Does One Size Fit All? Realistic Alternatives for COVID-19 Response in Low-Income Countries https://www.cgdev.org/blog/does-one-size-fit-all-realistic-alternatives-covid-19-response-low-income-countries#.XoYk22QwOAc.twitter

1. A critical policy question facing developing country policymakers is the best public health response to the worsening epidemic in their country.

2. Should they mimic the now accepted approach in rich countries? Social distancing, work from home, massive testing and shoring up household incomes and supporting enterprises?

3. @cgdev colleagues @glassmanamanda and @kchalkidou and coauthor @SullivanProf raise serious doubts. Their piece is worth reading reading. They argue:

4. Given so many households live in cramped conditions and share communal facilities, effective social distancing is unrealistic.

Work from home is not an option for majority of workforce that is engaged in day jobs or informal sector.

5. Given starting point of grossly inadequate hospitals and health facilities, no plausible ‘flattening of the curve’ will prevent overwhelmed health system capacity.

6. Many countries do not have the resources to pay idle workers to stay at home. Where they do, scaling up cash transfers should be a priority but will need to be complemented by other means to reach those not enrolled in such transfer schemes.

7. Bottom line. Economic and human consequences of lockdown strategy much larger And public health impact much less effective. Yet that thinking seems to be guiding initial design of international support packages for LMICs.

8. Urgent need instead for a public health response tailored to needs and circumstances of LMICs. One size not only doesn’t fit all, it can be positively damaging for the poorest.