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2019 Global Health Security Index: Countries Ranked by Preparedness for Pandemic

droptablemain 5y ago
This is somewhat hilarious. They ranked the U.S. #1 and we promptly had ~650,000 COVID-19 deaths (so far). China ranks #51 and has less than 5,000 deaths.
- gunfighthacksaw 5y ago
  I’m still completely baffled as to how China handled the pandemic. On the one hand, I entirely believe that their state has the reach and support to quarantine entire regions and crush the pandemic by force. On the other hand, nominally Marxist countries with massive bureaucracies and being honest about death tolls go together like shit and strawberry shortcake. I’m still probably erring on the side of China getting it right though. The Soviets barely managed to cover up Chernobyl for a few days and this is a much more visible event.
  - jdavis703 5y ago
    Chernobyl was a technical problem. Public health is a political problem. Authoritarian states are much better at handling political problems.
  - danieltanfh95 5y ago
    it isn't really hard to understand. The Chinese want to protect themselves and their loved ones so they expect themselves and others to self quarantine. Similar culture can be found across Taiwan, Korea and South East Asia so as you can see the pandemic is controlled in similar fashion. What the government does is to enforce what the public think is right to prevent the public from executing the offender themselves. This is a different culture from the West where people are expected only to protect themselves but there is no expectation for others to protect you.
    - nl 5y ago
      This clearly doesn't explain Western countries (Australia, NZ) where very hard lockdowns worked quite well.
      - CTDOCodebases 5y ago
        I live in Sydney Australia so I can provide some perspective. Lockdowns only seem to be effective when coupled with efficient testing, tracing, isolating and the use of face masks. At the moment the Delta strain is challenging this idea though. Cases here are plateauing or rising slowly and we are lockdown. Culturally there is more emphasis on the individual in western cultures vs the collective in eastern cultures. Perhaps due to historical religious differences. This clearly has an effect on things like mask wearing, self isolation, coming forward for testing and complying with lockdowns. While Australians generally aren’t as community minded as those in Asian countries they aren’t as individualistic as those in say the USA. This is clearly evidenced in the average Australians view towards gun control for instance.
        nl 5y ago
        I live in Adelaide. Lockdowns work well, Sydney was just too slow to act. Look at any epidemiological model and it pretty clear new cases will be emerging for a while yet. The real solution is the vaccine of course. But the point is that in both the long Melbourne and now Sydney lockdowns the majority of the population has been pretty happy with the approach. In both cases there were protests, but in both cases there were equal numbers asking for the government to lock down earlier than it did.
  - CTDOCodebases 5y ago
    The uncertainty at the beginning likely helped them. At the beginning it was thought of being another SARS there while later in the west it was downplayed with the narrative of it being “like the flu”. Death tolls in China were covered up according to citizen media. There were reports of crematoriums running at full capacity in Wuhan in January 2020. It’s hard for people to die of covid if they haven’t even been tested. Before Wuhan locked down and covid tests became a thing face masks became mandatory in public. Police would arrest people who refused to wear a mask. They were temperature checking people in their homes and in public and quarantining them in camps too. They didn’t have an issue with PPE because they soaked up supplies even going so far as to request citizens in other countries to buy up local supply. While all their efforts have appeared to be effective their vaccine hasn’t been shown to be as effective as the alternatives so there is still a chance for things to go wrong though.
  - larsga 5y ago
    What is baffling about it? There's huge numbers of reports in western media about the extremely severe lockdown in Wuhan. In addition they did testing and tracing to a quite frankly unbelievable extent. They had both the will and the ability. The west only had the ability unless you want to count Australia and NZ. They weren't honest about the death toll, and came close to fucking things up because of that, but once Beijing decided to be serious about stopping it they did stop it. We know from outside reporting that they handled it, so there's nothing to guess about there.
- senectus1 5y ago
  I dont believe the China numbers. But they did go full authoritarian on their own people... I remember reading in the very early days there were accounts of the state police WELDING people into their apartments in Wuhan to stop them going out for food etc. Scary stuff. I wonder how those people feel about those actions now, over a year later and 600k+ deaths in the US.
  - mandelbrotwurst 5y ago
    How did food get into the places that were welded shut?
    - asah 5y ago
      https://www.google.com/search?q=china+food+delivery+quarantine https://www.google.com/search?q=china+food+delivery+quaranti... (food delivery through openings)
    - senectus1 5y ago
      yeah I don't know. I did see some site unrelated reports that the gov were organizing deliveries. I would hope they were not letting those that they felt the need to "jail" in their own homes, starve to death...
      - bootsup 5y ago
        Three minute read about low tech quarantine management in Beijing in May 2020. I had hoped to collect many more, but failed: http://agk.sdf.org/lib/lrm/lrp20beijing.html http://agk.sdf.org/lib/lrm/lrp20beijing.html
  - graeme 5y ago
    Iirc the welding was of secondary entrances, forcing all buildings to have a single entrance for easier monitoring. Still extreme, but not quite what was reported.
  - Causality1 5y ago
    Accounts? There's plenty of videos from Chinese people receiving food deliveries in apartments with bigass levers welded to the door that only allowed it to open about five inches.
- refurb 5y ago
  Almost like China might not be the most forth coming with their numbers? I mean Laos seemed to be doing really well last year but they weren’t testing much so not many cases! Success!
- aaron695 5y ago
  What the US did is nothing short of amazing. They lead the early race on the science and continued to lead . China is complex. We underestimated their totalitarianism but they also had solid science which we ignored, reporters on CNN were happy to contradict China's head of health. China got the genome online when the death toll was one. https://www.ncbi.nlm.nih.gov/nuccore/MN908947.1 https://www.ncbi.nlm.nih.gov/nuccore/MN908947.1 That seems fast to me. The report is missing the media. They seem to have been the most destructive force during the pandemic. Only recently Europe has overtaken the USA on vaccines uptake - https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&time=2020-03-01..latest&pickerSort=desc&pickerMetric=total_vaccinations_per_hundred&Metric=Vaccine+doses&Interval=Cumulative&Relative+to+Population=true&Align+outbreaks=false&country=USA~GBR~ISR~DEU~ARE~ARG~FRA~SGP~NZL~JPN~AUS https://ourworldindata.org/explorers/coronavirus-data-explor...
- MattGaiser 5y ago
  But would you attribute the 650,000 American deaths to something in the index or merely political/population decisions? All the vaccines in the world are useless if the people won't take them. Stockpiles of masks are useless if people won't use them.
gmuslera 5y ago
Contrasting "old" predictions with reality is always a learning experience. This ranking was made a year before an actual pandemic and they had more misses than hits, and understanding why may help with other predictions about the future. At least the ones involving human actions.
- larsga 5y ago
  Human action is the key. The US was very well prepared, but when the federal government and many state governments weren't interested in stopping the virus of course being prepared doesn't help. Same with the UK: the response from their scientific community has been absolutely fantastic. But when Boris Johnson simply didn't want to lock down and couldn't make up his mind until too late that didn't count for much. Also he fucked up the test-trace-isolate system for ideological reasons. Sweden + Denmark were rated as more prepared than Norway, which could well be true, but Sweden chose the UK approach (for no sane reason) and has paid the price. In all of these cases the problem is not lack of ability to handle the pandemic, but a political lack of will to do it.
senectus1 5y ago
wow.. Australia ranks 4th. be interesting to run the numbers again given the last year and a half...
kfor 5y ago
It’s out of date at this point, but I plotted the Global Health Security Index against covid death rates back in November if you’d like to get a sense of the relationship: https://twitter.com/kforeman/status/1331035362676785152 https://twitter.com/kforeman/status/1331035362676785152
MattGaiser 5y ago
All policies being equal, I can see this accurate. What it does not (and realistically cannot) include is the willingness of the population to do anything about the pandemic. Western health systems probably held up better under similar caseloads. Western delivery of vaccines was probably close to the top. Certainly won on vaccine production and logistics and research. The death tolls in the USA and to a lesser extent Canada, the UK, Italy, and Spain were an unwillingness on the part of some of the population to act on the pandemic. They wouldn't social distance. They wouldn't put on masks. They wouldn't stop travelling. And the governments were unwilling or unable to force them to do so.
system2 5y ago
China let the virus explode, reported 5000 deaths. Anyone believes China is prepared is a fool.
- larsga 5y ago
  What the hell kind of bullshit is this? Everyone knows they did not let it explode and had things under control until the last few weeks. Compared to most of the world China has seen almost no covid. That's what the official numbers say and it's been borne out by independent western journalists over and over again.

This is somewhat hilarious. They ranked the U.S. #1 and we promptly had ~650,000 COVID-19 deaths (so far). China ranks #51 and has less than 5,000 deaths.

gunfighthacksaw 5y ago
I’m still completely baffled as to how China handled the pandemic. On the one hand, I entirely believe that their state has the reach and support to quarantine entire regions and crush the pandemic by force. On the other hand, nominally Marxist countries with massive bureaucracies and being honest about death tolls go together like shit and strawberry shortcake. I’m still probably erring on the side of China getting it right though. The Soviets barely managed to cover up Chernobyl for a few days and this is a much more visible event.
- jdavis703 5y ago
  Chernobyl was a technical problem. Public health is a political problem. Authoritarian states are much better at handling political problems.
- danieltanfh95 5y ago
  it isn't really hard to understand. The Chinese want to protect themselves and their loved ones so they expect themselves and others to self quarantine. Similar culture can be found across Taiwan, Korea and South East Asia so as you can see the pandemic is controlled in similar fashion. What the government does is to enforce what the public think is right to prevent the public from executing the offender themselves. This is a different culture from the West where people are expected only to protect themselves but there is no expectation for others to protect you.
  - nl 5y ago
    This clearly doesn't explain Western countries (Australia, NZ) where very hard lockdowns worked quite well.
    - CTDOCodebases 5y ago
      I live in Sydney Australia so I can provide some perspective. Lockdowns only seem to be effective when coupled with efficient testing, tracing, isolating and the use of face masks. At the moment the Delta strain is challenging this idea though. Cases here are plateauing or rising slowly and we are lockdown. Culturally there is more emphasis on the individual in western cultures vs the collective in eastern cultures. Perhaps due to historical religious differences. This clearly has an effect on things like mask wearing, self isolation, coming forward for testing and complying with lockdowns. While Australians generally aren’t as community minded as those in Asian countries they aren’t as individualistic as those in say the USA. This is clearly evidenced in the average Australians view towards gun control for instance.
      - nl 5y ago
        I live in Adelaide. Lockdowns work well, Sydney was just too slow to act. Look at any epidemiological model and it pretty clear new cases will be emerging for a while yet. The real solution is the vaccine of course. But the point is that in both the long Melbourne and now Sydney lockdowns the majority of the population has been pretty happy with the approach. In both cases there were protests, but in both cases there were equal numbers asking for the government to lock down earlier than it did.
- CTDOCodebases 5y ago
  The uncertainty at the beginning likely helped them. At the beginning it was thought of being another SARS there while later in the west it was downplayed with the narrative of it being “like the flu”. Death tolls in China were covered up according to citizen media. There were reports of crematoriums running at full capacity in Wuhan in January 2020. It’s hard for people to die of covid if they haven’t even been tested. Before Wuhan locked down and covid tests became a thing face masks became mandatory in public. Police would arrest people who refused to wear a mask. They were temperature checking people in their homes and in public and quarantining them in camps too. They didn’t have an issue with PPE because they soaked up supplies even going so far as to request citizens in other countries to buy up local supply. While all their efforts have appeared to be effective their vaccine hasn’t been shown to be as effective as the alternatives so there is still a chance for things to go wrong though.
- larsga 5y ago
  What is baffling about it? There's huge numbers of reports in western media about the extremely severe lockdown in Wuhan. In addition they did testing and tracing to a quite frankly unbelievable extent. They had both the will and the ability. The west only had the ability unless you want to count Australia and NZ. They weren't honest about the death toll, and came close to fucking things up because of that, but once Beijing decided to be serious about stopping it they did stop it. We know from outside reporting that they handled it, so there's nothing to guess about there.
senectus1 5y ago
I dont believe the China numbers. But they did go full authoritarian on their own people... I remember reading in the very early days there were accounts of the state police WELDING people into their apartments in Wuhan to stop them going out for food etc. Scary stuff. I wonder how those people feel about those actions now, over a year later and 600k+ deaths in the US.
- mandelbrotwurst 5y ago
  How did food get into the places that were welded shut?
  - asah 5y ago
    https://www.google.com/search?q=china+food+delivery+quarantine https://www.google.com/search?q=china+food+delivery+quaranti... (food delivery through openings)
  - senectus1 5y ago
    yeah I don't know. I did see some site unrelated reports that the gov were organizing deliveries. I would hope they were not letting those that they felt the need to "jail" in their own homes, starve to death...
    - bootsup 5y ago
      Three minute read about low tech quarantine management in Beijing in May 2020. I had hoped to collect many more, but failed: http://agk.sdf.org/lib/lrm/lrp20beijing.html http://agk.sdf.org/lib/lrm/lrp20beijing.html
- graeme 5y ago
  Iirc the welding was of secondary entrances, forcing all buildings to have a single entrance for easier monitoring. Still extreme, but not quite what was reported.
- Causality1 5y ago
  Accounts? There's plenty of videos from Chinese people receiving food deliveries in apartments with bigass levers welded to the door that only allowed it to open about five inches.
refurb 5y ago
Almost like China might not be the most forth coming with their numbers? I mean Laos seemed to be doing really well last year but they weren’t testing much so not many cases! Success!
aaron695 5y ago
What the US did is nothing short of amazing. They lead the early race on the science and continued to lead . China is complex. We underestimated their totalitarianism but they also had solid science which we ignored, reporters on CNN were happy to contradict China's head of health. China got the genome online when the death toll was one. https://www.ncbi.nlm.nih.gov/nuccore/MN908947.1 https://www.ncbi.nlm.nih.gov/nuccore/MN908947.1 That seems fast to me. The report is missing the media. They seem to have been the most destructive force during the pandemic. Only recently Europe has overtaken the USA on vaccines uptake - https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&time=2020-03-01..latest&pickerSort=desc&pickerMetric=total_vaccinations_per_hundred&Metric=Vaccine+doses&Interval=Cumulative&Relative+to+Population=true&Align+outbreaks=false&country=USA~GBR~ISR~DEU~ARE~ARG~FRA~SGP~NZL~JPN~AUS https://ourworldindata.org/explorers/coronavirus-data-explor...
MattGaiser 5y ago
But would you attribute the 650,000 American deaths to something in the index or merely political/population decisions? All the vaccines in the world are useless if the people won't take them. Stockpiles of masks are useless if people won't use them.

gmuslera 5y ago

Contrasting "old" predictions with reality is always a learning experience. This ranking was made a year before an actual pandemic and they had more misses than hits, and understanding why may help with other predictions about the future. At least the ones involving human actions.

larsga 5y ago
Human action is the key. The US was very well prepared, but when the federal government and many state governments weren't interested in stopping the virus of course being prepared doesn't help. Same with the UK: the response from their scientific community has been absolutely fantastic. But when Boris Johnson simply didn't want to lock down and couldn't make up his mind until too late that didn't count for much. Also he fucked up the test-trace-isolate system for ideological reasons. Sweden + Denmark were rated as more prepared than Norway, which could well be true, but Sweden chose the UK approach (for no sane reason) and has paid the price. In all of these cases the problem is not lack of ability to handle the pandemic, but a political lack of will to do it.

senectus1 5y ago

wow.. Australia ranks 4th. be interesting to run the numbers again given the last year and a half...

kfor 5y ago

It’s out of date at this point, but I plotted the Global Health Security Index against covid death rates back in November if you’d like to get a sense of the relationship: https://twitter.com/kforeman/status/1331035362676785152 https://twitter.com/kforeman/status/1331035362676785152

MattGaiser 5y ago

All policies being equal, I can see this accurate. What it does not (and realistically cannot) include is the willingness of the population to do anything about the pandemic. Western health systems probably held up better under similar caseloads. Western delivery of vaccines was probably close to the top. Certainly won on vaccine production and logistics and research. The death tolls in the USA and to a lesser extent Canada, the UK, Italy, and Spain were an unwillingness on the part of some of the population to act on the pandemic. They wouldn't social distance. They wouldn't put on masks. They wouldn't stop travelling. And the governments were unwilling or unable to force them to do so.

system2 5y ago

China let the virus explode, reported 5000 deaths. Anyone believes China is prepared is a fool.

larsga 5y ago
What the hell kind of bullshit is this? Everyone knows they did not let it explode and had things under control until the last few weeks. Compared to most of the world China has seen almost no covid. That's what the official numbers say and it's been borne out by independent western journalists over and over again.