Background. The coronavirus disease 2019 (COVID-19) pandemic has been a severe threat to global health.
Method. We calculated Spearman rank correlation coefficients between a country’s case fatality risk at various stages of the pandemic and the Healthcare Access and Quality (HAQ) index in 87 countries.
Results. COVID-19 case fatality risks and HAQ indexes were negatively correlated at <1000 confirmed cases. This negative correlation decreased and even turned positive (but nonsignificantly) as countries approached >5000 confirmed cases. As for per-capita cases, the aforementioned correlation was significantly negative at <100 cases per million people. This negative correlation decreased (r = −0.0429) and became nonsignificant as countries approached >500 cases per million people.
Conclusion. Negative correlations between COVID-19 case fatality risks and HAQ indexes weakened and then disappeared with the progressive burden of COVID-19 infection over time. In the end, even the best public health systems were overwhelmed by the COVID-19 pandemic.