This is in fact the case with most infectious diseases.ĭespite limited initial knowledge on COVID-19, most societies have deployed draconian measures, including lockdowns, to contain the virus and mitigate its impact. It is unique that an emerging respiratory virus becomes a pandemic, and can continue human-to-human transmission unabated, probably permanently.ĭepending on the context, the trajectory and the impact of the COVID-19 epidemic vary widely across affected countries. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, has spread to nearly all countries of the world in only a few months. Unravelling them will be important for discerning potential future scenarios, such as the first wave in virgin territories still untouched by COVID-19 and for future waves elsewhere. These unknowns and uncertainties require a deeper understanding of the variable trajectories of COVID-19. This paper tries to make sense of this variability-by exploring the important role that context plays in these different COVID-19 epidemics by comparing COVID-19 epidemics with other respiratory diseases, including other coronaviruses that circulate continuously and by highlighting the critical unknowns and uncertainties that remain. Learning from the variety of ways the COVID-19 epidemic is unfolding across the globe can potentially contribute to solving the COVID-19 puzzle. But important knowledge gaps remain (unknowns). In only a few months, an enormous amount of scientific evidence on SARS-CoV-2 and COVID-19 has been uncovered (knowns). But this variety of global trajectories is little described, analysed or understood. Until now, the insights gained on COVID-19 have been largely dominated by the COVID-19 epidemics and the lockdowns in China, Europe and the USA. However, in different countries, the COVID-19 epidemic takes variable shapes and forms in how it affects communities. Since its emergence in Wuhan, China, in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, has spread to nearly all countries of the world in only a few months. It is very exceptional that a new disease becomes a true pandemic. Correspondence to Professor Wim Van Damme wvdammeitg.be.25 School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.24 Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo.23 Health Equity Cluster, Institute of Public Health, Bengaluru, India.22 Center for International Health Protection, Robert Koch Institute, Berlin, Germany.21 Bureau GIZ à Kinshasa, Kinshasa, Democratic Republic of Congo.20 INDEPTH Network, Bandim Health Project, Bissau, Guinea-Bissau.19 Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.18 Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany.17 Public Health, University of Ouagadougou Health Sciences Training and Research Unit, Ouagadougou, Burkina Faso.16 University of Sherbrooke, Sherbrooke, Quebec, Canada.15 European Commission Directorate General for Civil Protection and Humanitarian Aid Operations, Kinshasa, Democratic Republic of Congo.14 Health and Nutrition Cluster, Institute of Development Studies, Brighton, UK.13 Health Systems Transformation Platform, New Delhi, India.12 Board Member, Institute of Tropical Medicine, Antwerpen, Belgium.11 The George Institute for Global Health, Sydney, New South Wales, Australia.10 School of Public Health, University of Sydney, Sydney, New South Wales, Australia.9 National Institute of Public Health, Phnom Penh, Cambodia.
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5 Centre for Health Systems Research and Development, University of the Free State-Bloemfontein Campus, Bloemfontein, Free State, South Africa.4 Department of Sociology and Centre for Population, University of Antwerp, Antwerpen, Belgium.
3 Africa Centre of Excellence for Prevention and Control of Transmissible Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea.2 Independent Researcher, Bengaluru, India.1 Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium.
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