Background: COVID-19's emergence carries with it many uncertainties and challenges, including strategies to manage the epidemic. Oman has implemented non-pharmaceutical interventions (NPIs) to mitigate the impact of COVID-19. However, responses to NPIs may be different across different populations within a country with a large number of migrants, such as Oman. This study investigated the different responses to NPIs, and assessed the use of the time-varying reproduction number (R t) to monitor them. Methods: Polymerase chain reaction (PCR) laboratory-confirmed COVID-19 data for Oman, from February 24 to June 3, 2020, were used alongside demographic and epidemiological information. Data were arranged into pairs of infector-infectee, and two main libraries of R software were used to estimate reproductive number (R t). R t was calculated for both Omanis and non-Omanis. Findings: A total of 13,538 cases were included, 44.9% of which were Omanis. Among all these cases we identified 2769 infector-infectee pairs for calculating R t. There was a sharp drop in R t from 3.7 (95% confidence interval [CI] 2.8-4.6) in mid-March to 1.4 (95% CI 1.2-1.7) in late March in response to NPIs. R t then decreased further to 1.2 (95% CI 1.1-1.3) in late April after which it rose, corresponding to the easing of NPIs. Comparing the two groups, the response to major public health controls was more evident in Omanis in reducing R t to 1.09 (95% CI 0.84-1.3) by the end of March. Interpretation: Use of real-time estimation of R t allowed us to follow the effects of NPIs. The migrant population responded differently than the Omani population.

To estimate the cost of a screening program for identifying latent tuberculosis (TB) infections in migrants to Oman. Methods: A Markov model was used to estimate the cost of screening using an interferon-gamma release assay (IGRA) applied to all migrants from high TB endemic countries, followed by preventive TB treatment. Results: The model compared seven different scenarios, with a comparison of the direct cost and the quality-adjusted life-years (QALYs) saved. Conclusions: IGRA testing followed by 3 months of preventive treatment with rifapentine/isoniazid (3HP) was the most cost-effective intervention.

The purpose of this viewpoint is to summarize the advantages and constraints of the tools and strategies available for reducing the annual incidence of tuberculosis (TB) by implementing the World Health Organization (WHO) End TB Strategy and the linked WHO TB Elimination Framework, with special reference to Oman. Methods: The case-study was built based on the presentations and discussions at an international workshop on TB elimination in low incidence countries organized by the Ministry of Health, Oman, which took place from September 5 to September 7, 2019, and supported by the WHO and European Society of Clinical Microbiology and Infectious Diseases (ESCMID). Results: Existing tools were reviewed, including the screening of migrants for latent TB infection (LTBI) with interferon-gamma release assays, clinical examination for active pulmonary TB (APTB) including chest X-rays, organization of laboratory services, and the existing centres for mandatory health examination of pre-arrival or arriving migrants, including examination for APTB. The need for publicprivate partnerships to handle the burden of screening arriving migrants for active TB was discussed at length and different models for financing were reviewed. Conclusions: In a country with a high proportion of migrants from high endemic countries, screening for LTBI is of high priority. Molecular typing and the development of public-private partnerships are needed.

COVID-19 in a case previously infected with MERS-CoV: No cross immunity Dear Editor, We read with interest the recent study published in this journal suggesting the immunological cross-reactivity between common cold coronaviruses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as explanation for the reduced incidence of COVID-19 in children. 1 Immunity due to past Middle East respiratory syndrome coronavirus (MERS-CoV) exposure in the Middle East has also been proposed as a potential reason for the lower mortality with COVID-19 in comparison to experience in USA and Europe. 2 In this report, we discuss a confirmed case of COVID-19 in June 2020 in a physician who was diagnosed previously with MERS-CoV infection in February 2019. Middle East respiratory syndrome (MERS) emerged in the Ara

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