02670nas a2200241   4500000000100000008004100001260001200042100001200054700002000066700001400086700001400100700001600114700001200130700001500142700001500157700001400172245010300186856008800289300000700377490000700384520202300391022001402414       2020                            d  c01/20201 aDahab M1 avan Zandvoort K1 aFlasche S1 aWarsame A1 aRatnayake R1 aFavas C1 aSpiegel PB1 aWaldman RJ1 aChecchi F00aCOVID-19 control in low-income settings and displaced populations: what can realistically be done?  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393328/pdf/13031_2020_Article_296.pdf  a540 v143 a<p>COVID-19 prevention strategies in resource limited settings, modelled on the earlier response in high income countries, have thus far focused on draconian containment strategies, which impose movement restrictions on a wide scale. These restrictions are unlikely to prevent cases from surging well beyond existing hospitalisation capacity; not withstanding their likely severe social and economic costs in the long term. We suggest that in low-income countries, time limited movement restrictions should be considered primarily as an opportunity to develop sustainable and resource appropriate mitigation strategies. These mitigation strategies, if focused on reducing COVID-19 transmission through a triad of prevention activities, have the potential to mitigate bed demand and mortality by a considerable extent. This triade is based on a combination of high-uptake of community led shielding of high-risk individuals, self-isolation of mild to moderately symptomatic cases, and moderate physical distancing in the community. We outline a set of principles for communities to consider how to support the protection of the most vulnerable, by shielding them from infection within and outside their homes. We further suggest three potential shielding options, with their likely applicability to different settings, for communities to consider and that would enable them to provide access to transmission-shielded arrangements for the highest risk community members. Importantly, any shielding strategy would need to be predicated on sound, locally informed behavioural science and monitored for effectiveness and evaluating its potential under realistic modelling assumptions. Perhaps, most importantly, it is essential that these strategies not be perceived as oppressive measures and be community led in their design and implementation. This is in order that they can be sustained for an extended period of time, until COVID-19 can be controlled or vaccine and treatment options become available.</p>  a1752-1505