26 March 2020

RIHS researcher Joost Hopman believes that low-and middle-income countries should intensify their preparedness for a possible COVID-19 outbreak. This was the core message of an opinion article that he wrote at the request of the medical journal JAMA. According to Hopman, the infection prevention standards of WHO should prevail, and good cooperation between governments and the media is required to prevent the spread of misinformation.

“We have seen in China that there is a demonstrable link between the availability of medical supplies and equipment and the mortality rate related to COVID-19: lower availability of medical resources in a country is associated with a higher mortality rate. This problem can be prevented by adhering to WHO infection prevention (IPC) standards. This concerns measures such as the timely implementation of quarantine/isolation and social distancing. It is also important to have sufficient stocks of medical devices such as respirators, and to provide protective equipment such as face masks to healthcare staff and patients. ”
“Certainly in low-income and middle-income countries, programs still need to be established to meet minimum IPC standards. The virus currently appears to be spreading mainly in the Northern Hemisphere, where it is winter. This suggests that the virus could also spread rapidly in the Southern Hemisphere when it is winter there. The low prevalence of SARS-CoV in Africa and South America in 2003 supports this hypothesis, but it has not been rigorously tested. In any case, the countries in the Southern Hemisphere now have the opportunity to prepare for a possible outbreak of COVID-19.”
Refugee camps
“The need for preventive measures is particularly high in refugee camps, many of which are located in countries with limited medical resources. Healthcare in these camps is lacking, and access is limited. Moreover, there is less monitoring of vulnerable people with conditions such as cardiovascular disease, diabetes, chronic respiratory diseases, high blood pressure and cancer. These groups are especially susceptible to COVID-19, which means that an outbreak could have disastrous consequences in these camps. ”
“A major outbreak of COVID-19 in low and middle-income countries can still be prevented if they comply with the minimum IPC standards of the WHO. In addition, good cooperation between governments and media is crucial. Accurate, concise and motivational messaging is crucial for supporting measures and legislation to prevent the spread of COVID-19.”
Managing COVID-19 in Low- and Middle-Income Countries 
Joost Hopman, MD, PhD, DTMH; Benedetta Allegranzi, MD, DTMH; Shaheen Mehtar, MBBS, MD (Lon).
JAMA: Published online March 16, 2020. doi:10.1001/jama.2020.4169

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