Alternative Global Health Security Indexes for Risk Analysis of COVID-19.

Michael McAleer,Chia-Lin Chang

doi:10.3390/ijerph17093161

Abstract

Given the volume of research and discussion on the health, medical, economic, financial, political, and travel advisory aspects of the SARS-CoV-2 virus that causes the COVID-19 disease, it is essential to enquire if an outbreak of the epidemic might have been anticipated, given the well-documented history of SARS and MERS, among other infectious diseases. If various issues directly related to health security risks could have been predicted accurately, public health and medical contingency plans might have been prepared and activated in advance of an epidemic such as COVID-19. This paper evaluates an important source of health security, the Global Health Security Index (2019), which provided data before the discovery of COVID-19 in December 2019. Therefore, it is possible to evaluate how countries might have been prepared for a global epidemic, or pandemic, and acted accordingly in an effective and timely manner. The GHS index numerical scores are calculated as the arithmetic (AM), geometric (GM), and harmonic (HM) means of six categories, where AM uses equal weights for each category. The GHS Index scores are regressed on the numerical score rankings of the six categories to check if the use of equal weights of 0.167 in the calculation of the GHS Index using AM is justified, with GM and HM providing a check of the robustness of the arithmetic mean. The highest weights are determined to be around 0.244–0.246, while the lowest weights are around 0.186–0.187 for AM. The ordinal GHS Index is regressed on the ordinal rankings of the six categories to check for the optimal weights in the calculation of the ordinal Global Health Security (GHS) Index, where the highest weight is 0.368, while the lowest is 0.142, so the estimated results are wider apart than for the numerical score rankings. Overall, Rapid Response and Detection and Reporting have the largest impacts on the GHS Index score, whereas Risk Environment and Prevention have the smallest effects. The quantitative and qualitative results are different when GM and HM are used.

Highlights

There is no doubt that the COVID-19 disease, and the SARS-CoV-2 virus that causes it, have captured the world’s attention
It is possible to evaluate how countries might have been prepared for a global epidemic, or pandemic, and acted
If various issues directly related to health security risks could have been predicted accurately, public health and medical contingency plans might have been prepared and activated well in advance of the onset of an epidemic such as COVID-19

Summary

Introduction

There is no doubt that the COVID-19 disease, and the SARS-CoV-2 virus that causes it, have captured the world’s attention. The GHS Index finds severe weaknesses in a country’s abilities to prevent, detect, and respond to health emergencies; severe gaps in health systems; vulnerabilities to political, socioeconomic, and environmental risks that can confound outbreak preparedness and response; and a lack of adherence to international norms.” (https://www.ghsindex.org/report-model/). The data for the 195 countries are reported on pages 20–29 at: https://www.ghsindex.org/wp-content/uploads/2019/10/2019-Global-Health-Security-Index.pdf, which provides a numerical Average Overall score and separate numerical scores for each of the six categories. The seven numerical score rankings are obtained from Global Health Security Index (2019), and are reported in Appendix A, while the seven ordinal rankings are presented in Appendix B

Empirical Evaluation

Conclusions