The emergence of the global COVID-19 pandemic in 2020 quickly generated claims that the crisis had demonstrated the superiority of extensive welfare states and a failure of market economies. We conduct cross-sectional statistical analyses to test this claim with regard to first response and reported COVID-19 related deaths per 31 December 2020 (N = 164–200), using government spending as a central variable. The analyses confirm some of what is known from other studies: COVID-19 deaths associate positively and robustly with ageing and more obese populations. However, we find no statistically significant associations between various measures of government size and the number of COVID-19 deaths, alone or when controlled against demographic, political and economic factors. If anything, the general effectiveness of government services and the availability of hospital beds seem more important than the simple size of government or level of health care expenditures.