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Public Health Experts Propose a COVID-Score to Improve the Response to Outbreaks

A group of experts proposes six recommendations for government action and a scorecard to assess their responses to the crisis

Photo: Markus Spiske/Pexels

The COVID-19 pandemic has underscored the need for governments to improve their preparedness and response to this and future epidemics. In a comment in Nature Medicine, a group of experts, including ISGlobal researcher Jeffrey V. Lazarus and ISGlobal’s general director Antoni Plasència, propose a scorecard that can help assess governments’ response to the current pandemic and better prepare for future outbreaks.

A wake-up call

“Many government leaders and citizens are putting their hopes on the rapid development and availability of a vaccine,” says Jeffrey V. Lazarus, first author of the comment. “However, this may take a long time. In the meantime, countries can implement a series of effective measures that have been tested and tried in previous epidemics. The COVID-19 pandemic is a wake-up call for governments and the global community, and the current crisis is the result of cuts to healthcare, social care, and public health budgets”, he adds.

Six recommendations

Building on the WHO’s framework for health systems, the authors have drawn up six recommendations for government action: improve public health communication and health literacy among the population; facilitate robust surveillance and reporting of diseases; be prepared by developing and maintaining the necessary human and physical resources; strengthen health systems, particularly primary care, community care and mental-health services; ensure health and social equity by providing the most vulnerable with access to free social and health services; and ensure that confinement and deconfinement strategies address not only health but also socioeconomic aspects.

And one scorecard

The authors argue that the success of these actions depends on public trust in the government. Hence, the COVID-19 Assessment Scorecard (COVID-SCORE), with a list of 19 statements that can be scored from 1 to 5 (from completely disagree to completely agree). “This scorecard enables anyone to conduct an easy assessment of a city, regional or national government’s response to COVID-19 and its preparedness for other public health emergencies,” says Lazarus. If used on a large scale, it could be a powerful tool for guiding government actions.

In the coming weeks, the research team led by Lazarus will conduct a first round of assessments among the general population of at least seven countries from around the world using COVID-Score.

COVID-19 Assessment Scorecard (COVID-SCORE)


Jeffrey V. Lazarus, Agnes Binagwaho, Ayman A. E. El-Mohandes, Jonathan E. Fielding, Heidi J. Larson, Antoni Plasència, Vytenis Andriukaitis & Scott C. Ratzan. Keeping governments accountable: the COVID-19 Assessment Scorecard (COVID-SCORE). Nature Medicine. 2020.