%0 Journal Article %1 walker2020impact %A Walker, Patrick G. T. %A Whittaker, Charles %A Watson, Oliver J. %A Baguelin, Marc %A Winskill, Peter %A Hamlet, Arran %A Djafaara, Bimandra A. %A Cucunubá, Zulma %A Olivera Mesa, Daniela %A Green, Will %A Thompson, Hayley %A Nayagam, Shevanthi %A Ainslie, Kylie E. C. %A Bhatia, Sangeeta %A Bhatt, Samir %A Boonyasiri, Adhiratha %A Boyd, Olivia %A Brazeau, Nicholas F. %A Cattarino, Lorenzo %A Cuomo-Dannenburg, Gina %A Dighe, Amy %A Donnelly, Christl A. %A Dorigatti, Ilaria %A van Elsland, Sabine L. %A FitzJohn, Rich %A Fu, Han %A Gaythorpe, Katy A. M. %A Geidelberg, Lily %A Grassly, Nicholas %A Haw, David %A Hayes, Sarah %A Hinsley, Wes %A Imai, Natsuko %A Jorgensen, David %A Knock, Edward %A Laydon, Daniel %A Mishra, Swapnil %A Nedjati-Gilani, Gemma %A Okell, Lucy C. %A Unwin, H. Juliette %A Verity, Robert %A Vollmer, Michaela %A Walters, Caroline E. %A Wang, Haowei %A Wang, Yuanrong %A Xi, Xiaoyue %A Lalloo, David G. %A Ferguson, Neil M. %A Ghani, Azra C. %D 2020 %I American Association for the Advancement of Science %J Science %K covid-19 %N 6502 %P 413--422 %R 10.1126/science.abc0035 %T The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries %U https://science.sciencemag.org/content/369/6502/413 %V 369 %X Lower-income countries have recognized the potential impact of coronavirus disease 2019 (COVID-19) from observing ongoing epidemics. Many have intervened quickly and early with measures to slow viral transmission, which may partly explain the low rates observed so far in these countries. Walker et al. calibrated a global model with country-specific data (see the Perspective by Metcalf et al.). Despite the potentially protective effects of younger demographics, the closer intergenerational contact, limitations on health care facilities, and frequency of comorbidities in lower-income countries require sustained nonpharmaceutical interventions (NPIs) to avoid overwhelming health care capacity. As a result of strict NPIs, the protective effects of immunity will be reduced, and it will be important to improve testing capacity. Ensuring equitable provision of oxygen and—when they are ready—pharmaceutical interventions should be a global priority.Science, this issue p. 413; see also p. 368The ongoing coronavirus disease 2019 (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 intergenerational 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 resulting from 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.

@article{walker2020impact, abstract = {Lower-income countries have recognized the potential impact of coronavirus disease 2019 (COVID-19) from observing ongoing epidemics. Many have intervened quickly and early with measures to slow viral transmission, which may partly explain the low rates observed so far in these countries. Walker et al. calibrated a global model with country-specific data (see the Perspective by Metcalf et al.). Despite the potentially protective effects of younger demographics, the closer intergenerational contact, limitations on health care facilities, and frequency of comorbidities in lower-income countries require sustained nonpharmaceutical interventions (NPIs) to avoid overwhelming health care capacity. As a result of strict NPIs, the protective effects of immunity will be reduced, and it will be important to improve testing capacity. Ensuring equitable provision of oxygen and{\textemdash}when they are ready{\textemdash}pharmaceutical interventions should be a global priority.Science, this issue p. 413; see also p. 368The ongoing coronavirus disease 2019 (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 intergenerational 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 resulting from 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.}, added-at = {2021-02-21T18:33:57.000+0100}, author = {Walker, Patrick G. T. and Whittaker, Charles and Watson, Oliver J. and Baguelin, Marc and Winskill, Peter and Hamlet, Arran and Djafaara, Bimandra A. and Cucunub{\'a}, Zulma and Olivera Mesa, Daniela and Green, Will and Thompson, Hayley and Nayagam, Shevanthi and Ainslie, Kylie E. C. and Bhatia, Sangeeta and Bhatt, Samir and Boonyasiri, Adhiratha and Boyd, Olivia and Brazeau, Nicholas F. and Cattarino, Lorenzo and Cuomo-Dannenburg, Gina and Dighe, Amy and Donnelly, Christl A. and Dorigatti, Ilaria and van Elsland, Sabine L. and FitzJohn, Rich and Fu, Han and Gaythorpe, Katy A. M. and Geidelberg, Lily and Grassly, Nicholas and Haw, David and Hayes, Sarah and Hinsley, Wes and Imai, Natsuko and Jorgensen, David and Knock, Edward and Laydon, Daniel and Mishra, Swapnil and Nedjati-Gilani, Gemma and Okell, Lucy C. and Unwin, H. Juliette and Verity, Robert and Vollmer, Michaela and Walters, Caroline E. and Wang, Haowei and Wang, Yuanrong and Xi, Xiaoyue and Lalloo, David G. and Ferguson, Neil M. and Ghani, Azra C.}, biburl = {https://www.bibsonomy.org/bibtex/297b13e594d13d37eb67b6506345aa576/fordham1}, description = {The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries | Science}, doi = {10.1126/science.abc0035}, eprint = {https://science.sciencemag.org/content/369/6502/413.full.pdf}, interhash = {cefa8c0a13638c346691b196787115a0}, intrahash = {97b13e594d13d37eb67b6506345aa576}, issn = {0036-8075}, journal = {Science}, keywords = {covid-19}, number = 6502, pages = {413--422}, publisher = {American Association for the Advancement of Science}, timestamp = {2021-02-21T18:33:57.000+0100}, title = {The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries}, url = {https://science.sciencemag.org/content/369/6502/413}, volume = 369, year = 2020 }