Health Risk Index Report

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CIEE has expanded the lens for assessing risk to include a multitude of inputs and indicators that better inform our senior leadership team on the relative safety of supporting students and staff in a particular region, country, and city. Among the variables we use in our assessments is the CIEE Health Risk Index (CIEE HRI or HRI), a snapshot of safety considerations in countries impacted by COVID-19. The index is calculated using multiple metrics (including prevalence of the virus, infection rates, transmission types, slope of new daily cases and mortality rates, health infrastructure ratings, and more) derived from multiple sources (WHO, Johns Hopkins, Worldometer, Department of State, Centers for Disease Control, DOMO, Global Health Survey, paid and open source intelligence services, and our own analytical tools).  Starting the week of June 23, we have updated our method of calculating the HRI to meet the evolving science and incorporate new data that is being collected by health authorities and analysts.

Because local COVID-19 risk has potential spillover impact on healthcare availability and travel restrictions, we plan to keep tracking the HRI even though the risk of a bad health outcome from COVID-19 lies chiefly with the unvaccinated and we expect that most, if not all, of our students will be vaccinated before traveling. 

A country's vaccination rate has a tremendous influence on the risk to our participants in that country because as the U.S. Centers for Disease Control (CDC) has stated: “People who are fully vaccinated are at low risk of symptomatic or severe infection, and a growing body of evidence suggests that people who are fully vaccinated are less likely to have asymptomatic infection or transmit the virus that causes COVID-19 to others.” 
Therefore, as more people around the globe become vaccinated, it is essential that we add this data point to our calculations to provide the clearest picture of risk to our participants and stakeholders.
Changes to our methodology include:
  • adding new metrics, including vaccination rate, that have become available since we began our bi-weekly HRI in April 2020.
  • including within the data inputs the current level of community transmission normalized by population (new cases during last 14 days per 100,000 people), which we previously reported separately as the Health Recency Report (HRR).
  • placing greater emphasis on normalizing metrics by population, rather than using raw case numbers.
As many of our risk metric inputs are new, you will see that most country risk ratings have changed from our last report – some considerably so. While this somewhat disrupts the trends we have been tracking over time using the previous risk metrics, we feel it is vitally important that our methods of assessing risk evolve as new information becomes available. On the table and figures shared below, we are calling the output of the revised methodology HRI 2.0.
The new methodology places a greater emphasis on recent conditions as we have found that past severe outbreaks are not necessarily predictors of future ones, especially as vaccination rates increase and countries adopt new approaches following severe outbreaks. You may see the HRI 2.0 for a country that has experienced a severe outbreak in the past may be considerably lower than the HRI shared in the last report, both because they may be currently experiencing very low case numbers, and because the calculation is now penalizing them less for the severity of past outbreaks.  

About the HRI:

  • The index is a numerical value from 1 to 100 where higher numbers indicate higher risk as assessed by our calculations.
  • The lower the number, the fewer risk factors that will require mitigation. 
  • Arrows represent changes to the index of greater than two points - green arrows if the change was in the direction of lower risk; red if the change was in the direction of increased risk.  
  • The values are for comparative purposes only and are calculated weekly or biweekly so we may assess changes over time.
  • The values do not represent absolute risk, and there are no universal thresholds at which CIEE would or would not run a program.
  • Data is provisional and subject to change. Some risk values for past weeks may change occasionally as countries and/or data source sites update their past data to reflect more accurate information such as case and death counts for specific days.
  • The vaccination column does not take into account vaccine type/brand. There are additional vaccines beyond the three authorized in the US being used throughout the world, which in studies have shown differing efficacy rates

Countries with Notable Change to HRI since Last Report

Since the last report, we have observed a decrease in risk in a number of countries, with a reduction in case numbers and spread. These include:

  • Europe
    • England/UK
    • Netherlands
  • Latin America & Caribbean
    • Argentina
    • Chile
    • Costa Rica

The following locations had an increase in risk since the last report:

  • Africa/Middle East
    • Botswana
    • Morocco
  • Asia-Pacific
    • Japan
  • Europe
    • France
  • North America
    • United States

Community Transmission (HRR) by Country

In the figure above you can see how the level of community transmission (as measured by new cases in the past 14 days per 100,000 people) in different countries compares with community spread in the United States as a whole (the red line). Because local COVID-19 impact is wildly variable across the United States, for additional comparison, there is a line to indicate community spread in the state with the lowest community spread (Vermont), 10th highest community spread (South carolina), and the highest community spread (Louisiana).

Health Risk Indices by Region

Below are four figures offering an additional way to visualize the changes to the HRI over time. Each figure shows the HRI from February 3, 2021 through July 7, 2021 for countries within a region and, for comparison, the United States. In each figure, the y-axis shows HRI values from 0 - 100. Because a lower HRI value indicates a lower risk as assessed by our calculations, a downward slope represents a decrease in risk (a.k.a. an improvement in conditions). Note there is a line to indicate when our calculation methodology changed (beginning of HRI 2.0).

Africa & Middle East

Asia Pacific


Latin America

North America


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