Decentralisation of health systems and subnational variation in COVID-19 responses in OECD countries

Existing work on policy responses to the COVID-19 pandemic has overwhelmingly concentrated on the national level, but more often than not responsibility for public health lies with the regional level of government. By wrongly attributing all authority to the national level, this "methodological nationalism" risks producing some misleading claims. In contrast to existing work, this project therefore analyses the divergence in regional policy responses across five OECD countries: Germany, Italy, Spain, the United Kingdom, and the United States. Divergence in responses can be the result of policies being tailored to specific regional contexts, but given the highly interdependent nature of the COVID-19 context, uncoordinated policy decisions taken might have severe negative externalities on other jurisdictions. This project seeks to find out whether divergence is the result of a lack of coordination or does whether it reflects a coordinated decision to allow divergence?