A Proactive Approach to Identify the Exposure Risk to COVID-19: Validation of the Pandemic Risk Exposure Measurement (PREM) Model Using Real-World Data.

purposeTo statistically validate the PREM (Pandemic Risk Exposure Measurement) model devised in a previous paper by the authors and determine the model's relationship with the level of current COVID-19 cases (NLCC) and the level of current deaths related to COVID-19 (NLCD) based on the real country data.

methodsWe used perceived variables proposed in a previous study by the same lead authors and applied the latest available real data values for 154 countries. Two endogenous real data variables (NLCC) and (NLCD) were added. Data were transformed to measurable values using a Likert scale of 1 to 5. The resulting data for each variable were entered into SPSS (Statistical Package for the Social Sciences) version 26 and Amos (Analysis of a Moment Structures) version 21 and subjected to statistical analysis, specifically exploratory factor analysis, Cronbach's alpha and confirmatory factor analysis.

resultsThe results obtained confirmed a 4-factor structure and that the PREM model using real data is statistically reliable and valid. However, the variable Q14 - hospital beds available per capita (1000 inhabitants) had to be excluded from the analysis because it loaded under more than one factor and the difference between the factor common variance was less than 0.10. Moreover, its Factor 1 and Factor 3 with NLCC and Factor 1 with NLCD showed a statistically significant relationship.

conclusionTherefore, the developed PREM model moves from a perception-based model to reality. By proposing a model that allows governments and policymakers to take a proactive approach, the negative impact of a pandemic on the functioning of a country can be reduced. The PREM model is useful for decision-makers to know what factors make the country more vulnerable to a pandemic and, if possible, to manage or set tolerances as part of a preventive measure.