Free speech costs: Public health policy and leadership matters

COVID-19 has presented a snapshot of public health policy outcomes. A quick ‘compare and contrast’ of health outcomes of the UK, the USA, New Zealand and Australia is telling. Each of these countries has world- class medical scientists, good health systems, a functioning state and strong borders. The USA has arguably provided the worst COVID-19 response in the world. The UK, a country ‘girt by sea’, with a universal health system, is the worst performing country in Europe. Australia and New Zealand share these characteristics yet are international leaders in their COVID-19 responses. 1 The UK has suffered well over 100 000 deaths so far. (For most of January 2021, the UK’s daily COVID-19 deaths were greater than Australia's 2020 annual road toll.) Adjusted for population, if Australia's COVID-19 outcomes were tracking at the UK rate, this would equate to 44 000 annual COVID-19 deaths. As of February 2021, Australia had 909 COVID-19 deaths and New Zealand had just 25.