The novel coronavirus that emerged in Wuhan, China, in December 2019 has leaped across borders, sending ripples around an interdependent and highly mobile global population. The virus, referred to as SARS-CoV-2, causes a disease that has been officially named COVID-19. On March 11, 2020, the Director General of the World Health Organization (WHO) declared COVID-19 a global pandemic. China has since managed to contain the virus through the use of draconian measures. However, Western Europe continues to grapple with severe outbreaks, while as of 6 April 2020 the United States (US) has over 330,000 cases, more than any other country. In New York City, the hardest hit state in the US, hospitals are barely coping with the soaring numbers of patients as supplies of personal protective equipment (PPE), ventilators and other essential equipment needed to treat patients are in short supply. On April 6, there were 1,275,856 confirmed cases and almost 70,000 deaths due to COVID-19 in 183 countries or regions globally. Given that testing rates have been poor in many countries, the true number of cases is likely to be much higher. As the virus continues to make its way around the world, the potential health impact of the pandemic in low-income countries, particularly in Africa, that already face struggling health care systems and a scarcity of skilled health workers, is of grave concern. While the pathogen’s epidemiological trajectory remains uncertain; various mathematical modelers have attempted to estimate the potential health impact of the disease. Their estimates range from 20% to 80% of the global population being infected.
There are currently no commercially available pharmaceutical interventions or vaccines to prevent infection, treat the disease or curb the pandemic. Countries are relying on behaviour change and non-pharmaceutical interventions, including, amongst others, self-isolation of symptomatic individuals; increased hand hygiene; physical distancing; working from home where possible; and school and business closure. National and local governments have closed their borders, restricting the movement of people in an attempt to contain the spread of the disease and to flatten the peak of the epidemic, with the aim of reducing the daily demand on health care resources. In the US, citizens of 40 states, along with a number of cities and counties, have been advised to stay home, while on 24 March, 1.3 billion people in India were placed under a nationwide ‘lockdown’ for 21 days.