Coronavirus disease 2019 (COVID-19) has impacted cities around the world. Global cities theory suggests that cities articulated to the global economy should be affected by such flows similarly. We start from this perspective and examine the impacts and outcomes of COVID-19 in three global cities: New York City, London and Tokyo. Our results focus on the speed, intensity, scale and characteristics of COVID-19 related cases and deaths in these cities and their respective countries. We find that while there are similarities between the experiences of global cities, there are also significant differences. The differences can be partially explained by policy, socio-economic and cultural differences. Our findings suggest that cities articulated to the global system could benefit from developing their own locally unique early warning and emergency response system, integrated with but separate from national systems.