Abstract:The atmospheric pressure that decreases with altitude affects lung physiology. However, these changes in physiology are not usually considered in ventilator design and testing. We argue that high altitude human populations require special attention to access the international supply of ventilators. Humans are naturally adapted to live at low altitude. Yet,~2% of the world's population permanently live at altitudes above 2500 meters 1. The majority of these populations live in areas that are either poor, such a… Show more
“…This makes our results not generalizable to the rest of the country, because besides the higher population, the northern part of Yemen has different characteristics including lower temperature and higher altitude. Some studies suggest that different climatic conditions, including temperature and altitude may affect the transmission and mortality due to SARS-CoV-2 infections [ 37 , 38 ]. The case fatality rate is unclear, as most of the cases reported through the surveillance system were severe.…”
Introduction
Yemen was one of the last countries in the world to declare the first case of the pandemic, on 10 April 2020. Fear and concerns of catastrophic outcomes of the epidemic in Yemen were immediately raised, as the country is facing a complex humanitarian crisis. The purpose of this report is to describe the epidemiological situation in Yemen during the first 2 months of the SARS-CoV-2 epidemic.
Methods
We analyzed the epidemiological data from 18 February to 05 June 2020, including the 2 months before the confirmation of the first case. We included in our analysis the data from 10 out of 23 governorates of Yemen, located in southern and eastern part of the country.
Results
A total of 469 laboratory confirmed, 552 probable and 55 suspected cases with onset of symptoms between 18 February and 5 June 2020 were reported through the surveillance system. The median age among confirmed cases was 46 years (range: 1–90 years), and 75% of the confirmed cases were male. A total of 111 deaths were reported among those with confirmed infection. The mean age among those who died was 53 years (range: 14–88 years), with 63% of deaths (n = 70) occurring in individuals under the age 60 years. A total of 268 individuals with confirmed SARS-CoV-2 infection were hospitalized (57%), among whom there were 95 in-hospital deaths,
Conclusions
The surveillance strategy implemented in the first 2 months of the SARS CoV 2 in the southern and eastern governorates of Yemen, captured mainly severe cases. The mild and moderate cases were not self-reported to the health facilities and surveillance system due to limited resources, stigma, and other barriers. The mortality appeared to be higher in individuals aged under 60 years, and most fatalities occurred in individuals who were in critical condition when they reached the health facilities. It is unclear whether the presence of other acute comorbidities contributed to the high death rate among SARS-CoV-2 cases. The findings only include the southern and eastern part of the country, which is home to 31% of the total population of Yemen, as the data from the northern part of the country was inaccessible for analysis. This makes our results not generalizable to the rest of the country.
“…This makes our results not generalizable to the rest of the country, because besides the higher population, the northern part of Yemen has different characteristics including lower temperature and higher altitude. Some studies suggest that different climatic conditions, including temperature and altitude may affect the transmission and mortality due to SARS-CoV-2 infections [ 37 , 38 ]. The case fatality rate is unclear, as most of the cases reported through the surveillance system were severe.…”
Introduction
Yemen was one of the last countries in the world to declare the first case of the pandemic, on 10 April 2020. Fear and concerns of catastrophic outcomes of the epidemic in Yemen were immediately raised, as the country is facing a complex humanitarian crisis. The purpose of this report is to describe the epidemiological situation in Yemen during the first 2 months of the SARS-CoV-2 epidemic.
Methods
We analyzed the epidemiological data from 18 February to 05 June 2020, including the 2 months before the confirmation of the first case. We included in our analysis the data from 10 out of 23 governorates of Yemen, located in southern and eastern part of the country.
Results
A total of 469 laboratory confirmed, 552 probable and 55 suspected cases with onset of symptoms between 18 February and 5 June 2020 were reported through the surveillance system. The median age among confirmed cases was 46 years (range: 1–90 years), and 75% of the confirmed cases were male. A total of 111 deaths were reported among those with confirmed infection. The mean age among those who died was 53 years (range: 14–88 years), with 63% of deaths (n = 70) occurring in individuals under the age 60 years. A total of 268 individuals with confirmed SARS-CoV-2 infection were hospitalized (57%), among whom there were 95 in-hospital deaths,
Conclusions
The surveillance strategy implemented in the first 2 months of the SARS CoV 2 in the southern and eastern governorates of Yemen, captured mainly severe cases. The mild and moderate cases were not self-reported to the health facilities and surveillance system due to limited resources, stigma, and other barriers. The mortality appeared to be higher in individuals aged under 60 years, and most fatalities occurred in individuals who were in critical condition when they reached the health facilities. It is unclear whether the presence of other acute comorbidities contributed to the high death rate among SARS-CoV-2 cases. The findings only include the southern and eastern part of the country, which is home to 31% of the total population of Yemen, as the data from the northern part of the country was inaccessible for analysis. This makes our results not generalizable to the rest of the country.
“…Although prior studies have suggested that altitude may be a protective factor from COVID-19 (ref. 27,30-32,36-40), our analysis is the first to employ a large longitudinal database encompassing all COVID-19 cases and deaths registered in Peru through July 17, 2020 (https://www.datosabiertos.gob.pe/group/datos-abiertos-de-covid-19). In order to correct for population density, which tends to be significantly higher on the coastal lowlands, we have normalized case and death counts by population density and per million people in all districts.…”
The COVID-19 pandemic had a delayed onset in South America compared to Asia (outside of China), Europe or North America. In spite of the presumed time advantage for the implementation of preventive measures to help contain its spread, the pandemic in that region followed growth rates that paralleled, and currently exceed, those observed several weeks before in Europe. Indeed, in early August, 2020, many countries in South and Central America presented among the highest rates in the world of COVID-19 confirmed cases and deaths per million inhabitants. Here, we have taken an ecological approach to describe the current state of the pandemic in Peru and its dynamics. Our analysis supports a protective effect of altitude from COVID-19 incidence and mortality. Further, we provide circumstantial evidence that internal migration through a specific land route is a significant factor progressively overriding the protection from COVID-19 afforded by high altitude. Finally, we show that protection by altitude is independent of poverty indexes and is inversely correlated with the prevalence in the population of risk factors associated with severe COVID-19, including hypertension and hypercholesterolemia. We discuss long-term multisystemic adaptations to hypobaric hypoxia as possible mechanisms that may explain the observed protective effect of high altitude from death from COVID-19.
“…These inventory shortages have placed major strains on international diplomacy, as countries have exercised restrictions of the transport of ventilators across borders, and in some cases gone as far as resorting to the confiscation of other countries' ventilators during international transit (Kamdar, 2020 ). The developing world remains most vulnerable to these shortages (Breevoort et al, 2020 ), inspiring innovative design solutions for low cost and readily transportable ventilators from youth teams. These include ventures by US university students (Levy, 2020b ; Rusch, 2020 ), as well as a team of young engineers from India, a country with an especially sparse ventilator inventory compared to the domestic population (Biswas, 2020 ).…”
Section: Youth Network and The Covid-19 Pandemicmentioning
confidence: 99%
“…Of particular interest, is the focus youth networks have made on advocating for the attention to how regional aspects of the developing world pose specific challenges to coping with a spreading pandemic. For instance, populations living in high altitude regions such as Ethiopia, Ecuador, Bolivia, and Tibet, are sensitive to environmental conditions and physiological adaptations that influence the effectiveness of common ventilator design (Breevoort et al, 2020 ). Given the limited influence these regions have in the development of traditional health care equipment, special considerations will be necessary to design and supply ventilators capable of functioning effectively for high altitude populations.…”
Section: Youth Network and The Covid-19 Pandemicmentioning
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