On Monday, the U.S. reached a heartbreaking 500,000 deaths from COVID-19.

But widespread death from COVID-19 isn't necessarily inevitable.

Data from Johns Hopkins University shows that some countries have had few cases and fewer deaths per capita. The U.S. has had 152 deaths per 100,000 people, for example, versus .03 in Burundi and .04 in Taiwan.

There are many reasons for these differences among countries, but a study in The Lancet Planetary Health published last month suggests that a key factor may be cultural.

The study looks at "loose" nations — those with relaxed social norms and fewer rules and restrictions — and "tight" nations, those with stricter rules and restrictions and harsher disciplinary measures. And it found that "loose" nations had five times more cases (7,132 cases per million people versus 1,428 per million) and over eight times more deaths from COVID-19 (183 deaths per million people versus 21 per million) than "tight" countries during the first ten months of the pandemic.

Gelfand says her past research suggested that tight cultures may be better equipped to respond to a global pandemic than loose cultures because their citizens may be more willing to cooperate with rules, and that the pandemic "is the first time we have been able to examine how countries around the world respond to the same collective threat simultaneously."

For the Lancet article, the researchers examined data from 57 countries in the fall of 2020 using the online database "Our World in Data," which provides daily updates on COVID-19 cases and deaths. They paired this information with previous research classifying each of the countries on a scale of cultural tightness or looseness. Results revealed that nations categorized as looser — like the U.S., Brazil and Spain — experienced significantly more cases and deaths from COVID-19 by October 2020 than countries like South Korea, Taiwan and Singapore, which have much tighter cultures.