The UK And US Were Ranked Top For Pandemic Preparedness. What Went Wrong?

According to one researcher, we had everything – except leadership.

In October 2019, an extensive report two years in the making placed the US and the UK first and second respectively in a global ranking of countries’ pandemic preparedness.

Even more impressively, Britain led the world in a sub-section on a country’s ability to respond rapidly and halt the spread of devastating diseases.

A year later, the US and the UK have been crippled both physically and economically by coronavirus. So what went wrong?

In short, everyone did what they were supposed to when Covid-19 hit – except the politicians.

Health secretary Matt Hancock in Downing Street in February
Health secretary Matt Hancock in Downing Street in February

The report

The Global Health Security (GHS) Index was the most comprehensive global study on pandemic preparedness to date. It was a collaboration between the John Hopkins University, The Economist Intelligence Unit (EIU) and the Nuclear Health Initiative (NTI).

Its results were relatively unsurprising – wealthier countries tend to be better prepared than poor ones.

Global Health Security Index
Global Health Security Index
Statista/Global Health Security Index

The report did not go unnoticed – here’s a picture of President Trump waving the very same chart around at a press briefing at the White House in February last year, while assuring his country that all would be well.

One year later and more than 400,000 Americans have died of coronavirus

Global Health Security Index
Global Health Security Index
Tasos Katopodis/Getty Images

The scores

Overall, the US and the UK topped the chart, scoring 83.5 and 77.9 respectively – but the conclusion of the report was sobering.

“No country is fully prepared for epidemics or pandemics,” it read. “Collectively, international preparedness is weak.”

Still, a few months later – and certainly in February, when Trump was touting America’s score in the survey – the findings suggested both countries would fare better than most as the pandemic progressed.

The reality

As you will no doubt be aware, the US and the UK are two of the hardest hit countries in the world, with the UK this week passing the grim milestone of 100,000 dead.


The subsections

Key to understanding this massive discrepancy is how the GHS Index was compiled.

Jessica Bell, NTI’s co-lead on the project, told HuffPost UK: ”[The report] measures six categories and in each we drill down into 140 questions. We examine data that speaks to legislation, regulations, plans, academic publications and things of that nature.

“It was years in the making.”

In those six subsections, the UK’s score varied wildly.

The planning

In those subsections that looked at planning for a pandemic, the UK scored highly – successive governments for years have compiled, maintained. and updated national plans on how to cope specifically with influenza pandemics.

Academics, think tanks and health bodies all did what was required of them and contributed to plans that were in place in case the worst happened.

In 2011 the Department of Health published the “influenza pandemic preparedness strategy”, and it was updated regularly and remained the go-to document when coronavirus struck.

The GHS Index highlighted this in its third subsection, titled “rapid response to and mitigation of the spread of an epidemic”.

Explaining what they examined, Priya Bapat of the EIU told HuffPost UK: “So, do you have these emergency plans in place and do they cover lots of different types of diseases?

“Do they incorporate planning for vulnerable populations? We looked at exercising response plans, so – you have these plans on paper but, in the last year, have you actually tested them out in a scenario planning exercise?

“Do they have a plan on how to communicate with the public?”

When it came to the UK, the answers were “yes, yes, yes and yes” and it scored 91.9 out of 100, more than 10 points ahead of any other country.

The implementation

But the UK didn’t score quite so well on subsection six, which looked at how well a country can actually implement the plans it has.

“Six looks at aspects that aren’t traditionally looked at like the strength of the government and social economic risks and infrastructure,” said Bapat.

“And if you look at the UK, some of the areas where it scored lower have been the story of this outbreak. One aspect in particular – when you look at high income European countries, the UK has the lowest doctors per capita than any of those countries except for Poland.

“There’s been huge underinvestment in the NHS and that’s shown itself in the number of health care workers per capita.”

This underinvestment has of course been thanks to a decade of austerity under a Conservative government. But this still can’t explain why the UK has so far fared worse than countries with inferior healthcare systems – like Vietnam, for example.

To explain that we have to look to our political leaders.

The leadership

The UK had the plans, so why didn’t they work?

“Even though the US and the UK had the best environments in terms of plans in place and thinking about what they would need in terms of capacity,” said Bapat, “when it came to the moment that everyone had been preparing for, the decision-making really hampered the actual ability of the country to respond.”

Documenting the UK government’s delayed response to the pandemic is an ongoing process but there are already a number of things the public inquiry that Boris Johnson has committed to might want to examine.

The nationwide lockdown was by some accounts too late and “cost a lot of lives”; face masks in shops are only being made mandatory on July 24 after months of dithering; contact tracing has been discussed endlessly but is still not up and running; and quarantine rules have changed like the seasons.

Then there’s the way the government has let down Black, Asian and minority ethnic people, who have been worse hit by coronavirus than their white counterparts despite repeated warnings being sounded. That has already been the subject of a review, but it was heavily criticised for containing little new information and making no recommendations.


Asked about the biggest factor in the current situations facing both the UK and the US, Bell said: “If I was going to put my finger on any one large influencer, it would be the political leadership.”

In a statement, a UK government spokesperson told HuffPost UK: ”Every death is a tragedy and our deepest sympathies are with all those who have lost loved ones.

“The government has been working day and night to battle against the pandemic and has taken swift action to protect our NHS, and save lives and livelihoods.

“Our approach continues to be guided by scientific and medical experts, and we have never shied away from lifesaving measures, including restrictions and lockdown measures.

“This is an unprecedented situation and we have made significant strides in our response to tackling Covid-19 including building the largest diagnostic testing system in British history from scratch and developing the biggest vaccination programme the NHS has ever had.

“As the prime minister has said previously, we will have an independent inquiry to understand what happened during the pandemic and to learn lessons for the future.”


What's Hot