In Brief

What a Global Health Survey Found Months Before the Coronavirus Pandemic

On paper, the world wasn’t ready for a pandemic. This year’s coronavirus outbreak has proven that to be true.

Last year, a group of the world’s top public health security researchers warned that no country was fully prepared for a pandemic. The spread of a new coronavirus has shown that they were right.

The 2019 Global Health Security Index showed that international preparedness for a health crisis was weak. The index, a project of the Nuclear Threat Initiative, the Johns Hopkins Center for Health Security, and the Economist Intelligence Unit, assesses 195 countries’ health security and capabilities. Researchers answered 140 questions about each country using publicly available data and gave each country a score. The average score for all countries assessed was 40.2 out of 100.

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But how have countries measured up against the real-life crisis posed by the coronavirus pandemic? Here’s how their scores compare to their responses.  

United States: First in Its Class but Struggling to Respond

The United States appeared to be the most prepared of the 195 countries assessed, but its coronavirus response has faced criticism. Its strongest category was detection, receiving a 98.2 out of 100, reflecting the high quality of its laboratories and a skilled epidemiological workforce.

Its lowest score was in the health system category, due in part to low access to health care and lower capacity in clinics, hospitals, and community care centers. It also received low scores for emergency response plans. Amid the coronavirus outbreak, the U.S. government has struggled to inform the public of dangers posed by the virus, develop and widely distribute testing kits, and ramp up the production of medical supplies such as respirators.  

South Korea: Passing the Test

In responding to the coronavirus, South Korea has mostly lived up to its ninth-place rank. Experts say the country’s experience battling Severe Acute Respiratory Syndrome (SARS) in 2002 and 2003 helped it prepare for another outbreak. It scored high in the detection category, which assesses the skills of its epidemiological workforce and the ability to conduct real-time surveillance. To fight the coronavirus, South Korea has tested hundreds of thousands of people for free.

Italy: A Solid System Overwhelmed

Ranked thirty-first on the index, Italy has struggled with its response. More people have died of the coronavirus in Italy than anywhere else in the world. An analysis of flight data released by the GHS Index team in March 2020 demonstrated why the country has been hit particularly hard. Their analysis showed that Italy ranked lower in its ability to detect and respond to an outbreak and that it experiences a high number of domestic and foreign travelers who could transmit illnesses every year, making it more vulnerable to an outbreak. Today, the country’s health systems are overwhelmed, with shortages of hospital beds, ventilators, and health-care workers.

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China: Flawed Then Forceful Response

China, ranked fifty-first by the index, scored lowest in compliance with international norms for failing to complete several internationally recognized health security plans. Among its serious errors at the outset of the outbreak in Wuhan was its failure to communicate. Local authorities withheld information about the virus from the public and the central government and silenced doctors who spoke out.

Beijing eventually locked down entire cities, affecting an estimated 760 million people. Authorities ordered the construction of new hospitals and fever clinics for people to be tested and treated. Now, China is sharing health-care supplies with other hard-hit nations.

Iran: Neglected, Ill-Equipped

Iran, ranked ninety-seventh, has responded poorly to the coronavirus outbreak, and suffers one of the world’s highest death tolls. GHS Index researchers found Iran did not have an up-to-date public health emergency response plan and was not prepared to communicate health threats to the public. In reality, the government failed to take quick action to stop the coronavirus’s spread and build public trust.

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