lower COVID-19 mortality.

Conclusions: The analyses demonstrated the importance of societal and social psychological factors in the spread of the COVID-19 epidemic. By considering multiple perspectives, this study showed that country differences in Europe are major, and this will have an impact on how countries will cope with the ongoing crisis in the following months. The results indicated the importance of timely restrictions and cooperation with people.

Keywords: Europe; infectious diseases; mortality; prevention; sociability; trust.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
First national restrictions placed before (-) or after (+) the first COVID-19 death (days).
Figure 2
Figure 2
Mean deaths per million inhabitants by countries' level of institutional trust.
Figure 3
Figure 3
Deaths per day after first COVID-19 death in low- and high-trust countries. COVID-19: coronavirus disease.
Figure 4
Figure 4
Deaths per day after first COVID-19 death in countries reacting late and early. COVID-19: coronavirus disease.
See this image and copyright information in PMC

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