The report, released by the International Federation of Red Cross and Red Crescent Societies, cites the Johns Hopkins–backed 2021 Global Health Security Index, which rated nearly 200 countries on health emergency preparedness. On a scale of 100, no country ranked above an 80—and the global average was a mere 39.

The average is nearly identical to what it was in 2019, before the pandemic, “indicating there has been no real improvement in health emergency preparedness” since the beginning of the pandemic, the authors wrote.

COVID has been “the biggest disaster in living memory, by almost any measure,” according to the report. So far, global recorded deaths sit above 6.5 million—this in contrast to the No. 2 deadliest disaster on the organization’s list, the Indian Ocean tsunami of 2004, which killed around a quarter-million people.

Preparation for the next pandemic must start now—in the midst of the current pandemic—because the next pandemic could be “just around the corner,” the report states.

“If the experience of COVID-19 won’t quicken our steps toward preparedness, what will?” the authors wrote, calling on governments to build trust in public health systems ahead of tragedies, and to address health inequities, which worsen during tragedies.

WHO extends COVID-19 pandemic status

The World Health Organization is keeping its eye on a list of “priority pathogens” that have the potential to cause outbreaks and pandemics, including Crimean-Congo hemorrhagic fever; the Ebola and Marburg viruses; Lassa fever; coronaviruses Middle Eastern respiratory syndrome (MERS), severe acute respiratory syndrome (SARS), and COVID-19; henipaviruses, Rift Valley fever, and “Disease X,” which represents an unknown pathogen with pandemic potential. The list was last updated in 2019, and a revised list should be released in the first quarter of this year, according to the organization.

The release of the International Federation of Red Cross and Red Crescent Societies’ report comes the same day as the WHO announced that it would extend the COVID-19 international public health emergency another three months, pushing it into its fourth year.

“There is no doubt we are in a far better situation now than we were a year ago, when the Omicron wave was at its peak,” WHO Director General Tedros Adhanom Ghebreyesus said in a news release—three years to the day he announced the start of the emergency.

But weekly global COVID deaths have been rising since the beginning of December, and more than 170,000 people have died of COVID over the past two months, he added. “And that’s just the reported deaths. We know the actual number is much higher.”

The extension comes as China endures some of its darkest days of the pandemic, after ending long-standing “zero COVID” restrictions in December. An estimated 900 million Chinese have been infected with COVID as of Jan. 11, according to a recent study. With rampant infection comes a greater chance of the virus evolving a more dangerous strain that could sweep the globe.

Japan, too, recently saw its darkest days of the pandemic, when back-to-back waves of Omicron strain BA.5 caused deaths there to skyrocket to an all-pandemic high.

Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP), told Fortune on Friday he wasn’t sure if the committee’s decision made a difference from a practical standpoint, given that emergency status doesn’t offer much in the way of additional funds, power, or options to respond.

“The only thing that is important is the public perception,” he said. “Most of the world is over this pandemic, even though the virus is not done with us yet. If you say it’s no longer an emergency, most people are going to interpret that as the pandemic is done.”