The United Kingdom and the United States experienced some of the world’s highest COVID-19 death rates, and are the two countries that are most frequently compared with Canada in health systems and policy studies. In this NAO Lecture, two experts – Lynn Unruh and Gemma Williams – who have been involved in tracking the range of policy and system responses to COVID in their jurisdictions will provide insights into what went on and why. We will consider what lessons we may learn from the COVID-19 policy responses taken in these two countries, including mistakes to avoid, and challenges to prepare for as we continue to deal with the direct and indirect consequences of the global pandemic.