COVID-19 in Low- and Middle-Income Countries (LMICs): A Narrative Review from Prevention to Vaccination Strategy

The management of the COVID-19 pandemic represents a challenging process, especially for low- and middle-income countries (LMICs) due to the serious economic and health resource problems it generates. In this article, we assess COVID-19 situation in LMICs and outline emerging problems and possible solutions. The prevention and control of COVID-19 would be based on focused tests exploiting those systems (e.g., GeneXpert(®)) already used in other scenarios. This would be less stressful for the healthcare system in LMICs. Avoiding close contact with people suffering from acute respiratory infections, frequent handwashing, and avoiding unprotected contact with farm or wild animals are recommended infection control interventions. The appropriate use of personal protective equipment (PPE) is required, despite its procurement being especially difficult in LMICs. Patients’ triage should be based on a simple and rapid logarithm to decide who requires isolation and targeted testing for SARS-CoV-2. Being able to estimate which patients will develop severe disease would allow hospitals to better utilize the already limited resources more effectively. In LMICs, laboratories are often in the capital cities; therefore, early diagnosis and isolation become difficult. The number of ICU beds is often insufficient, and the equipment is often old and poorly serviced. LMICs will need access to COVID-19 treatments at minimal prices to ensure that all who need them can be treated. Year-to-date, different vaccines have been approved and are currently available. The main obstacle to accessing them is the limited ability of LMICs to purchase significant quantities of the vaccine.