ArticleScientific reports2022
Analyzing the GHSI puzzle of whether highly developed countries fared worse in COVID-19.
Article in Scientific reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- No Place to Hide? Regional Resilience and Vulnerability to Global Catastrophic Risk.Global challenges (Hoboken, NJ) · 2026Review
- Structural gradients in excess mortality during and after the COVID-19 pandemic: economic development, preparedness, and cross-national differences, 2020-2024.Journal of global health · 2026Article
- Article
- Countries' progress towards Global Health Security (GHS) increased health systems resilience during the Coronavirus Disease-19 (COVID-19) pandemic: A difference-in-difference study of 191 countries.PLOS global public health · 2025Article
- The Global Health Security Index and Its Role in Shaping National COVID‑19 Response Capacities: A Scoping Review.Annals of global health · 2025Article
- Systems Biology Approaches to Understanding COVID-19 Spread in the Population.Methods in molecular biology (Clifton, N.J.) · 2024Article
- A large-scale machine learning study of sociodemographic factors contributing to COVID-19 severity.Frontiers in big data · 2023Article
- The role of international support programmes in global health security capacity building: A scoping review.PLOS global public health · 2023Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Global Health Security Index (GHSI) categories are formulated to assess the capacity of world countries to deal with infectious disease risks. Thus, higher values of these indices were expected to translate to lower COVID-19 severity. However, it turned out to be the opposite, surprisingly suggesting that higher estimated country preparedness to epidemics may lead to higher disease mortality. To address this puzzle, we: (i) use a model-derived measure of COVID-19 severity; (ii) employ a range of statistical learning approaches, including non-parametric machine learning methods; (iii) consider the overall excess mortality, in addition to official COVID-19 fatality counts. Our results suggest that the puzzle is, to a large extent, an artifact of oversimplified data analysis and a consequence of misclassified COVID-19 deaths, combined with the higher median age of the population and earlier epidemics onset in countries with high GHSI scores.
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