About: Long-term strategies to control COVID-19 in low and middle-income countries: an options overview of community-based, non-pharmacological interventions

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About: Long-term strategies to control COVID-19 in low and middle-income countries: an options overview of community-based, non-pharmacological interventions Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Long-term strategies to control COVID-19 in low and middle-income countries: an options overview of community-based, non-pharmacological interventions
Creator	Chowdhury, Rajiv Franco, Oscar Choudhury, Reza Khan, Nusrat Luhar, Shammi Matin, Imran Sohel, ·
Source	Medline; PMC
abstract	In low and middle-income countries (LMICs), strict social distancing measures (e.g., nationwide lockdown) in response to the COVID-19 pandemic are unsustainable in the long-term due to knock-on socioeconomic and psychological effects. However, an optimal epidemiology-focused strategy for ‘safe-reopening’ (i.e., balancing between the economic and health consequences) remain unclear, particularly given the suboptimal disease surveillance and diagnostic infrastructure in these settings. As the lockdown is now being relaxed in many LMICs, in this paper, we have (1) conducted an epidemiology-based “options appraisal” of various available non-pharmacological intervention options that can be employed to safely lift the lockdowns (namely, sustained mitigation, zonal lockdown and rolling lockdown strategies), and (2) propose suitable application, pre-requisites, and inherent limitations for each measure. Among these, a sustained mitigation-only approach (adopted in many high-income countries) may not be feasible in most LMIC settings given the absence of nationwide population surveillance, generalised testing, contact tracing and critical care infrastructure needed to tackle the likely resurgence of infections. By contrast, zonal or local lockdowns may be suitable for some countries where systematic identification of new outbreak clusters in real-time would be feasible. This requires a generalised testing and surveillance structure, and a well-thought out (and executed) zone management plan. Finally, an intermittent, rolling lockdown strategy has recently been suggested by the World Health Organization as a potential strategy to get the epidemic under control in some LMI settings, where generalised mitigation and zonal containment is unfeasible. This strategy, however, needs to be carefully considered for economic costs and necessary supply chain reforms. In conclusion, while we propose three community-based, non-pharmacological options for LMICs, a suitable measure should be context-specific and based on: (1) epidemiological considerations, (2) social and economic costs, (3) existing health systems capabilities and (4) future-proof plans to implement and sustain the strategy.
has issue date	2020-07-13(xsd:dateTime)
bibo:doi	10.1007/s10654-020-00660-1
bibo:pmid	32656618
has license	cc-by
sha1sum (hex)	bbcf94fd1591c3f7f3c6483164066698eac88774
schema:url	https://doi.org/10.1007/s10654-020-00660-1
resource representing a document's title	Long-term strategies to control COVID-19 in low and middle-income countries: an options overview of community-based, non-pharmacological interventions
has PubMed Central identifier	PMC7354877
has PubMed identifier	32656618
schema:publication	Eur J Epidemiol
resource representing a document's body	covid:bbcf94fd1591c3f7f3c6483164066698eac88774#body_text
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