Assessments of the performance of pandemic preparedness measures must properly account for national income

⇒ More than a dozen studies and reports have assessed the association between COVID-19 health outcomes and the leading country-level metrics of pandemic preparedness: States Parties Annual Report, the Joint External Evaluation and the Global Health Security (GHS) Index.⇒ The recent article by Ledesma et al in this journal is the rare exception in finding several correlations between GHS indicators and COVID-19 excess mortality, but it has a critical error-it fails to account properly for gross domestic product per capita.⇒ Doing so fundamentally changes the conclusions of the research as nearly all the paper's significant findings are no longer statistically significant when this problem is addressed.