The reputation of the United States in the international community has taken a hit due to President Donald Trump’s handling of COVID-19, according to a Pew Research survey released Tuesday. The survey asked 13 nations about how they viewed the U.S. response to COVID-19 and whether they have confidence in Trump’s leadership.

A median of just 15% say that the U.S. has done a good job handling the outbreak. In Spain, for example, only 20% say the U.S. has done a good job, with just 6% of the South Korean public expressing the same opinion. 

European nations largely have an extremely negative perception of the U.S. during the Trump era. Only 24% of Belgians have a favorable view of the U.S., with 9% having confidence in Trump. Just 26% of Germans view the U.S. favorably, with 10% having confidence in Trump. 

Trump has frequently criticized German Chancellor Angela Merkel due to her response to the 2015 refugee crisis. He has also threatened tariffs on German automobiles, adding tension to the U.S.-Germany relationship.

Trump’s favorability is highest in Japan, with 25% of Japanese viewing him favorably. The country surveyed with the highest overall favorability of the U.S is South Korea, at 59%. 

Trump has called Japanese President Shinzo Abe "a great friend," with the two countries achieving a free trade agreement in October.

Trump has pursued an “America First” agenda, pulling the U.S. out of multiple international agreements and asking European allies of the North Atlantic Treaty Organization to contribute more in defense spending. His actions have often irked American allies such as Canada, Germany and the U.K.

On the other hand, Trump has strengthened the U.S. relationship with Israel, due to his decision to move the U.S. embassy from Tel Aviv to Jerusalem. Trump has also gained support in the Philippines, due to his controversial comments praising leader Rodrigo Duterte.