We discuss and analyze how political institutions shape the abilities and incentives of political leaders to respond to the Covid-19 pandemic. More specifically, we discuss how political regime type and state capacity affect government responses. We argue that there is likely a complementary relationship between democracy and state capacity, both in terms of mitigating actual consequences of the pandemic, such as deaths, and the honest reporting of these consequences. We expect higher state capacity to mitigate disease severity in different contexts, but more so in democratic countries. Expectations are unclear as to how democracies perform in mitigating disease severity in weak-capacity states, but we anticipate that democracy mitigates disease severity in high-capacity states. Further, we expect that both high state capacity and democracy reduce underreporting of disease severity through, respectively, enhancing the capabilities to detect and register Covid-19 deaths and increasing the incentives to report them honestly. Using a recent, global dataset on officially reported Covid-19 deaths and estimated deaths based on excess mortality, we find evidence supporting different implications from our argument. Democracies have much higher officially reported death tolls than autocracies, but this basically reflects underreporting in autocracies. In high-capacity states, democracies have fewer actual deaths, as proxied by excess mortality, than autocracies. State capacity, generally, seems to mitigate both actual deaths and underreporting, and these relationships are stronger in democracies. Countries that combine democracy and high state capacity experience fewer Covid-19 deaths and provide their citizens with a much more accurate toll of the pandemic’s consequences.