Johns Hopkins Global Security Index

[nomadreid]

TL;DR Summary

I have read (source in main text) that Johns Hopkins rated the US as the #1 country in preparedness against COVID-19. I do not want to get into a political argument, and I recognize that there are countries that are less prepared, but "#1" seems to contradict other reports. Is there something I am missing here?

I emphasize that I am not posing a rhetorical question, and am not trying to make a political statement (and would ask all respondents to steer clear of politics), but would genuinely appreciate knowing whether the report in question is considered valid by those in the field who are impartial and qualified. (I myself am not in the medical or biological sciences, and do not have the tools to judge the validity of the report.)

I refer to the report on the Johns Hopkins site: https://hub.jhu.edu/2020/02/27/trum...-coronaviruscovid-19-649-em0-art1-dtd-health/.

Johns Hopkins University is a highly respected source, but this does not exempt it from critical analysis.

On one side, this report seems to contradict reports by many other reputable sources inside the US. (I do not cite sources on this, as no matter what choice I made, I might be accused of selective bias -- but relevant sources are not hard to find.) On the other side, although many countries lack the proper infrastructure, I personally live in a country where the testing, preventative measures and treatment infrastructure were in place in a fashion that definitely compares favourably to that of the US reaction. Therefore I do not understand the conclusion of the report.

I would be grateful for explanations.

 

[jedishrfu]

This report was compiled over a 2 1/2 year period and was released in October 2019. They used a list of 140 questions to assess a country's preparedness. This is likely based on known pathogens and to a much lesser degree on unknown pathogens.

Early detection is the big problem with an unknown pathogen. How can you have testing kits when you don't know what to test for? How good will your detection stats be? How quickly can you field an accurate test kit for everyone to use to get those stats?

A key feature of the COVID-19 virus is its ability to replicate and spread days before the host shows any symptoms and this makes it much more difficult to contain.

China's draconian lockdown turned the tide of the COVID-19 outbreak in China. However, that is a much harder thing to do here in the US with freedom of movement, rapid transit to any point and multiple entry points into the US. We didn't contain it at the entry points and now it is popping up everywhere people travel and so shelter-in-place and limited contact is the best hope we have to flatten the effects enough so we can deal with it effectively over a longer period.

 

[BillTre]

Not commenting on the question about the specific article, but...

Even if you are the best prepared for something, if you don't make use of those preparations in a timely manner, the results can be poor.
This can lead to a mismatch between degree of preparedness and the overall result.

 

[sysprog]

Males are almost entirely asymptomatic for HPV, and we still don't have a routinely available test for it for males. I would like to be determinationally tested for it. I don't want want to possibly inflict on a woman a potentially lethal disease. I love women. I detest the fact that I could be a possible unknowing disease vector.

 

[nomadreid]

This is likely based on known pathogens and to a much lesser degree on unknown pathogens.

Very good surmise; it would most likely be closest to answering my question. Unfortunately I have not found the text of the report itself (but I will search further; however, if anyone's search skills are better than mine, and if the text is freely available on the Internet, I would be grateful for the link), so I do not know if this is the central issue.

This report was compiled over a 2 1/2 year period and was released in October 2019.

Hm, that would mean that during part of the question period, the Directorate for Global Health Security and Bioterrorism of the National Security Council (established in 2015) was fully operating, and during part of the question period, it effectively was no longer functional (after sometime in 2018). Could the data have been skewed by using answers given when preparedness was high for a report released when preparedness was no longer high?

 

[Astronuc]

The U.S. scored 83.5 and ranked No. 1 in five of six categories: prevention, early detection and reporting, rapid response and mitigation, sufficient and robust health system, and compliance with international norms.

One would have to read the study to determine how the US was graded with respect to each criterion. Certainly, experience over the last 2 months calls into question the results of the study, especially with respect to prevention, early detection and reporting, rapid response and mitigation, sufficient and robust health system.

 

[nomadreid]

experience over the last 2 months calls into question the results of the study, especially with respect to prevention, early detection and reporting, rapid response and mitigation, sufficient and robust health system.

Precisely the reason for which I started this thread!

 

[sysprog]

Precisely the reason for which I started this thread!

The panickers have somewhat abated their zeal -- I can now buy bread, and regular-sized boxes of tissues and packs of napkins, although the branded bread and 'bathroom tissue' rolls are still swept off of the shelves at some stores. One store near me limited customers to no more than 2 loaves of bread, foregoing immediate profit, and I thought that was quite neighborly of them.

 

[nomadreid]

Oops, I do not know how I overlooked this on my first search. The study being referenced is to be found here https://www.ghsindex.org/wp-content/uploads/2019/10/2019-Global-Health-Security-Index.pdf.

I am afraid I am too used to mathematics and physics, so it may be my bias making it seem like the report is mainly numbers which are attached to hand-waving. That is why I am appealing to those in the medical field on this forum who do not share my bias to indicate to me whether, in light of recent events, the study is (still) considered valid.

For example, in physics, if a theory predicts that a certain phenomenon will not occur, and then experimental evidence shows that the phenomenon will indeed occur, then one discards the results. The ether was a nice theory until ... it wasn't. So could I say analogously that this study was a nice study until ... it wasn't?

 

[sysprog]

Oops, I do not know how I overlooked this on my first search. The study being referenced is to be found here https://www.ghsindex.org/wp-content/uploads/2019/10/2019-Global-Health-Security-Index.pdf.

I am afraid I am too used to mathematics and physics, so it may be my bias making it seem like the report is mainly numbers which are attached to hand-waving. That is why I am appealing to those in the medical field on this forum who do not share my bias to indicate to me whether, in light of recent events, the study is (still) considered valid.

For example, in physics, if a theory predicts that a certain phenomenon will not occur, and then experimental evidence shows that the phenomenon will indeed occur, then one discards the results. The ether was a nice theory until ... it wasn't. So could I say analogously that this study was a nice study until ... it wasn't?

I think that you might need to do a little breathing from a tank of dephlogisticated air.

 

[Astronuc]

early detection and reporting, rapid response and mitigation,

The Atlantic did a critical piece.
Early detection did not happen. Infected travelers were entering the US and no one knew. Then when cases started popping up, the testing was inadequate and unavailable to many.

https://www.theatlantic.com/health/archive/2020/03/how-will-coronavirus-end/608719/

More transmissible and fatal than seasonal influenza, the new Coronavirus is also stealthier, spreading from one host to another for several days before triggering obvious symptoms. To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those they’ve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the United States did not.

the Centers for Disease Control and Prevention developed and distributed a faulty test in February. Independent labs created alternatives, but were mired in bureaucracy from the FDA. In a crucial month when the American caseload shot into the tens of thousands, only hundreds of people were tested. That a biomedical powerhouse like the U.S. should so thoroughly fail to create a very simple diagnostic test was, quite literally, unimaginable.

As for a sufficient and robust health system, in the face of a pandemic, it isn't as evidenced in NY, and potentially in Wa, Ca and La.

Health-care workers are already seeing worrying signs: dwindling equipment, growing numbers of patients, and doctors and nurses who are themselves becoming infected.

Italy and Spain offer grim warnings about the future. Hospitals are out of room, supplies, and staff. Unable to treat or save everyone, doctors have been forced into the unthinkable: rationing care to patients who are most likely to survive, while letting others die. The U.S. has fewer hospital beds per capita than Italy.

In NY City, "more than 3,922 Coronavirus patients have been hospitalized in the city."

All of the more than 1,800 intensive care beds in the city are expected to be full by Friday, according to a Federal Emergency Management Agency briefing obtained by The New York Times. Patients could stay for weeks, limiting space for newly sickened people.

https://www.nytimes.com/2020/03/25/nyregion/nyc-coronavirus-hospitals.html?smtyp=cur&smid=fb-nytimes

Some patients have been found dead in their rooms while doctors were busy helping others, they said.

 

[nomadreid]

The Atlantic article is an example of the sources that I mentioned in my original post that one could find. To extend my earlier analysis, suppose someone had come out with a series of research papers that upheld the idea of the existence of luminiferous aether, and that the evidence was collated and published in a leading journal in 1887. Then came along the Michelson-Morley experiment. One would no longer be justified in citing the earlier result. So too, given the evidence we have now, is it still justifiable to cite the Johns Hopkins report?

 

[TeethWhitener]

In other news:

"… it seems probable that most of the grand underlying principles have been firmly established … An eminent physicist remarked that the future truths of physical science are to be looked for in the sixth place of decimals."
-Michelson, 1894 (this is the source of the misattribution to Lord Kelvin, "There is nothing new to be discovered in physics.")

"Stock prices have reached what looks like a permanently high plateau."
-Irving Fisher, 1929