Safe Reopening Following Generalized Lockdowns: A Strategy Based on Evidence from 24 Worldwide Countries

2021 ◽  
Author(s):  
Abu S. Shonchoy ◽  
Khandker S. Ishtiaq ◽  
Sajedul Talukder ◽  
Nasar U. Ahmed ◽  
Rajiv Chowdhury
Keyword(s):  
Low Income ◽  
Large Scale ◽  
Simulation Analysis ◽  
Epidemiological Data ◽  
World Health ◽  
Optimal Timing ◽  
Middle Income ◽  
Capacity Limits ◽  
Positive Rate ◽  
Health Organization

Abstract While the effectiveness of lockdowns to reduce Coronavirus Disease-2019 (COVID-19) transmission is well established, uncertainties remain on the lifting principles of these restrictive interventions. World Health Organization recommends case positive rate of 5% or lower as a threshold for safe reopening. However, inadequate testing capacity limits the applicability of this recommendation, especially in the low-income and middle-income countries (LMICs). To develop a practical reopening strategy for LMICs, in this study, we first identify the optimal timing of safe reopening by exploring accessible epidemiological data of 24 countries during the initial COVID-19 surge. We find that safely reopening requires a two-week waiting period, after the crossover of daily infection and recovery rates – coupled with a post-crossover continuous negative trend in daily new cases. Epidemiologic SIRM model-based simulation analysis validates our findings. Finally, we develop an easily interpretable large-scale reopening (LSR) index, which is an evidence-based toolkit – to guide/inform the reopening decisions for LMICs.

scholarly journals A novel index-based decision support toolkit for safe reopening following a generalized lockdown in low and middle-income countries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Abu S. Shonchoy ◽  
Khandker S. Ishtiaq ◽  
Sajedul Talukder ◽  
Nasar U. Ahmed ◽  
Rajiv Chowdhury
Keyword(s):  
Low Income ◽  
Large Scale ◽  
Epidemiological Data ◽  
World Health ◽  
Optimal Timing ◽  
Middle Income ◽  
Capacity Limits ◽  
Middle Income Countries ◽  
Positive Rate ◽  
Health Organization

AbstractWhile the effectiveness of lockdowns to reduce Coronavirus Disease-2019 (COVID-19) transmission is well established, uncertainties remain on the lifting principles of these restrictive interventions. World Health Organization recommends case positive rate of 5% or lower as a threshold for safe reopening. However, inadequate testing capacity limits the applicability of this recommendation, especially in the low-income and middle-income countries (LMICs). To develop a practical reopening strategy for LMICs, in this study, we first identify the optimal timing of safe reopening by exploring accessible epidemiological data of 24 countries during the initial COVID-19 surge. We find that a safe opening can occur two weeks after the crossover of daily infection and recovery rates while maintaining a negative trend in daily new cases. Epidemiologic SIRM model-based example simulation supports our findings. Finally, we develop an easily interpretable large-scale reopening (LSR) index, which is an evidence-based toolkit—to guide/inform reopening decision for LMICs.

scholarly journals The burden of serious health-related suffering among cancer decedents: Global projections study to 2060

2020 ◽  
pp. 026921632095756
Author(s):  
Katherine E Sleeman ◽  
Barbara Gomes ◽  
Maja de Brito ◽  
Omar Shamieh ◽  
Richard Harding
Keyword(s):  
Palliative Care ◽  
Low Income ◽  
Population Based ◽  
World Health ◽  
Low Income Countries ◽  
Cancer Type ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Related ◽  
Health Organization

Background: Palliative care improves outcomes for people with cancer, but in many countries access remains poor. Understanding future needs is essential for effective health system planning in response to global policy. Aim: To project the burden of serious health-related suffering associated with death from cancer to 2060 by age, gender, cancer type and World Bank income region. Design: Population-based projections study. Global projections of palliative care need were derived by combining World Health Organization cancer mortality projections (2016–2060) with estimates of serious health-related suffering among cancer decedents. Results: By 2060, serious health-related suffering will be experienced by 16.3 million people dying with cancer each year (compared to 7.8 million in 2016). Serious health-related suffering among cancer decedents will increase more quickly in low income countries (407% increase 2016–2060) compared to lower-middle, upper-middle and high income countries (168%, 96% and 39% increase 2016-2060, respectively). By 2060, 67% of people who die with cancer and experience serious health-related suffering will be over 70 years old, compared to 47% in 2016. In high and upper-middle income countries, lung cancer will be the single greatest contributor to the burden of serious health-related suffering among cancer decedents. In low and lower-middle income countries, breast cancer will be the single greatest contributor. Conclusions: Many people with cancer will die with unnecessary suffering unless there is expansion of palliative care integration into cancer programmes. Failure to do this will be damaging for the individuals affected and the health systems within which they are treated.

scholarly journals COVID-19, an Opportunity for Developing Countries?

2020 ◽  
Vol 8 ◽  
Author(s):  
Lee Smith ◽  
Nicola Veronese ◽  
Vincenzo Racalbuto ◽  
Damiano Pizzol
Keyword(s):  
Low Income ◽  
Large Scale ◽  
World Health ◽  
Low Income Countries ◽  
Prevention Measures ◽  
Viral Reservoirs ◽  
Case Scenario ◽  
Worst Case ◽  
Global Pandemic ◽  
Health Organization

The COVID-19 outbreak was declared by the World Health Organization (WHO) as global pandemic in March 2020. Considering the necessity to implement rapid response to control the pandemic and the fragility and the state of need of low income countries, it will be mandatory to develop a global approach in order to reduce the spread of infection and the creation of community viral reservoirs. So far, we could hypothesize a worst case scenario in which when the COVID-19 outbreak hits a peak in Africa and in low-income countries, the majority of such countries will be unprepared, with low resources allocated for affording the viral emergency and the consequences will be catastrophic with no lesson learnt. In the best case scenario, the COVID-19 will not affect Africa or South America on a large scale and, if the prevention measures will be implemented, we could register a lower incidence of hygiene linked diseases that still represent leading causes of death.

scholarly journals Influence of important environmental parameters on the spread and severity of COVID-19: Part 1

2020 ◽  
pp. 1-12
Author(s):  
Vikrant Tiwari ◽  
Nimisha Sharma
Keyword(s):  
Large Scale ◽  
Environmental Parameters ◽  
Large Data ◽  
Epidemiological Data ◽  
Good Health ◽  
World Health ◽  
Data Set ◽  
Contagious Diseases ◽  
Health Organization ◽  
High Degree

In the absence of the detailed COVID-19 epidemiological data or large benchmark studies, an effort has been made to explore and correlate the relation of parameters like environment, economic indicators, and the large scale exposure of different prevalent diseases, with COVID-19 spread and severity amongst the different countries affected by COVID-19. Data for environmental, socio-economic and others important infectious diseases were collected from reliable and open source resources like World Health Organization, World Bank, etc. Further, this large data set is utilized to understand the COVID-19 worldwide spread using simple statistical tools. Important observations that are made in this study are the high degree of resemblance in the pattern of temperature and humidity distribution among the cities severely affected by COVID-19. Further, It is surprising to see that in spite of the presence of many environmental parameters that are considered favorable (like clean air, clean water, EPI, etc.), many countries are suffering with the severe consequences of this disease. Lastly a noticeable segregation among the locations affected by different prevalent diseases (like Malaria, HIV, Tuberculosis, and Cholera) was also observed. Among the considered environmental factors, temperature, humidity and EPI should be an important parameter in understanding and modelling COVID-19 spreads. Further, contrary to intuition, countries with strong economies, good health infrastructure and cleaner environment suffered disproportionately higher with the severity of this disease. Therefore, policymaker should sincerely review their country preparedness toward the potential future contagious diseases, weather natural or manmade.

scholarly journals Intellectual disability in India: the evolving patterns of care

2011 ◽  
Vol 8 (2) ◽  
pp. 29-31
Author(s):  
Satish Chandra Girimaji
Keyword(s):  
Intellectual Disability ◽  
Urban Areas ◽  
Epidemiological Data ◽  
World Health ◽  
Indian Literature ◽  
Middle Income ◽  
The Past ◽  
History Of ◽  
Health Organization ◽  
Government Benefits

Intellectual disability was recognised in ancient Indian literature, but organised services have a history of just five decades. India shares many features of low- and middle-income (LAMI) countries regarding intellectual disability. There is a low level of awareness about its nature, causes and interventions. One can come across many superstitions, myths and misconceptions about intellectual disability. In general, services are inadequate, being concentrated in big cities and urban areas. There is generally limited access to support services and few government benefits, and these, in any case, are often of little value (World Health Organization, 2007). Locally and nationally, there are few relevant and reliable epidemiological data on the prevalence of intellectual disability. However, there have been some positive developments within the past three decades, and they are the focus of this paper.

scholarly journals The cross-national epidemiology of specific phobia in the World Mental Health Surveys

2017 ◽  
Vol 47 (10) ◽  
pp. 1744-1760 ◽  
Author(s):  
K. J. Wardenaar ◽  
C. C. W. Lim ◽  
A. O. Al-Hamzawi ◽  
J. Alonso ◽  
L. H. Andrade ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Epidemiological Data ◽  
Specific Phobia ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Co Morbidity ◽  
The World ◽  
Health Organization ◽  
Cross National

BackgroundAlthough specific phobia is highly prevalent, associated with impairment, and an important risk factor for the development of other mental disorders, cross-national epidemiological data are scarce, especially from low- and middle-income countries. This paper presents epidemiological data from 22 low-, lower-middle-, upper-middle- and high-income countries.MethodData came from 25 representative population-based surveys conducted in 22 countries (2001–2011) as part of the World Health Organization World Mental Health Surveys initiative (n = 124 902). The presence of specific phobia as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition was evaluated using the World Health Organization Composite International Diagnostic Interview.ResultsThe cross-national lifetime and 12-month prevalence rates of specific phobia were, respectively, 7.4% and 5.5%, being higher in females (9.8 and 7.7%) than in males (4.9% and 3.3%) and higher in high- and higher-middle-income countries than in low-/lower-middle-income countries. The median age of onset was young (8 years). Of the 12-month patients, 18.7% reported severe role impairment (13.3–21.9% across income groups) and 23.1% reported any treatment (9.6–30.1% across income groups). Lifetime co-morbidity was observed in 60.5% of those with lifetime specific phobia, with the onset of specific phobia preceding the other disorder in most cases (72.6%). Interestingly, rates of impairment, treatment use and co-morbidity increased with the number of fear subtypes.ConclusionsSpecific phobia is common and associated with impairment in a considerable percentage of cases. Importantly, specific phobia often precedes the onset of other mental disorders, making it a possible early-life indicator of psychopathology vulnerability.

scholarly journals Recruitment of consultant psychiatrists from low- and middle-income countries

2004 ◽  
Vol 1 (6) ◽  
pp. 15-18 ◽  
Author(s):  
David Ndetei ◽  
Salman Karim ◽  
Malik Mubbashar
Keyword(s):  
Low Income ◽  
Health Sector ◽  
World Health ◽  
Low Income Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Fellowship Programme ◽  
Health Organization ◽  
Rich Countries ◽  
Low And Middle Income

The UK's 2-year International Fellowship Programme for consultant doctors has inadvertently highlighted the long-standing issues of the costs and benefits of such recruitment for the countries of origin, and of whether it is ethical for rich countries to recruit health personnel not only from other rich countries but also from low- and middle-income countries. The ‘brain drain’ from poor to rich countries has been recognised for decades; it occurs in the health sector as well as other sectors, such as education, science and engineering. It has had serious ramifications for the health service infrastructure in low-income countries, where poverty, morbidity, disability and mortality are increasing rather than decreasing, and it is a matter of serious concern for both the World Health Organization and the International Monetary Fund (Carrington & Detragiache, 1998; Lee, 2003).

scholarly journals Mitotic Poisons in Research and Medicine

Molecules ◽  
2020 ◽  
Vol 25 (20) ◽  
pp. 4632 ◽  
Author(s):  
Jan Škubník ◽  
Michal Jurášek ◽  
Tomáš Ruml ◽  
Silvie Rimpelová
Keyword(s):  
Low Income ◽  
Cancer Therapeutics ◽  
Modern Medicine ◽  
World Health ◽  
Low Income Countries ◽  
Cancer Therapies ◽  
Middle Income ◽  
Treatment Services ◽  
The World ◽  
Health Organization

Cancer is one of the greatest challenges of the modern medicine. Although much effort has been made in the development of novel cancer therapeutics, it still remains one of the most common causes of human death in the world, mainly in low and middle-income countries. According to the World Health Organization (WHO), cancer treatment services are not available in more then 70% of low-income countries (90% of high-income countries have them available), and also approximately 70% of cancer deaths are reported in low-income countries. Various approaches on how to combat cancer diseases have since been described, targeting cell division being among them. The so-called mitotic poisons are one of the cornerstones in cancer therapies. The idea that cancer cells usually divide almost uncontrolled and far more rapidly than normal cells have led us to think about such compounds that would take advantage of this difference and target the division of such cells. Many groups of such compounds with different modes of action have been reported so far. In this review article, the main approaches on how to target cancer cell mitosis are described, involving microtubule inhibition, targeting aurora and polo-like kinases and kinesins inhibition. The main representatives of all groups of compounds are discussed and attention has also been paid to the presence and future of the clinical use of these compounds as well as their novel derivatives, reviewing the finished and ongoing clinical trials.

scholarly journals Price, availability and affordability of medicines

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Brenda S. Mhlanga ◽  
Fatima Suleman
Keyword(s):  
Supply Chain ◽  
Public Sector ◽  
Low Income ◽  
Essential Medicines ◽  
World Health ◽  
Middle Income ◽  
Originator Brand ◽  
Private And Public ◽  
Daily Wage ◽  
Health Organization

Background: Medicines play an important role in healthcare, but prices can be a barrier to patient care. Few studies have looked at the prices of essential medicines in low- and middle-income countries in terms of patient affordability.Aim: To determine the prices, availability and affordability of medicines along the supply chain in Swaziland.Setting: Private- and public-sector facilities in Manzini, Swaziland.Methods: The standardised methodology designed by the World Health Organization and Health Action International was used to survey 16 chronic disease medicines. Data were collected in one administrative area in 10 private retail pharmacies and 10 public health facilities. Originator brand (OB) and lowest-priced generic equivalent (LPG) medicines were monitored and these prices were then compared with international reference prices (IRPs). Affordability was calculated in terms of the daily wage of the lowest-paid unskilled government worker.Results: Mean availability was 68% in the public sector. Private sector OB medicines were priced 32.4 times higher than IRPs, whilst LPGs were 7.32 times higher. OBs cost473% more than LPGs. The total cumulative mark-ups for individual medicines range from 190.99% – 440.27%. The largest contributor to add-on cost was the retail mark-up (31% – 53%). Standard treatment with originator brands cost more than a day’s wage.Conclusion: Various policy measures such as introducing price capping at all levels of the medicine supply chain, may increase the availability, whilst at the same time reducing the prices of essential medicines for the low income population.

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