The COVID-19 pandemic: diverse contexts; different epidemics—how and why?

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By Wim Van Damme, Ritwik Dahake, Alexandre Delamou, Brecht Ingelbeen, Edwin Wouters, Guido Vanham, Remco van de Pas, Jean-Paul Dossou, Por Ir, Seye Abimbola, Stefaan Van der Borght, Devadasan Narayanan, Gerald Bloom, Ian Van Engelgem, Mohamed Ali Ag Ahmed, Joël Arthur Kiendrébéogo, Kristien Verdonck, Vincent De Brouwere, Kéfilath Bello, Helmut Kloos, Peter Aaby, Andreas Kalk, Sameh Al-Awlaqi, NS Prashanth, Jean-Jacques Muyembe-Tamfum, Placide Mbala, Steve Ahuka-Mundeke, Yibeltal Assefa


It is very exceptional that a new disease becomes a true pandemic. 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. However, in different countries, the COVID-19 epidemic takes variable shapes and forms in how it affects communities. 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. But this variety of global trajectories is little described, analysed or understood. In only a few months, an enormous amount of scientific evidence on SARS-CoV-2 and COVID-19 has been uncovered (knowns). But important knowledge gaps remain (unknowns). Learning from the variety of ways the COVID-19 epidemic is unfolding across the globe can potentially contribute to solving the COVID-19 puzzle. 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. These unknowns and uncertainties require a deeper understanding of the variable trajectories of COVID-19. 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.