Claim CME

Global Health

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

JAMA

April 28, 2020

Viewpoint

Article Information and Disclosures

Joost Hopman, MD, PhD, DTMH^1,2;

Benedetta Allegranzi, MD, DTMH^3,4;

Shaheen Mehtar, MBBS, MD (Lon)⁵

Author Affiliations

¹Radboudumc Center for Infectious Diseases, Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands
²Médecins Sans Frontières, Amsterdam, the Netherlands
³Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
⁴Institute of Global Health, University of Geneva, Geneva, Switzerland
⁵Infection Control Africa Network, Cape Town, South Africa

Read article on JAMA Network

Read Article Claim 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.

Claim CME

Buy This Activity

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

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.2020.2648 PubMed Google Scholar

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

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)30068-1 PubMed Google Scholar

Gates B . Responding to Covid-19: a once-in-a-century pandemic? N Engl J Med. Published online February 20, 2020. doi:10.1056/NEJMp2003762 PubMed Google Scholar

Nkengasong JN , Mankoula W . Looming threat of COVID-19 infection in Africa: act collectively, and fast. Lancet. Published online February 27, 2020. doi:10.1016/S0140-6736(20)30464-5 PubMed Google Scholar

Xie J , Tong Z , Guan X , Du B , Qiu H , Slutsky AS . Critical care crisis and some recommendations during the COVID-19 epidemic in China. Intensive Care Med. Published online March 2, 2020. doi:10.1007/s00134-020-05979-7 PubMed Google Scholar

Touray S , Sanyang B , Zandrow G , et al. An assessment of critical care capacity in the Gambia. J Crit Care. 2018;47:245-253. doi:10.1016/j.jcrc.2018.07.022 PubMed Google Scholar Crossref

Minimum requirements for infection prevention and control (IPC) programmes. World Health Organization website. Accessed March 12, 2020. https://www.who.int/infection-prevention/publications/core-components/en/

Roberts B , Patel P , McKee M . Noncommunicable diseases and post-conflict countries. Bull World Health Organ. 2012;90(1):2. doi:10.2471/BLT.11.098863 PubMed Google Scholar Crossref

10.

Kayali M , Moussally K , Lakis C , et al. Treating Syrian refugees with diabetes and hypertension in Shatila refugee camp, Lebanon: Médecins Sans Frontières model of care and treatment outcomes. Confl Health. 2019;13:12. doi:10.1186/s13031-019-0191-3 PubMed Google Scholar Crossref

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

Preparing for the Most Critically Ill Patients With COVID-19: The Potential Role of ECMO

COVID-19 in Singapore—Experience and Critical Issues That Require Attention and Action

Presumed Asymptomatic Carrier Transmission of COVID-19

The Coronavirus Disease 2019 (COVID-19) Outbreak in China—Summary of a China CDC Report

RT-PCR Test Results in Patients Recovered From COVID-19

COVID-19—New Insights on a Rapidly Changing Epidemic

Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing

Priorities for the US Health Community Responding to COVID-19

Care for Critically Ill Patients With COVID-19

Supporting the Health Care Workforce During the COVID-19 Global Epidemic

From Containment to Mitigation of COVID-19 in the US

Critical Care and the COVID-19 Outbreak in Italy: Early Experience and Forecast

Editorial Concern—Possible Reporting of the Same Patients With COVID-19 in Different Reports

The Differential Outcomes of Coronavirus Disease 2019 in Low- and Middle-Income Countries vs High-Income Countries

COVID-19 Response in Lebanon—Experiences and Challenges in a Low-Resource Setting

See More

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

Preparing for the Most Critically Ill Patients With COVID-19: The Potential Role of ECMO

COVID-19 in Singapore—Experience and Critical Issues That Require Attention and Action

Presumed Asymptomatic Carrier Transmission of COVID-19

The Coronavirus Disease 2019 (COVID-19) Outbreak in China—Summary of a China CDC Report

RT-PCR Test Results in Patients Recovered From COVID-19

COVID-19—New Insights on a Rapidly Changing Epidemic

Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing

Priorities for the US Health Community Responding to COVID-19

Care for Critically Ill Patients With COVID-19

Supporting the Health Care Workforce During the COVID-19 Global Epidemic

From Containment to Mitigation of COVID-19 in the US

Critical Care and the COVID-19 Outbreak in Italy: Early Experience and Forecast

Editorial Concern—Possible Reporting of the Same Patients With COVID-19 in Different Reports

The Differential Outcomes of Coronavirus Disease 2019 in Low- and Middle-Income Countries vs High-Income Countries

COVID-19 Response in Lebanon—Experiences and Challenges in a Low-Resource Setting

See More

See More About

If you are not a JN Learning subscriber, you can either:

A subscription to JN Learning (CME from JAMA Network) provides:

Sign in to access

If you are not a JN Learning subscriber, you can either:

Sign in to customize your interests

With a personal account, you can:

Name Your Search

Sign in to save your search

With a personal account, you can:

Lookup An Activity

My Saved Searches

Sign in to customize your interests

With a personal account, you can:

Purchase access