Health Risk Index Report

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​ ​​Click here to open figure in a new window to see full size.

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).     

The column on the far right of the Health Index Report,  is our Health Recency Report or HRR. This metric represents reported new cases during the last 14 days per 100,000 people, and is provided so CIEE and stakeholders can compare the current level of community transmission, normalized by population.

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.

About the HRR:

  • The HRR does not take into account past cumulative infections beyond 14 days or any other risk factors, only provides insight into real-time community spread. 
  • The minimum value for the HRR is zero, as that would represent virtually no community spread in the last 14 days. 
  • The larger the HRR value, the more people being infected daily in that country. 
  • CIEE has aligned the HRR step metric system with the ECDC (European Centre for Disease Prevention and Control) 14-day new cases per 100,000 system.
    • Fewer than 20 new cases per 100K means low transmission and appears as green in the table above.
    • HRR of 20 – 59.9 indicates moderate transmission and appears yellow
    • HRR of 60-119.9 indicates high transmission and appears light orange
    • HRR greater than 120 means very high transmission and appears as dark orange.

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 are lines to indicate community spread in different states, including the state with the lowest community transmission (Hawaii with 103 cases per 100,000) and the highest community spread (North Dakota with 2,029 cases per 100,000).

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 April 13 through January 4 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).

Africa & Middle East

  • Jordan – Showed a decrease in risk since the last report.
  • Morocco – Showed a decrease in risk since the last report.
  • South Africa –  Showed an increase in risk since the last report, with a rise in daily new cases that began in mid-November and a rise in daily deaths in December. President Cyril Ramaphosa has announced plans to tighten South Africa's restrictions due to a significant increase in coronavirus disease (COVID-19). Effective Dec. 28, authorities moved the country from Level 1 to adjusted Level 3 of its five-level risk scale and imposed a nationwide curfew 2100-0600 through mid-January. An 1100-0400 nightly curfew was previously in place.

Asia Pacific

  • Japan – Showed an increase in risk since the last report, with a rise in daily new cases that began in early November and a rise in deaths in late November. 


  • Czech Republic – Showed an increase in risk since the last report, with a rise in daily new cases that began in mid-December.
  • Denmark – Showed a decrease in risk since the last report.
  • England – Showed an increase in risk since the last report, with a rise in daily new cases that began in late December and a rise in daily deaths in early January. Authorities in the UK tightened coronavirus disease (COVID-19) restrictions in England and Scotland from Jan. 5. In England, people will need to remain at home except for essential work, grocery shopping, seeking medical help, and outdoor exercise once per day. In addition, all nonessential stores will be closed. Furthermore, schools and colleges will switch to distance learning. These measures will replace the previously introduced tiered restrictions.
  • Ireland – Showed an increase in risk since the last report, with a rise in daily new cases that began in late December. As part of ongoing efforts to limit the spread of coronavirus disease (COVID-19), authorities in Ireland tightened domestic restrictions due to an increase in infection rates on 31 December.
  • Italy – Showed a decrease in risk since the last report.
  • Portugal – Showed an increase in risk since the last report, with a rise in daily new cases that began in early January.

Latin America

  • Dominican Republic – Showed an increase in risk since the last report, with a rise in daily new cases that began in late November. Authorities in the Dominican Republic tightened the country's nationwide nightly curfew on January 1, as part of ongoing efforts to curb the spread of the coronavirus disease (COVID-19).

North America

  • United States – The U.S. remains the global-leader in total and active COVID-19 cases with 21,427,057 total cumulative cases, 8,311,103 active cases. It also is the nation with the most fatalities due to COVID-19, with 363,573 total deaths. The U.S. also continues to experience a significant number of daily new cases with a current 7-day moving average of 218,000+ new cases daily, and a 7-day moving average of 2,700+ deaths daily. For additional perspective, the US has a current HRR value of 895 (meaning there were 895 new cases per 100,000 people within the last two weeks). It is worth noting that this count/average is for the entire country, and there is great variance in localized severity of impact between states and even within each state. The state least impacted is Hawaii (127 cases per 100,000) and the greatest impacted state is Arizona (1,462 cases per 100,000). Without a national disease management strategy, individual states are each managing the presence of COVID-19 differently, with varying degrees of success in controlling the spread of coronavirus infection.

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