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Managing COVID-19 in Low- and Middle-Income Countries

Educational Objective
Review the response to COVID-19 and the association of mortality with health care resources
1 Credit CME

The public health response to coronavirus disease 2019 (COVID-19) in China has illustrated that it is possible to contain COVID-19 if governments focus on tried and tested public health outbreak responses.1,2 Isolation, quarantine, social distancing, and community containment measures were rapidly implemented. In China, patients with COVID-19 were immediately isolated in designated existing hospitals, and new hospitals were rapidly built to manage the increasing numbers of cases in the most affected areas. Home quarantine for contacts was initiated and large gatherings were canceled. Additionally, community containment for approximately 40 million to 60 million residents was instituted. A significant positive association between the incidence of COVID-19 cases and mortality was apparent in the Chinese response.3 That is, the rapid escalation in the number of infections in China had resulted in insufficient health care resources, followed by an increase in mortality.

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Article Information

Corresponding Author: Joost Hopman, MD, PhD, DTMH, Radboudumc Center for Infectious Diseases, Department of Medical Microbiology, Radboud University Medical Center, Geert Grooteplein 10, Postbus 9101, 6500 HB, Nijmegen, the Netherlands (joost.hopman@radboudumc.nl).

Published Online: March 16, 2020. doi:10.1001/jama.2020.4169

Conflict of Interest Disclosures: None reported.

Disclaimer: The opinions expressed herein reflect the collective views of the coauthors and do not necessarily represent the official position of Radboud University Medical Center, Médecins Sans Frontières, Infection Control Africa Network, or the World Health Organization. The World Health Organization takes no responsibility for the information provided or the views expressed in this article.

References
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Wu  Z, McGoogan  JM.  Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention.  JAMA. Published online February 24, 2020. doi:10.1001/jama.2020.2648PubMedGoogle Scholar
2.
Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). World Health Organization; 2020. https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
3.
Ji  Y, Ma  Z, Peppelenbosch  MP, Pan  Q.  Potential association between COVID-19 mortality and health-care resource availability.  Lancet Glob Health. Published online February 25, 2020. doi:10.1016/S2214-109X(20)30068-1PubMedGoogle Scholar
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