Association Between Preparedness and Response Measures and COVID-19 Incidence and Mortality

  1. Christopher T. Lee
  2. Marine Buissonnière
  3. Amanda McClelland
  4. Thomas R. Frieden

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Abstract

The COVID-19 pandemic is the most disruptive global health threat in a century. We analyzed publicly available data on preparedness capacity, COVID-19 incidence and mortality, governance, and testing. Although other analyses have suggested that preparedness assessments do not correlate with effective pandemic response, we found that testing rates correlate with both COVID-19 incidence and mortality and strongly correlated with country preparedness capacity as measured by the Joint External Evaluation (JEE). There is a statistically significant association between preparedness capacities and COVID-19 case incidence and an independent association between governance and COVID-19 case and mortality rates. Legislation, surveillance, and risk communication capacities were associated with lower COVID-19 case incidence and mortality. Preparedness and governance are independently associated with COVID-19 pandemic severity. Preparedness capacities are not sufficient — capacity and governance are both critical to pandemic control. Countries must improve public health systems and implement strong government leadership.

Article Summary

Country preparedness capacities and country leadership policy response (governance) are both critically important to control pandemics. Without appropriate policy action, public health preparedness is insufficient for effective pandemic response.

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  1. ScreenIT

    SciScore for 10.1101/2021.02.02.21251013: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: This analysis is subject to several limitations. The cross-country analyses performed might not capture the many complex dynamics of a specific disease, but the measures being tested are generally available only at the national level. There were limited data available on testing (only 49 countries analyzed had completed a JEE) and on policy response (index data were available for only 16 countries with a completed JEE). Other sophisticated modeling efforts reviewed a number of factors to identify predictors of COVID-19; our hypothesis was to test the role of capacities and governance rather than the etiological dynamics of COVID-19 or other infectious diseases, so we do not provide analysis of the predictive effect capacity or governance as defined in this paper. Last, JEEs are only conducted every 4–5 years and the process began in 2017; it is possible that country capacities have changed since the time the JEE was conducted.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.02.02.21251013v1 on medRxiv