BACKGROUND content: Understanding public
perceptions of government responses to COVID-19 may foster
improved public cooperation. Trust in government and population
risk of exposure may influence public perception of the
response. Other population-level characteristics, such as
country socio-economic development, COVID-19 morbidity and
mortality, and degree of democratic government, may influence
perception. - Label: METHODS AND FINDINGS content: We developed
a novel ten-item instrument that asks respondents to rate key
aspects of their government's response to the pandemic
(COVID-SCORE). We examined whether the results varied by gender,
age group, education level, and monthly income. We also examined
the internal and external validity of the index using
appropriate predefined variables. To test for dimensionality of
the results, we used a principal component analysis (PCA) for
the ten survey items. We found that Cronbach's alpha was 0.92
and that the first component of the PCA explained 60% of
variance with the remaining factors having eigenvalues below 1,
strongly indicating that the tool is both reliable and
unidimensional. Based on responses from 13,426 people randomly
selected from the general population in 19 countries, the mean
national scores ranged from 35.76 (Ecuador) to 80.48 (China) out
of a maximum of 100 points. Heterogeneity in responses was
observed across age, gender, education and income with the
greatest amount of heterogeneity observed between countries.
National scores correlated with respondents' reported levels of
trust in government and with country-level COVID-19 mortality
rates. - Label: CONCLUSIONS content: The COVID-SCORE survey
instrument demonstrated satisfactory validity. It may help
governments more effectively engage constituents in current and
future efforts to control COVID-19. Additional country-specific
assessment should be undertaken to measure trends over time and
the public perceptions of key aspects of government responses in
other countries