The COVID-19 pandemic can no longer be mitigated bya nationwide approach of individual nations alone. Given its scale and accelerating expansion, COVID-19 requires a coordinated and simultaneous Whole-of-World approach that galvanizes clear global leadership and solidarity from all governments of the world. Considering an 'all hands-on deck' concept, we present a comprehensive list of tools and entities responsible for enabling them, as well a conceptual framework to achieve the maximum impact. The list is drawn from pandemic mitigation tools developed in response to past outbreaks including influenza, coronaviruses, and Ebola, and includes tools to minimize transmission in various settings including person-to-person, crowd, funerals, travel, workplace, and events and gatherings including business, social and religious venues. Included are the roles of individuals, communities, government and other sectors such as school systems, health, institutions, and business. While individuals and communities have significant responsibilities to prevent person-to-person transmission, other entities can play a significant role to enable individuals and communities to make use of the tools. Historic and current data indicate the role of political will, whole-of-government approach, and the role of early introduction of mitigation measures. There is also an urgent need to further elucidate the immunologic mechanisms underlying the epidemiological characteristics such as the low disease burden among women, and the role of COVID-19 in inducing Kawasaki-like syndromes in children. Understanding the role of and development of anti-inflammatory strategies based on our understanding of pro-inflammatory cytokines (IL1, IL-6) is also critical. Similarly, the role of oxygen therapyas an anti-inflammatory strategy is evident and access to oxygen therapy should be prioritized to avoid the aggravation of COVID-19 infection. We highlight the need for global solidarity to share both mitigation commodities and infrastructure between countries. Given the global reach of COVID-19 and potential for repeat waves of outbreaks, we call on all countries and communities to act synergistically and emphasize the need for synchronized pan-global mitigation efforts to minimize everyone's risk, to maximize collaboration, and to commit to shared progress.

Using photo-epidemiology, we found extreme variation in COVID-19 related face covering use in Phnom Penh, Cambodia (97%); Lima, Peru (86%); Kerala, India (41%); Cuernavaca, Mexico (25%); Atlanta, USA (21%); and Kinshasa, DRC (4%) probably attributable to differences in population experience with face coverings and variations in timing and implementation of relevant advisories.

Highlights Health systems in the least developed, fragile, and conflict-affected countries (LDFCAC) are chronically underfunded and are often sustained largely by international development assistance. The perception of the impact of coronavirus disease 2019 (COVID-19) in LDFCAC populations is likely to be dwarfed by their experience with other existential threats, such as the daily need to find food for their families, violence, or even death from conflicts. LDFCAC must have access to tests, treatments, and vaccines as they become available in developed countries. As long as human mobility cannot be adequately curtailed, circulating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in LDFCAC will become a permanent threat. There is an urgent need in LDFCAC for funds to expand testing and contact-tracing, and when feasible, for the use of proximity-tracing technology and apps that allow people to self-report symptoms and confirmed infections.

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Background. The objective of this study was to describe the prevalence and clinical features of coronavirus disease 2019 (COVID-19) among children (≤18 years) evaluated for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection at a testing centre in Lagos, Nigeria. Methodology. This was a retrospective study. Data on the sociodemographic, clinical characteristics and SARS-CoV-2 results of participants at a modified drive-through centre for COVID-19 test sample collection over four months were retrieved from the electronic medical records (EMR). Data obtained were analyzed using SPSS version 22.0. Results. A total of 307 children (≤18 years) were evaluated in this review. The prevalence of SARS-CoV-2 infection among the paediatric population was 16.3%. The median age (interquartile range (IQR)) was 9 (4–14) years. Common symptoms reported by the positive cases were fever (40.0%), cough (32.9%), sore throat (17.1%), and runny nose (15.7%). The majority of the positive cases had mild symptoms. Fever and sore throat were associated with the positive cases. Conclusion. Fever and sore throat were associated with SARS-CoV-2 infection among our cohort which buttresses the need for a high level of suspicion and clinical acumen in the management of common febrile diseases in paediatric settings.