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September 16, 2020

Suboptimal US Response to COVID-19 Despite Robust Capabilities and Resources

Author Affiliations
  • 1Center for Health Security, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
  • 2Department of Environmental Health and Engineering and Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
  • 3Global Biological Policy and Programs, Nuclear Threat Initiative, Washington, DC
JAMA. 2020;324(14):1391-1392. doi:10.1001/jama.2020.17395

The coronavirus disease 2019 (COVID-19) pandemic may have caught governments by surprise, but medical and public health communities have long warned of the potential for a high-consequence pandemic. Most recently, in September 2019, a report by the independent Global Preparedness Monitoring Board urged political leaders to take steps in their countries to improve preparedness for such events.1 One month later, the Global Health Security (GHS) Index, a framework for benchmarking health security in 195 countries, found that no country was fully prepared for a major health emergency.2 The Index identified serious weaknesses in many countries that could undermine their ability to respond to a pandemic, but it did not anticipate the poor response to the pandemic by high-scoring countries such as the US where major gaps in federal leadership resulted in a failure to mobilize the country’s substantial capacity.

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    2 Comments for this article
    Eric Stein, MD | Main Line Health Hospitals (Emeritus)
    The authors correctly identify S Korea, Thailand and other nations as having mounted a relatively successful response to COVID-19. By comparison, the US response has been considerably worse than "suboptimal"; it has been dismal. The lack of consistent messaging, the failure of leadership to seek guidance from experts, the inexcusable lack of adequate PPE for health care workers and the foolhardy downplaying of the significance of the pandemic have done more than cost us more than 200K American lives - these failures have exacerbated the negative economic impact that the Administration sought to minimize.
    Global Health Security Index and Responses to COVID-19
    Michael McAleer, PhD(Econometrics),Queen's | Asia University, Taiwan
    There is no doubt that the USA has performed rather poorly in dealing with the COVID-19 pandemic.

    Although the USA was the highest ranked country in 5 of the 6 categories in the Global Health Security Index, it was ranked 19 in terms of the "Risk Environment: Overall risk environment and country vulnerability to biological threats", a category in which Liechtenstein was ranked number 1, despite being ranked 71 overall (Chang and McAleer, 2020).

    it is worth mentioning that, ignoring nations with small populations, Taiwan with a population of just under 24 million (2018 estimate) has been the most successful country
    in terms of dealing with COVID-19, with 509 total cases and 7 deaths (

    It is also worth mentioning that Taiwan was not included in the Global Health Security Index.


    Chang, C.-L. and M. McAleer (2020), Alternative Global Health Security Indexes for Risk Analysis of COVID-19, Int. J. Environ. Res. Public Health, 17(9:31), 3161, 1-17; (file:///C:/Users/user/Desktop/ijerph-17-03161-v2.pdf).