VoxEU Column COVID-19

Family ties and pandemics: Evidence from Covid-19

It was clear from early on in the Covid-19 pandemic that combatting it would require governments to monitor mass transit, schools, workplaces, and large public events. Less appreciated was the role played by social capital and family ties in the spread of the virus. This column provides an empirical analysis demonstrating a robust positive relationship between family ties and the contagion rate across the world. Death rates, by contrast, are not affected by family ties or other social factors, but by structural variables – from geography and GDP to median age and available hospital beds.

We still have imperfect knowledge of the 2020 pandemic from the Sars-CoV-2 virus, its origin, how it is evolving, and when it will come to an end. The history of humankind is full of pandemics, each with profound impacts on the habits of people, the evolution of health treatments, and the economy (Baldwin and Weder di Mauro eds. 2020a and 2020b). There are still some uncertainties about the implementation of containment measures and the intensity of lockdown needed (Flaxman et al. 2020, Barro 2020, Barro et al. 2020, Asvae et al. 2020, Scala et al. 2020, Hsiang et al. 2020, Aksoy et al. 2020, Van Bavel et al. 2020, Bartscher et al. 2020a, 2020b, Barrios et al. 2020, Bayer and Kuhn 2020, Borgonovi and Andrieu 2020). In the absence of a vaccine, self-isolation and social distancing, along with mask-wearing and cleaning hands, are the only protection tools against the virus (Greenstone and Nigam 2020, Scott and Old 2020, Hsiang et al. 2020, Aksoy et al. 2020, Flaxman et al. 2020). Such actions, however, generate a painful disruption to economic activities. That disruption, in turn, feeds deniers, populism, and social discontent.

We do not have yet the epidemiological proof to affirm specific cause-and-effect links. It is now clear, however, that close relationships between people in transport (trains, buses, and airplanes), schools, workplaces, and mass events significantly increase the probability of contracting the virus. When the medium is the air, to stop a possible exponential growth1 one must avoid staying close to potentially infected people; subsequently, the identification of contagion chains and the isolation of spreaders are essential aspects to slowing the spread. However, it was underappreciated – at least at the beginning of the pandemic – that social capital, family ties, and personal behaviour are also crucial factors in the spread of the virus.2 

In our recent study (di Gialleonardo et al. 2020), we provide an empirical analysis of the relationship between the spread of Covid-19 and the strength of family ties. The dataset combines different sources for a cross-section of 63 countries3 taking into account seven dimensions: diffusion of the virus, the power of family ties, social capital in terms of trust and religion, the policy instruments implemented to stop the outbreak, the status of the economy, geography, and demography.4 Figure 1 and Figure 2 report the main variables of the study related, respectively, to the spread of Covid-19 and the strength of family ties.

Figure 1 Covid-19 outbreak data registered from 22 January to 12 September for the 63 countries included in the analysis


Source: Center for Systems Science and Engineering (CSSE) of the Johns Hopkins University.

Figure 2 Family-ties variables for the 63 countries included in the analysis


Source: authors’ elaboration using data from World Values Survey.

As suggested in Marè-Motroni-Porcelli (2020), we measure the strength of family ties considering the principal component of three World Values Survey (WVS) variables: the importance of the family, the children’s respect for parents (love-parents), and the generosity of parents towards children (help-child).5 

Final results confirm a robust positive relationship between the strength of family ties and the contagion rate across the world. Our estimates show that one standard deviation increase in the principal component of the strength of family ties generates a 0.454 increase in the standard deviation of the number of daily cases per capita.6 As visualised in Figure 3, the main force driving the positive correlation is the generosity of parents towards their children (variable help-child). 

Figure 3 Correlation between family ties and Covid-19 cases from 22 January to 12 September 


Source: authors elaboration using data from World Values Survey and Center for Systems Science and Engineering (CSSE) of the Johns Hopkins University.

In line with the existing literature, our paper also shows interesting evidence stemming from social capital variables - trust – in other people and religiosity are negatively correlated with the number of cases, while trust in the church shows a positive correlation (Borgonovi and Andrieu 2020, Durante et al. 2020, Bartscher et al. 2020a and 2020b, Barrios et al. 2020, Bayer and Kuhn 2020). Our study also shows that the mortality rate (number of deaths over the number of registered cases) appears to be independent of social behaviours, including family ties. Mortality is positively correlated with other structural variables, such as income, the number of hospital beds, life expectancy, and the average age of the population. More advanced countries have richer and more efficient healthcare systems and healthier lifestyles, which are key factors for virus tracing and treatment strategies. Finally, geographical position and latitude also appear relevant.

 A ‘pact between generations’ is therefore essential. Young people must be "prudent at school, respecting the rules, and keeping the measures at home".7 Some clinical evidence in Italy shows that family lunch on Sundays is more dangerous than going to the supermarket. There is no doubt that, until the vaccine is distributed, pharmacological therapies will not be sufficient to contract the spread of Covid-19 if not complemented with the social measures that proved effective during past pandemic events. As far as possible, contacts between the elderly and grandchildren must be limited; we have to protect the former with socially bearable distancing measures such as wearing masks, hand washing, and maintaining appropriate safety distances. It is yet another confirmation that family ties, social capital, and trust are essential not only for economic and social issues, but also for key policies in health care and management of a pandemic. The final question is: Will the pandemic change our social habits in the long run, including the strength of family ties


Aksoy, C G, M Ganslmeier and P Poutvaara (2020), “Public Attention and Policy Responses to Covid-19 Pandemic”, Cesifo Working Paper, no. 8409. 

Asvae, A, G Alfani, F Gandolfi and M Le Moglie (2020), “Epidemics and Trust: The Case of the Spanish Flu”, IGIER Working Paper Series, March. 

Baldwin, R (2000), “Covid-19 testing for testing times: Fostering economic recovery and preparing for the second wave”,, 26 March.

Baldwin, R and B Weder di Mauro (2020a), Economics in the Time of COVID-19,, 6 March.

Baldwin, R and B Weder di Mauro (2020b), Mitigating the COVID economic crisis: Act fast and do whatever it takes,, 18 March. 

Barrios J, E Benmelech, Y Hochberg, P Sapienza and L Zingales (2020), “Civic Capital and Social Distancing during the Covid-19 Pandemic”, Working paper, University of Chicago, 28 May.

Barro, R J (2020), “Non-Pharmaceutical Interventions and Mortality in U.S. Cities during the Great Influenza Pandemic, 1918-1919”, NBER Working Papers, No. 27049. 

Barro, R J, F Ursùa and J Weng (2020), “The coronavirus and the great influenza pandemic: Lessons from the ‘Spanish flu’ for the coronavirus’s potential effects on mortality and economic activity”, NBER Working Papers, No. 26866.

Bartscher, A, S Seitz, S Siegloch, M Slotwinski and N Wehrhöfer (2020a), “Social Capital and the spread of Covid-19: Insights from European Countries”, CEPR Discussion Paper No. 14711.

Bartscher, A, S Seitz, S Siegloch, M Slotwinski and N Wehrhöfer (2020b), “The role of social capital in the spread of Covid-19”,, 18 June.

Bayer, C and M Kuhn (2020), “Intergenerational ties and case fatality rates: A cross-country analysis”,, 20 March.

Borgonovi, F and E Andrieu (2020), “The role of social capital in promoting social distancing during the Covid-19 pandemic in the US”,, 10 June. 

Center for Systems Science and Engineering (CSSE) (2020), COVID 19 Dashboard, John Hopkins University.

Di Gialleonardo, L, M Marè, A Motroni and F Porcelli (2020), “Family Ties and the Pandemic, Some Evidences from Sars-CoV-2”, Covid Economics 60, 4 December.

Durante, R, L Guiso and G Gulino (2020), “Civic capital and social distancing: Evidence from Italians’ response to Covid-19”,, 16 April.

Flaxman, S, S Mishra, A Gandy et al. (2020), “Estimating the effects of non- pharmaceutical interventions on COVID-19 in Europe”, Nature  584, 257–261.

Greenstone, M and V Nigam (2020), “Does Social Distancing Matter?”, Working Paper Becker Friedman Institute, n. 26, 25 March.

Hsiang S, D Allen, S Annan-Phan et al. (2020), “The effect of large-scale anti-contagion policies on the COVID-19 pandemic”, Nature  584.

Marè, M, A Motroni, F Porcelli (2020), “How family ties affect trust, tax morale and underground economy”, Journal of Economic Behavior & Organization 174, 235–252.

Scala A, A Flori, A Spelta, E Brugnoli, M Cinelli, W Quattrociocchi and F Pammolli (2020), “Time, space and social interactions: exit mechanisms for the Covid-19 epidemics”, Sci Rep 10, 13764. 

Scott, A and J D Old (2020), “The interaction between Covid-19 and an ageing society”,, 27 April.

Van Bavel,  B, P  Boggio, V Capraro et al. (2020), “Using social and behavioural science to support COVID-19 pandemic response”, Nature Human Behavior 4, May.


1 A recent analysis by Baldwin (2020) shows that the epidemiological curve not necessarily follow the path of an exponential curve, but rather tends to rise rapidly, peaks, and then flattens.

2 Van Bavel et al. (2020) highlights that the perception of threat plays a very important role. Like other animals, human beings can perceive emotions and the feeling of threat that can be very effective in the virus containment, since it motivates people to adopt good practices and changes unhealthy behaviours. 

3 This is the maximum number of countries for which we have been able to measure the strength of family ties in a consistent way by using World Values Survey data.

4 Information on COVID-19 outbreak are taken from the Center for Systems Science and Engineering (CSS 2020) of the Johns Hopkins University. Data include, for 187 countries, the number of confirmed cases, the number of deaths, and the number of recovered, from 22 January to 12 September, the day we closed the estimation.

5 In the empirical analysis, the overall measure of family ties is computed using the principal component of the three variables: "importance of family", "love-parents", and "help-child".

6 This result, robust to different specifications of our model, is obtained through the OLS estimator (robust for heteroscedasticity) applied to a linear regression model in which we control for the following variables: Religiosity, trust church, trust people, rule of law index, COVID measures stringency index, GDP per capita in Purchasing Power Parity, human development index, health spending in % of GDP, number of beds per 1,000 inhabitants, latitude, northern hemisphere dummy, median age in years, life expectancy, diabetes prevalence, and cardiovascular death rate. Information on the composition of the population, status of the economy, the policy response to the pandemic, and other general structural characteristics of each country (including data on health care systems), are taken from "" and "". These two web repositories combine official statistics and research data sources on almost all countries. Finally, information on trust, attitude toward religion, and composition of the family (especially to monitor the ratio of older people living within a family) have been collected from the latest World Values Survey edition available at the time.

7 The French Health Prefecture has recently reiterated that "a significant number of outbreaks originate in the family or friends", and for this reason, private meetings should be limited to fewer than six or ten people. In Spain, the limit was set to six, as in the UK and Italy. Giuseppe Ippolito, the scientific director of Italian "Istituto Lazzaro Spallanzani", a major Covid centre in Italy, stated that the resurgence of infections could be attributed to "a transmission model that involves family contacts between different age groups".

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