Table 1

Pearson r correlation coefficients between 2021 Global Health Security indicators and comparative COVID-19 excess mortality ratio

Pandemic preparedness capacityPearson rP value
Global Health Security Index Score −0.392<0.0001
  Prevention score −0.322<0.0001
  (1.1) Antimicrobial resistance−0.330<0.0001
  (1.2) Zoonotic disease−0.2600.0006
  (1.3) Biosecurity−0.2800.0002
  (1.4) Biosafety−0.2410.0015
  (1.5) Dual-use research and culture of responsible science−0.1200.1180
  (1.6) Immunisation−0.1430.0620
  Detection score −0.2550.0007
  (2.1) Laboratory systems strength and quality−0.1360.0746
   (2.1.1) Lab capacity for detecting priority diseases−0.1460.0552
   (2.1.2) Laboratory quality systems−0.0990.1980
  (2.2) Laboratory supply chains−0.2020.0080
  (2.3) Real-time surveillance and reporting−0.1170.1275
  (2.4) Surveillance data accessibility and transparency−0.305<0.0001
  (2.5) Case-based investigation−0.1830.0166
  (2.6) Epidemiology workforce−0.1100.1506
  Response score −0.336<0.0001
  (3.1) Emergency preparedness and response planning−0.2700.0003
   (3.1.1) National public health emergency preparedness plan−0.2250.0030
   (3.1.3) Non-pharmaceutical interventions planning−0.2380.0017
  (3.2) Exercising response plans−0.1230.1074
  (3.3) Emergency response operation−0.0270.7290
  (3.4) Linking public health and security authorities−0.2240.0031
  (3.5) Risk communication−0.2320.0022
  (3.6) Access to communications infrastructure−0.402<0.0001
  (3.7) Trade and travel restrictions0.0420.5812
  Health system score −0.2900.0001
  (4.1) Health capacity in clinics, hospitals and community care centres−0.412<0.0001
   (4.1.2) Facilities capacity−0.312<0.0001
  (4.2) Supply chain for health system and healthcare workers−0.2180.0040
  (4.3) Medical countermeasures and personnel deployment−0.1120.1440
  (4.4) Healthcare access0.1350.0780
  (4.5) Communications with healthcare workers during health emergency−0.1850.0150
  (4.6) Infection control practices−0.2860.0001
  (4.7) Capacity to test and approve new medical countermeasures−0.1030.1799
  International norms score −0.2150.0046
  (5.1) IHR reporting compliance and disaster risk reduction0.0520.4948
  (5.2) Cross-border agreements on public health emergency response−0.3010.0001
  (5.3) International commitments−0.2500.0009
  (5.4) JEE and PVS0.1710.0245
  (5.5) Financing−0.0570.4605
  (5.6) Commitment to sharing of genetic and biological data and specimens−0.1100.1517
  Risk environment score −0.590<0.0001
  (6.1) Political and security risk−0.568<0.0001
   (6.1.1) Government effectiveness−0.603<0.0001
  (6.2) Socioeconomic resilience−0.508<0.0001
   (6.2.3) Social inclusion−0.408<0.0001
   (6.2.4) Public confidence in government−0.369<0.0001
   (6.2.6) Inequality−0.1700.0260
  (6.3) Infrastructure adequacy−0.524<0.0001
  (6.4) Environmental risks−0.1060.1659
  (6.5) Public health vulnerabilities−0.480<0.0001
   (6.5.1) Access to quality healthcare−0.1120.1449
   (6.5.4) Trust in medical and health advice−0.2200.0037
    (6.5.4a) Trust medical and health advice from the government−0.1490.0511
    (6.5.4b) Trust medical and health advice from medical workers−0.2430.0013

  • Some risk environment category capacities including political and security risk, inequality, environmental risks, public health vulnerabilities are reverse coded such that higher levels indicate lower risks.

  • IHR, International Health Regulations; JEE, Joint External Evaluation; PVS, Performance Veterinary Services.