global health security capacity against covid-19 outbreak: an analysis of annual data from 210 countries and territories

Objectives: to review the most recent ghs index annual report to observe the regional and global level of health security against the covid19 outbreak, as well as their relationship with the case fatality rate, among 210 countries and territories worldwide. methods: we analyzed october 2019 ghs index, to assess the capacity of health securitybased on the ghs index in the context of six categories. we prioritized not only the capacities of 210 countries and territories around the world using the ghs index but also the existence of functional capabilities to prevent pandemics at the source. data were collected from global databases, including worldometer, who, and disease control and prevention center (cdc). results: this study collected data on 210 countries and territories, of which up to april 14, 2020, 72 countries (34.28%) with more than 1,000 total covid19 cases were present. in the most prepared group, the number of total covid19 diagnostic tests had a significant positive relationship with the ghs index (r = 0.713; p = 0.006). case fatality rate was directly associated with the detection index (r = 0.304; p = 0.023) in more prepared group”. in the lowermiddleincome economies group, the case fatality rate was positively related to detection, response, and risk environment indices. conclusions: with the exception of a very small number, countries that were ranked as most prepared countries were more likely to be affected by the covid19 outbreak of the virus and its health consequences and needed to seriously reconsider their capabilities and health security in the context of detection, prevention, rapid response, health system facilities, and risk environment against disease outbreak.