A proactive Covid-19 response associated with better health and economic outcomes for OECD High-Income Island Countries

Abstract

Objectives: We examined how the Covid-19 pandemic response and outcomes varied amongst the six island countries that were all in the high-income OECD grouping. Methods: The OECD island countries were ranked according to key health and macroeconomic outcomes, and stringency of control measures compared with proactivity of pandemic response. Results: The top ranked country for health outcomes was NZ with the lowest cumulative excess mortality rate to the end of 2023 (20 per 100,000 population), followed by Australia and Iceland (both 137), Japan (226), Ireland (229) and the UK (390). For combined macroeconomic outcomes (changes in GDP per capita growth [2019 to 2020; 2020 to 2021] and changes in unemployment levels [2020–2023]), the countries with the best rankings were Australia, NZ and Ireland. Median stringency was lowest for NZ, but highest for Australia. NZ had the highest average rank for proactivity of key control measures. Conclusions: This study provides additional evidence, for island nations, that an exclusion and elimination strategy can provide superior health/macroeconomic pandemic outcomes, compared with suppression/mitigation strategies.