Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Pan Afr Med J. 2021 Feb 22;38:196. doi: 10.11604/pamj.2021.38.196.25559. eCollection 2021.
The onslaught of COVID-19 pandemic has greatly overwhelmed some of the best healthcare systems in the world. Medical practitioners working in hospitals at the epicenters of COVID-19 pandemic have emphasized on the need to manage mildly ill and convalescent COVID-19 patients at home or community facilities rather than at hospitals during a pandemic. In this article, we highlight that a standardized home- and community-based (HCBC) approach for management of COVID-19 patients will be a key component for preparing hospitals in sub-Saharan Africa (SSA) for a potential surge in COVID-19 cases. So far, based on the trajectory of infection, we think that SSA seems to have a window of opportunity, albeit narrowing, for implementing HCBC. However, there are challenges that will need to be addressed in order to implement and maintain HCBC. Successful implementation and maintenance of HCBC in SSA will require international agencies and key donors to work closely with the national governments; providing them with policy, technical, and financial assistance. Home- and community-based care (HCBC) is also important because it can play a role in advocacy, education, training, and health promotion during COVID-19 pandemic. We further underscore the need for a delicate balance between HCBC and hospital-based care (HBC) approach as well as with COVID-19 mitigation and suppression measures in order to reduce the risk of SARS-CoV-2 community transmission and allow optimal continuity of the HBC. We conclude by emphasizing once again that, for countries in SSA to adequately prepare for the worst-case scenario of COVID-19 pandemic in the absence of a cure, policy makers of member states need to act collectively and fast.
新冠疫情的爆发使一些世界上最好的医疗体系不堪重负。在新冠疫情中心的医院工作的医务人员强调，在大流行期间，需要将轻度和康复期的新冠患者在家庭或社区设施中进行管理，而不是在医院进行管理。在本文中，我们强调，为新冠患者制定标准化的家庭和社区（HCBC）管理方法将是为撒哈拉以南非洲（SSA）的医院为新冠病例的潜在激增做好准备的关键组成部分。到目前为止，根据感染轨迹，我们认为 SSA 似乎有一个机会窗口，尽管这个窗口正在缩小，但要实施 HCBC。然而，为了实施和维持 HCBC，还需要解决一些挑战。要在 SSA 成功实施和维持 HCBC，国际机构和主要捐助者需要与各国政府密切合作；向他们提供政策、技术和财政援助。家庭和社区护理（HCBC）也很重要，因为它可以在大流行期间发挥倡导、教育、培训和促进健康的作用。我们进一步强调，需要在 HCBC 和基于医院的护理（HBC）方法之间以及在新冠缓解和抑制措施之间取得微妙的平衡，以降低 SARS-CoV-2 社区传播的风险，并允许 HBC 最佳地连续进行。最后，我们再次强调，为了使 SSA 国家在没有治愈方法的情况下为最坏情况下的新冠疫情做好充分准备，成员国的政策制定者需要迅速采取集体行动。
