Less than half of Americans trust the government to take care of their health, according to a global survey, exposing a potential obstacle for a country that the World Health Organization warns could become the new epicenter of the novel coronavirus.
Trust is critical in combating epidemics, experts say, and a global pandemic such as the coronavirus is no exception.
"My belief is that we need trust most at times when the health care system is stressed and attention to public health is critical," says Dr. Katrina Armstrong, physician-in-chief at Massachusetts General Hospital. "People who don't follow recommendations to stay at home risk huge epidemic issues, and if you don't trust the people making the recommendations, the less likely you are to follow them."
The difference trust can make in managing an outbreak is evident, in part, in patterns of the spread of coronavirus.
New coronavirus cases continue to rise exponentially in the United States and Italy, with data from the Johns Hopkins University Center for Systems Science and Engineering showing an average of more than 8,500 and 5,500 new cases daily since March 20, respectively.
The United States landed seventh on the list of countries where residents trust their government least to take care of their health, according to a Best Countries survey of more than 21,000 people from 36 countries in all regions of the world conducted last summer. Just 44% agreed with the statement to any extent, while most of those who disagreed felt strong disagreement.
Italy also ranked among the countries whose citizens least trust their government to care for their health, with just 52% of residents saying they agree.
More than 80% of the public in China and nearly 65% in South Korea said that they trust their government to take care of their health. New coronavirus cases in those countries have slowed to an average of less than 100 per day, according to the Johns Hopkins University tool.
In Korea, the response to the coronavirus threat was swift and measured, with testing rates that outpace the U.S. more than 6 to 1. About 350,000 tests have been administered in both the U.S. and Korea, but the population in Korea is significantly smaller.
The government in Seoul also recognized the need to get the public onboard with the plan, continually sharing the latest information and asking for their help.
"Public trust can only be earned and harnessed through full openness and transparency," Lee Tae-ho, vice minister of foreign affairs, told reporters at a briefing earlier this month. "This public trust has resulted in a very high level of civic awareness and voluntary cooperation that strengthens our collective effort."
Both experts and the general public hold South Korea up as an example for others.
In a separate U.S. News survey, more than a third of respondents identified South Korea as the country they say is handling the coronavirus pandemic the best.
About 20,000 people responded to the question in an ongoing survey about the coronavirus hosted on the U.S. News website as of Tuesday morning, including about 16% who either said they lived outside the U.S. or did not provide figures that would be valid as a U.S. ZIP code.
Another 36% said that they thought the U.S. was handling it best, though state and local governments have been praised more than the federal government for their response.
Scientists, public health officials and leaders are learning more about the novel coronavirus each day. As evidenced not only in Korea but also in Taiwan, sharing new information with the public can help with managing the response.
"Trust is a construct which can overcome complexity," says Felix Gille, a researcher at the Swiss Federal Institute of Technology Zurich whose work includes public trust in health care systems. "Not everyone is trained as a doctor, and they need to trust what the professionals are telling them is true."
Yet, that idea is complicated in the U.S. as President Donald Trump's tone on the issue continues to fluctuate and is often at odds with that of health care professionals.
Just 22% of survey respondents who said they were not from the U.S. identified the U.S. as the country with the best response to the coronavirus threat, compared to about 40% of Americans who said their own country had the best response.
Deidre McPhillips is a Data Editor at U.S. News & World Report, overseeing and conducting data collection and analysis for projects in the News channel, including Best Countries, Best States and Healthiest Communities. She previously worked as a data analyst and project manager at JPMorgan Chase, and her writing has appeared in The Washington Post, USA Today and a number of regional publications. She is a graduate of Fordham University, and earned her masters in journalism at the University of Maryland. She was awarded a 2019 University of Southern California Center for Health Journalism Data Fellowship, through which she produced a series of articles about the health effects of racial bullying, and she was a 2015 finalist for the Society of Professional Journalists Mark of Excellence Awards. Follow her on Twitter, connect with her on LinkedIn or email her at firstname.lastname@example.org.