Abstract
The global health regime is caught in a paradox, whereby connecting "human" to "(inter)national" security to prevent the spread of infectious diseases unwittingly introduces into this complex and expertise-reliant domain of "low politics" the notion of "sovereign decisionism"-states' prerogative to identify a threat and counter it with exceptional measures that may in turn constrain their ability to unilaterally securitize disease. This article introduces an analytical framework presenting three pathways through which state leaders with different conceptions of sovereignty and varying constraints on their legitimacy among their domestic audiences may nevertheless securitize policy domains traditionally considered as falling within the scope of sub-state "low politics." Two of the pathways begin with scientific objectivation rather than politicization, and one trades power concentration for collaboration with sub-state and global authorities. I then compare the Canadian and American responses during the first wave of the coronavirus pandemic to uncover how these contextual factors disposed Donald Trump to politicize COVID-19, while Justin Trudeau emulated the World Health Organization's securitization of the virus without centralizing state powers.