Kitara David Lagoro, Ikoona Eric Nzirakaindi
Harvard T.H. Chan School of Public health, Department of Global Health and Population, Boston, Massachusetts, United States of America.
Gulu University, Faculty of Medicine, Department of surgery, Gulu, Uganda.
Pan Afr Med J. 2020 Jul 13;36:179. doi: 10.11604/pamj.2020.36.179.24194. eCollection 2020.
As SARS-CoV-2 rapidly spread across the globe, short-term modeling forecasts provided time-critical information for containment and mitigation strategies. Global projections had so far incorrectly predicted large numbers of COVID-19 cases in Africa and that its health systems would be overwhelmed. Significantly higher COVID-19-related mortality were expected in Africa mainly because of its poor socio-economic determinants that make it vulnerable to public health threats, including diseases of epidemic potential. Surprisingly as SARS-CoV-2 swept across the globe, causing tens of thousands of deaths and massive economic disruptions, Africa has so far been largely spared the impact that threw China, USA, and Europe into chaos. To date, 42 African countries imposed lockdowns on movements and activities. Experience from around the world suggests that such interventions effectively suppressed the spread of COVID-19. However, lockdown measures posed considerable economic costs that, in turn, threatened lives, put livelihoods at risk, exacerbated poverty and the deleterious effects on cultures, health and behaviours. Consequently, there has been great interest in lockdown exit strategies that preserve lives while protecting livelihoods. Nonetheless in the last few weeks, African countries have started easing restrictions imposed to curb the spread of SARS-CoV-2. WHO recommends lifting of lockdowns should depend on the ability to contain SARS-CoV-2 and protect the public once restrictions are lifted. Yet, the greatest challenge is the critical decision which must be made in this time of uncertainties. We propose simple strategies on how to ease lockdowns in Africa based on evidence, disease dynamics, situational analysis and ability of national governments to handle upsurges.
随着严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在全球迅速传播,短期建模预测为防控和缓解策略提供了时间紧迫的信息。到目前为止,全球预测错误地预计非洲会出现大量2019冠状病毒病(COVID-19)病例,且其卫生系统将不堪重负。预计非洲与COVID-19相关的死亡率会显著更高,主要是因为其社会经济决定因素较差,使其易受公共卫生威胁影响,包括具有流行潜力的疾病。令人惊讶的是,当SARS-CoV-2席卷全球,造成数万人死亡和大规模经济混乱时,非洲迄今为止在很大程度上免受了使中国、美国和欧洲陷入混乱的影响。迄今为止,42个非洲国家对人员流动和活动实施了封锁。世界各地的经验表明,此类干预措施有效抑制了COVID-19的传播。然而,封锁措施带来了相当大的经济成本,进而威胁到生命,使生计面临风险,加剧了贫困以及对文化、健康和行为的有害影响。因此,人们对既能挽救生命又能保护生计的解封策略产生了浓厚兴趣。尽管如此,在过去几周里,非洲国家已开始放宽为遏制SARS-CoV-2传播而实施的限制措施。世界卫生组织建议,解除封锁应取决于在解除限制后控制SARS-CoV-2和保护公众的能力。然而,最大的挑战是在这个充满不确定性的时期必须做出的关键决策。我们根据证据、疾病动态、情况分析以及各国政府应对疫情激增的能力,提出了关于非洲如何放宽封锁的简单策略。
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