Adoption of COVID 19 triage strategies for low-income settings

Despite major advances in epidemic preparedness, Africa remains uniquely susceptible to novel coronavirus disease 2019 (COVID-19). According to the Infectious Disease Vulnerability Index,1 22 of the 25 countries most susceptible to an infectious disease outbreak are in Africa. The high prevalence of HIV, tuberculosis, and other pathogens might potentiate the severity of COVID-19 and contribute to diagnostic uncertainty. Health-care systems and human resources are already spread thin. And although the young age of the population (with more than half aged younger than 20 years) might prove protective, it also means that Africa has much to lose in terms of disabilityadjusted life years. On Feb 27, 2020, the first case of COVID-19 in sub-Saharan Africa was reported in Nigeria, making spread in the region more probable.2