Before the COVID-19 pandemic, physical distancing behaviours were not familiar to any culture or country. Humans are social beings - used to being in direct contact with other people in public transit, in the market, in the street, when at work or when meeting our friends and loved ones. Therefore, adopting physical distancing measures will be a significant challenge for all of us.
However physical distancing behaviours may pose an even bigger challenge in low and middle income countries (LMICs). This is because:
People in LMICs may be more likely to live in environments that make physical distancing challenging. For example people in LMIC settings are more likely to have more people living in a household with them (making it harder to limit transmission if any one individual gets COVID-19) and are more likely to have intergenerational families (in some settings this may create more of a risk for vulnerable individuals - but not all). Larger proportions of the population may also live in informal settlements in urban areas or camps for displaced populations. These densely populated environments often also have lower rates of water, sanitation and hygiene access, more limited access to health care and face other chronic health challenges. Together, this means that populations living in these settings are more vulnerable to infection and may experience more severe outcomes due to reduced treatment access.
People in LMICs are more likely to be adversely affected by the secondary impacts of physical distancing measures. The closure of workplaces, schools and other services has had substantial effects on the global economy. People in LMIC settings are more likely to rely on informal sources of daily income and are therefore more likely to experience losses of income at this time. There may also be fewer formal systems to support people if there are disruptions to local markets and supply chains or disruptions to key health care services.
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Author: Eva Manzano and Sam Gil (CAWST)