Managing COVID-19 in Low- and Middle-Income Countries

Abstract

The public health response to coronavirus disease 2019 in China has illustrated that it is possible to contain COVID-19 if governments focus on tried and tested public health outbreak responses. 1,2 Isolation, quarantine, social distancing, and community containment measures were rapidly implemented. In China, patients with COVID-19 were immediately isolated in designated existing hospitals, and new hospitals were rapidly built to manage the increasing numbers of cases in the most affected areas. Home quarantine for contacts was initiated and large gatherings were canceled. Additionally, community containment for approximately 40 million to 60 million residents was instituted. A significant positive association between the incidence of COVID-19 cases and mortality was apparent in the Chinese response. 3 That is, the rapid escalation in the number of infections in China had resulted in insufficient health care resources, followed by an increase in mortality.The association of mortality with health care resources should provide guidance for resource-limited regions on how and when to prepare for possible local outbreaks. 3 In addition, lessons learned from the 2003 severe acute respiratory syndrome coronavirus (SARS-CoV) outbreak geared toward strengthening of public health systems will be helpful. COVID-19 Preparedness in AfricaLeaders have 2 important responsibilities in times of crisis: to solve the immediate problem and keep it from happening again. 4 An African task force for coronavirus preparedness and response (AFTCOR) has been established,

Clinical features of the first cases and a cluster of Coronavirus Disease 2019 (COVID-19) in Bolivia imported from Italy and Spain

“…However, the question is if the spread occurs rapidly in the country, with communitytransmission as is now observed in other countries in the continent [72][73][74], Bolivia, as well as other low-and middle-income countries in the region, e.g. Haiti, Venezuela [75], Nicaragua, among others, will not be able to afford large-scale diagnostics [24]. Therefore, in the absence of testing, triage based on clinical case definition or presumptive diagnosis should be prioritized.…”

“…A national telehealth program is running for multiple purposes, including training on COVID-19. Albeit that, it is debatable whether countries such as Bolivia can fund the additional cost of critical care units from our limited health budgets [24,27], that need to attend not only the epidemic of COVID-19 but also other non-communicable diseases as well as communicable diseases, such as dengue, diarrhoea, malaria, HIV, tuberculosis, among many other diseases [27,75].…”

“…After its zoonotic emergence in China, during November-December 2019 [1][2][3][4][5][6][7][8], the Coronavirus Disease 2019 (COVID- 19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) [9], spread significantly into other countries in Asia [10][11][12][13][14]. Then, to other continents such as the Pacific region [15], North America [16,17], Europe [18][19][20][21][22], and even Africa [23][24][25][26].…”

Interplay of host regulatory network on SARS-CoV-2 binding and replication machinery

“…An increase in patient number increases the fatality rate because of non-specific treatment against SARS-CoV-2. Today COVID-19 became a serious threat in both developed and under-developing countries [4]. There is an urgent need to accelerate work on specific treatments to decrease disease, morbidity and mortality [5,6].…”

Early reflection on the global impact of COVID19, and implications for physiotherapy

“…An increasing number of high-income countries (HICs) have partially or completely closed borders and significantly restricted human movement with the ambition of viral containment. Meanwhile, some low and middle income (LMICs) countries with fragile infrastructure fear being unable to meet the health needs during an pandemic [1,2].…”