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

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Walker, Patrick G. T., Whittaker, Charles, Watson, Oliver J, Baguelin, Marc, Winskill, Peter, Hamlet, Arran, Djafaara, Bimandra A., Cucunubá, Zulma, Olivera Mesa, Daniela, Green, Will, Thompson, Hayley, Nayagam, Shevanthi, Ainslie, Kylie E. C., Bhatia, Sangeeta, Bhatt, Samir, Boonyasiri, Adhiratha, Boyd, Olivia, Brazeau, Nicholas F., Cattarino, Lorenzo, Cuomo-Dannenburg, Gina, Dighe, Amy, Donnelly, Christl A., Dorigatti, Ilaria, van Elsland, Sabine L., FitzJohn, Rich, Fu, Han, Gaythorpe, Katy A.M., Geidelberg, Lily, Grassly, Nicholas, Haw, David, Hayes, Sarah, Hinsley, Wes, Imai, Natsuko, Jorgensen, David, Knock, Edward, Laydon, Daniel, Mishra, Swapnil, Nedjati-Gilani, Gemma, Okell, Lucy C., Unwin, H. Juliette, Verity, Robert, Vollmer, Michaela, Walters, Caroline E., Wang, Haowei, Wang, Yuanrong, Xi, Xiaoyue, Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200, Ferguson, Neil M. and Ghani, Azra C. (2020) 'The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries'. Science, Vol 369, Issue 6502, pp. 413-422.

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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.

Item Type: Article
Subjects: WA Public Health > WA 105 Epidemiology
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 505 Viral respiratory tract infections
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1126/science.abc0035
Depositing User: Stacy Murtagh
Date Deposited: 16 Jun 2020 09:55
Last Modified: 03 Sep 2020 13:12
URI: https://archive.lstmed.ac.uk/id/eprint/14763

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