Does the quality of health security of a country moderate the link between bilateral tourism flows and the COVID-19 death rate?

This study investigates the link between tourist flows to and from China and the COVID-19 death rate. This includes the moderating influence of the quality of health security in the underlying relationship. Bilateral tourist flows data to and from China to 152 countries are used for the empirical analysis. The results show that tourist flows to and from China are associated with a higher COVID-19 death rate. This suggests that international tourism flow is one of the major conduits for the transmission of COVID-19 across borders, especially at the initial stage of the pandemic. Furthermore, the results show that countries with stronger health security capabilities are better at reducing COVID-19 death rates even when they attract a higher number of tourist inflows from China or when they register a higher number of tourist flows to China. Governments, especially in countries that are more globally connected through international tourism, should consider using some share of the economic stimulus funds to enhance health capabilities to deal with the COVID-19 pandemic as well as potential future pandemics.