Health inequality among different economies during early phase of COVID-19 pandemic.
Health inequality among different economies during early phase of COVID-19 pandemic.
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DOI：
10.1186/s42506-021-00067-0
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发表时间：
2021-02-17
影响因子：
--
通讯作者：
Yuasa M
中科院分区：
文献类型：
--
作者：
Aung MN;Koyanagi Y;Yuasa M
于二零二零年一月开始于中国武汉爆发的新型冠状病毒疫情于二零二零年三月升级为地球仪大流行。它导致前所未有的发病率和震惊的卫生系统和供应链在新的震中，如意大利，西班牙和美国，夺去数千人的生命。与此同时，疫情正迅速悄无声息地蔓延到国际媒体报道较少的低收入国家，不同经济体国家在疫情期间的健康结果可能存在多大差异尚未有报道。在方法上，我们应用欧洲疾病控制中心的COVID-19全球数据（包括截至二零二零年三月三十一日的199个国家的数据），在疫情早期阶段对COVID-19死亡进行分析，比较不同收入类别国家的病死率。我们根据世界银行截至2020年的收入分类，将国家分为高收入国家（HIC），中上收入国家（UMIC），中低收入国家（LMIC）和低收入国家（LIC）。从统计学上看，不同收入组的国家在最近2周发现的新发病例和病死率方面存在显著差异（MANOVA，P值< 0.001）。在低收入国家和低收入国家，新的检测和检测到的病例数急剧上升。分析结果指出，在疫情持续期间，经济状况不同的国家之间存在重大差距。在HIC，接触者追踪、检测能力和疫情应对以及临床服务都很强。低收入国家的疫情应对能力较低，这反映在诊断检测的数量明显较少。因此，低收入国家报告的COVID-19病例数可能无法反映疫情的实际负担。如果没有有效的预防，这种流行病很容易侵入薄弱的卫生系统，给穷国的医院和临床服务造成过重负担。这一发现表明，富人和穷人之间的健康不平等正在被COVID-19大流行放大。通过地方治理和全球综合应对措施来解决这一差距，不仅可以防止前所未有的死亡，还可以保持实现可持续发展目标的势头。
The new coronavirus outbreak originated in Wuhan, China, started in January 2020 is escalating as a pandemic across the globe in March 2020. It causes unprecedented morbidity and shocked health systems and the supply chains in new epicenters such as Italy, Spain, and the USA, claiming thousands of lives. Meanwhile, the pandemic is reaching swiftly and silently to low-income countries where international media cover less. How likely health outcomes among the countries with different economies may differ during the pandemic has not been reported yet. Methodologically, we conducted an analysis of COVID-19 deaths comparing case fatality rate (CFR) among countries with different income categories, applying COVID-19 global data from the European Centre for Disease Control including 199 countries’ data as of 31 March 2020, in the early phase of the pandemic. We categorized countries into high-income countries (HIC), upper-middle-income countries (UMIC), lower-middle-income countries (LMIC), and low-income countries (LIC) according to World Bank classification by income as of 2020. Statistically, countries in different income groups are significantly different in terms of new cases identified in the last 2 weeks and the case fatality rate (MANOVA, P value < 0.001). New tests and detected case numbers shot up in HICs where CFR shot up in LMICs and LICs. The results of this analysis pointed out an important gap among countries with different economic status during the ongoing pandemic. In the HIC, contact tracing, testing capacity, and outbreak response, as well as clinical services, are strong. In the LICs, there is a low capacity of outbreak response which is reflected by the significantly lower number of diagnostic tests. Consequently, the reported number of COVID-19 cases in LICs may not reflect the actual burden of the pandemic. Without effective prevention, the pandemic can readily break into the weak health system and over-burden the hospitals and clinical services in poor countries. This finding is showing health inequality between the rich and the poor being amplified by the COVID-19 pandemic. Addressing such a gap through the local governance and integrated global responses will not only prevent unprecedented deaths, but also preserve the momentum towards Sustainable Development Goals (SDGs).
影响因子：
4.4
作者：
Pulia MS;O'Brien TP;Hou PC;Schuman A;Sambursky R
通讯作者：
Sambursky R
影响因子：
15.9
作者：
Bekerman, Elena;Neveu, Gregory;Einav, Shirit
通讯作者：
Einav, Shirit
影响因子：
168.9
作者：
Gilbert, Marius;Pullano, Giulia;Colizza, Vittoria
通讯作者：
Colizza, Vittoria