The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries

Abstract

The ongoing COVID-19 pandemic poses a severe threat to public health worldwide. We combine data on demography, contact patterns, disease severity, and health care capacity and quality to understand its impact and inform strategies for its control. Younger populations in lower income countries may reduce overall risk but limited health system capacity coupled with closer inter-generational contact largely negates this benefit. Mitigation strategies that slow but do not interrupt transmission will still lead to COVID-19 epidemics rapidly overwhelming health systems, with substantial excess deaths in lower income countries due to the poorer health care available. Of countries that have undertaken suppression to date, lower income countries have acted earlier. However, this will need to be maintained or triggered more frequently in these settings to keep below available health capacity, with associated detrimental consequences for the wider health, well-being and economies of these countries.

Africa's Pulse, No. 21, Spring 2020 : An Analysis of Issues Shaping Africa’s Economic Future

“…The unmitigated scenario predicts 1 billion infections and 2.4 million deaths, and the moderate suppression scenario calculates 450 million infections and 1.2 million deaths. A more aggressive suppression scenario implies 110 million infections and 300,000 deaths (Walker et al 2020). In an environment with rationed testing, widespread randomized testing of the population will help inform policy on where it is most needed.…”

Higher education institutions and the use of online instruction and online tools and resources during the COVID-19 outbreak - An online review of selected U.S. and SA's universities

“…As a non-expert in epidemiology and medical science, I will focus, in this paper, only on the higher education sector, especially on the response of this sector to the pandemic. In this regard, special attention will be paid to how certain higher education institutions (HEIs), particularly selected United States (U.S.) and South Africa universities, Amos & Howard, 2020;Germann et al, 2019;Nicola et al, 2020;Sahu, 2020;Uscher-Pines et al, 2018;Walker et al, 2020;Wang, 2020).…”

COVID-19 in unequally ageing European regions

“…We explore differences in population age structures across European NUTS-3 regions (Eurostat 2019) focusing at the crude estimate of the proportion of population expected to die due to COVID-19 (figure). We assume that 5/6 of the populations get infected (Walker et al 2020) and experience age-specific infection-fatality ratios (IFRs) modelled by the Imperial College COVID-19 Response Team (Ferguson et al 2020). We adjust IFRs by sex ratios of agespecific case-fatality ratios observed in Italy (Istituto Superiore di Sanità 2020).…”