Trust and transfer during the covid-19 pandemic: did digital cash transfer save lives?

BACKGROUND In the first semester of 2020 one in six people in the world (1.36 billion) received cash transfers to tide them over the spreading pandemic that originated in Wuhan. By December 2021 it had claimed up to 18.2 million excess deaths. Compared to no (digital) transfer, did digital cash transfer reduce excess deaths? Serendipitously, two years earlier the world reported levels of trust in science. Did such trust inoculate societies from the pandemic? MATERIALS & METHODS The growing excess deaths literature distinguishes causal factors (e.g. digital transfer) from risk factors (e.g. trust). During the pandemic period, no randomised trials of digital transfer with excess deaths as primary outcome were registered. This study used reports from 170 countries and applied endogenous treatment models to overcome the endogeneity of digital transfer. RESULTS & DISCUSSION I found that serendipity matters: countries with high trust in science suffered fewer excess deaths. But creativity matters more. Digital transfers –some creatively scrambled from scratch– reduced excess deaths by many more. Equally marked, North-South inequity in excess deaths persists, consistent with the concentration of vaccine distributions in the North early on. All three are statistically significant. A series of robustness analyses points to the results being reliable to change in outcome estimates, change in trust sources, and change in treatment of omitted countries. Mechanistic analyses show evidence that digital transfer created leg room for governments to expand stringent restrictions to control the spread of SARS-CoV-2, while in the South it weakened the correlation between informal economy and excess deaths. This study of the causal effect of digital cash transfer on a hard outcome (excess deaths) revealed ample global digital dividends across the largest number of countries. This new evidence also suggests that improving and monitoring trust in science can offer considerable benefits for humanity. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. 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). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present work are contained in the manuscript.