The relationship between measures of individualism and collectivism and the impact of COVID-19 across nations

BACKGROUND: The global COVID-19 pandemic has been characterized by marked variations in prevalence, mortality and case fatality across nations. The available evidence to date suggests that social factors significantly influence these variations. The sociological concepts of individualism and collectivism provide a broad explanatory framework for the study of these factors. There is evidence to suggest that cross-cultural variations in collectivism may have emerged via a process of natural selection, as a protective mechanism against infectious diseases. As a test of this hypothesis, this paper examined the association between indices of individualism and collectivism and the prevalence, mortality and case fatality rates of COVID-19 across nations. STUDY DESIGN: This study was a population-level association study based on data in the public domain and from prior publications. METHODS: Data on four standard measures of individualism/collectivism were obtained from the original publications. These were correlated with estimates of the nation-wide prevalence, mortality and fatality rates for COVID-19 in 94 countries, obtained from the Johns Hopkins Medical University real-time dashboard. RESULTS: Individualism was positively correlated with COVID-19 prevalence, mortality and case fatality rates; conversely, measures of collectivism were negatively correlated with these parameters. The strongest association was between scores for individualism and mortality rate, and remained significant after correcting for several potential confounders. CONCLUSIONS: These findings are consistent with the prior hypothesis of a relationship between individualism-collectivism and the impact of infectious disease across populations, and have implications in terms of social strategies aimed at minimizing the impact of COVID-19.