Defeating a pandemic such as COVID-19 is a challenge of public administration as much as medicine or science. In 2020, before vaccines were widely available, governments were forced to rely upon non-pharmaceutical interventions (NPIs), policies designed to keep transmission to a minimum by curbing human interactions [1] and ‘test-trace-isolate-support’ (TTIS, sometimes also referred to as "test-trace-isolate-protect" or "find-test-trace-isolate-support) [2,3] to control spread. Public health policy to confront the pandemic initially relied on NPIs that, for example, mandate closures of businesses and schools, limit public gatherings, restrict internal and international travel, mandate face coverings, or impose additional rules on businesses and other organizations such as improved ventilation or reduced capacity. Implementing and enforcing these public health measures was a whole of government challenge if there ever was one.

In the context of a large and devastating pandemic, the alignment between public health policy (test, trace and isolate) and social policy (protect and support) becomes even more important. Social policies enable public health responses by reducing the cost of NPI compliance, e.g. by preserving businesses without turnover, or sustaining people through a sudden period of involuntary unemployment without obliging them to work. They also manage the consequences of the pandemic and allocate the burdens, by for example helping households subject to eviction or sudden loss of income. Social policy is a blanket term encompassing a range of welfare state and economic policies that attempt to achieve social goals [4].

Social policies implemented during the pandemic vary extensively across countries. They include automatic stabilizers such as unemployment insurance and income replacement schemes, policies supporting businesses such as government loan programs, changes to the normal rules of how markets operate such as suspension of evictions or additional protections for workers, as well as supplementing services that support people in need such as covering COVID-related healthcare costs, providing social care, or food support programs.

Our question is how federal political institutions affect the ability of countries to align social and public health policy in pandemic response. Federal political institutions arrange the territorial politics of countries with multiple elected general-purpose governments which cannot unilaterally abolish each other. Alignment refers to the ability of a general-purpose government to match different necessary components of a strategy; in a system with alignment, certain governments (e.g. central or regional) will have the ability to enact a comprehensive strategy should they choose. In particular, this means aligning the power to adopt NPIs and the ability to compensate for their costs with social policy. Drawing on a review of literature in comparative federalism (authors, 2019) we identify three factors that could potentially impact policy alignment in countries’ responses to the pandemic: allocation of authority, finances, and intergovernmental relations.

The first issue is the allocation of authority [5]. This simply refers to the competencies and responsibilities of different governments at different levels. What are they responsible for doing, and what are they capable of doing? The allocation of authority is a mixture of constitutional law and program design. The most basic distinction was formulated by Elazar, between self-rule (the autonomy of federal states) versus shared rule (the extent to which federal states participate in governing the federation) [6].

The second major issue is finance [7,8]. As a rule, subnational governments have more restricted sources of revenue - both fewer tax bases and less ability to use them, whether as a question of law or practicality. Subnational governments are then usually compensated by vertical redistribution from, or orchestrated by, the central state. The design of these systems can vary and is important to understand the nature of subnational governments' potential and constraints.

The third factor affecting alignment is the state of intergovernmental relations [9]. There are very few meaningful policies that can be executed by one government alone, which means that coordination among governments is necessary to accomplish much. Intergovernmental relations is the term for the institutions and actions that carry out coordination and channel conflict between governments. Formal institutions are not the only intergovernmental coordinating mechanism. Informal/de facto institutions are also matter in these scenarios Statewide political parties are also important in coordinating policies since they encourage politicians of a particular party to see their interests as aligned across levels of government.

Successful alignment would involve alignment of allocated powers and finances; interregional redistribution so that regions are not dependent on their own tax revenue during a major crisis; and strong intergovernmental coordination to ease both coordination between regions and reduce central or regional unilateralism and egotism. We assume, and believe other work reviewed elsewhere shows (authors, 2022) that policy alignment enables (but does not guarantee) individual and organizational-level compliance with NPIs, which enables (but does not guarantee) lower mortality as a reason to study the particular problems of intergovernmental policy alignment in federations.