COVID-19 control in low-income settings and displaced populations: what can realistically be done?
- PDF / 591,513 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 1 Downloads / 181 Views
COMMENTARY
Open Access
COVID-19 control in low-income settings and displaced populations: what can realistically be done? Maysoon Dahab1* , Kevin van Zandvoort2, Stefan Flasche2, Abdihamid Warsame2, Ruwan Ratnayake2, Caroline Favas2, Paul B. Spiegel3, Ronald J. Waldman4,5 and Francesco Checchi2
Abstract COVID-19 prevention strategies in resource limited settings, modelled on the earlier response in high income countries, have thus far focused on draconian containment strategies, which impose movement restrictions on a wide scale. These restrictions are unlikely to prevent cases from surging well beyond existing hospitalisation capacity; not withstanding their likely severe social and economic costs in the long term. We suggest that in low-income countries, time limited movement restrictions should be considered primarily as an opportunity to develop sustainable and resource appropriate mitigation strategies. These mitigation strategies, if focused on reducing COVID-19 transmission through a triad of prevention activities, have the potential to mitigate bed demand and mortality by a considerable extent. This triade is based on a combination of high-uptake of community led shielding of highrisk individuals, self-isolation of mild to moderately symptomatic cases, and moderate physical distancing in the community. We outline a set of principles for communities to consider how to support the protection of the most vulnerable, by shielding them from infection within and outside their homes. We further suggest three potential shielding options, with their likely applicability to different settings, for communities to consider and that would enable them to provide access to transmission-shielded arrangements for the highest risk community members. Importantly, any shielding strategy would need to be predicated on sound, locally informed behavioural science and monitored for effectiveness and evaluating its potential under realistic modelling assumptions. Perhaps, most importantly, it is essential that these strategies not be perceived as oppressive measures and be community led in their design and implementation. This is in order that they can be sustained for an extended period of time, until COVID-19 can be controlled or vaccine and treatment options become available.
Background Modelling predictions [1] suggest that uncontrolled COVID-19 epidemics will result in 7.0 billion infections and 40 million deaths globally this year, with the impact expected to be most severe in low-income settings and forcibly displaced populations [2]. Three mechanisms could determine this: (i) higher transmissibility due to * Correspondence: [email protected] 1 Conflict & Health Research Group, King’s Centre for Global Health and Health Partnerships, King’s College London, London, UK Full list of author information is available at the end of the article
larger household sizes [3], intense social mixing [4] between the young and elderly [5], overcrowding in urban slums and displaced people’s camps, inadequate water and sanitation,
Data Loading...
