Role of Professionalism in the Policy Response to COVID-19: Does a Public Health or Medical Background Help?


Less than 5 percent of Chinese cities had top-ranked officials with public health or medical backgrounds (PHMBGs). Does professionalism improve their response to a public crisis like the COVID-19 pandemic? Collecting resumes of government and Party officials in almost all prefectural Chinese cities, and matching with other data sources, including weather conditions, city characteristics, COVID-19-related policies, and health outcomes, we demonstrate that cities 15 whose top officials had PHMBGs witnessed significantly lower infection rates, and often lower death rates, than cities whose top officials lacked such backgrounds. Mechanism testing suggests that the effects were at least partially explained by more rapid lockdown or community closure. Our findings offer insights into better preparation for future epidemics via improving leadership team composition, particularly recruiting major officials with PHMBGs.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

Financial support from the China Central University Special Scientific Fund, the U.S. PEPPER Center Scholar Award (P30AG021342), and two NIH/NIA grants (K01AG053408; R03AG048920) are acknowledged.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.


The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Studies reported in the manuscript do not involve human subjects.

All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.


I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).


I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.


Data Availability

All data, code, and materials are available upon request.

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