Correspondence

COVID-19 gives the lie help with the response, and welcomed understanding and operation of global
sick cruise ship passengers refused health.
to global health entry by the USA. Conversations about how to do
expertise Although it is too early to assess so, although just beginning, are long
the strength of the COVID-19 overdue.
As the coronavirus disease 2019 response in Africa, African countries, I declare no competing interests.
(COVID-19) outbreak began spreading despite limited resources, have also
Sarah L Dalglish
in Europe and the USA, a chart started adopted measures worth imitating, [email protected]

Gallo Images/Getty Images

circulating online showing ratings such as simplified triage strategies3
Department of International Health, Johns Hopkins
from the 2019 Global Health Security and proactive screening (Uganda), School of Public Health, Baltimore, MD 21205, USA;
Index, an assessment of 195 countries’ handwashing stations at transport and Institute for Global Health, University College
capacity to face infectious disease hubs (Rwanda), WhatsApp chatbots London, London, UK
outbreaks, compiled by the US-based providing reliable information and 1 WHO. Critical preparedness, readiness and
response actions for COVID-19. Geneva:
Nuclear Threat Initiative and the Johns rapid testing diagnostics (Senegal), World Health Organization, 2020. Published Online
Hopkins School of Public Health’s and volunteer-staffed call centres 2 Johnson J. Economists demand Trump
March 26, 2020
https://doi.org/10.1016/
Center for Health Security. The USA and celebrity campaigns to promote immediately lift Iran, Cuba, and Venezuela
S0140-6736(20)30739-X
sanctions that are ‘feeding the coronavirus
was ranked first, and the UK second; responsible actions during the epidemic’. March 19, 2020. https://www. For the 2019 Global Health
South Korea was ranked ninth, and pandemic (Nigeria). Yet relatively little commondreams.org/news/2020/03/19/ Security Index see https://
economists-demand-trump-immediately-lift-
China 51st; most African countries has been heard on the global stage iran-cuba-and-venezuela-sanctions-are
www.ghsindex.org

were at the bottom of the ranking. about these efforts or from African (accessed March 25, 2020).
Things look different now. The US veterans of the Ebola epidemics in 3 Ayebare RR, Flick R, Okware S, Bodo B,
Lamorde M. Adoption of COVID-19 triage
and UK Governments have provided west Africa and central Africa, even strategies for low-income settings.
among the world’s worst responses though COVID-19 appears to spread in Lancet Resp Med 2020; published online
March 11. https://doi.org/10.1016/
to the pandemic, with sheer lies and similar ways—through family clusters. S2213-2600(20)30114-4.
incompetence from the former, and Is preparedness in the eye of the 4 Global Health 50/50. The Global Health 50/50
near-criminal delays and obfuscation beholder? COVID-19 is giving the lie Report 2020: power, privilege and priorities.
March, 2020. https://globalhealth5050.
from the latter. Neither country to prevailing notions of expertise and org/2020report/ (accessed March 25, 2020).
has widespread testing available, solidarity. The global health model
as strongly recommended by WHO, is based in large part on technical
alongside treatment and robust assistance and capacity building A role for CT in
contact tracing.1 In neither country do by the US, the UK, and other rich
health workers have adequate access countries, whose response has been
COVID-19? What data Published Online
to personal protective equipment; sclerotic and delayed at best. A recent really tell us so far March 26, 2020
https://doi.org/10.1016/
nor are there nearly enough hospital report by Global Health 50/50 showed S0140-6736(20)30728-5
beds to accommodate the onslaught that 85% of global organisations Radiologists have watched the
of patients. Even worse, by refusing to working in health have headquarters coronavirus disease 2019 (COVID-19)
ease sanctions against Iran, Venezuela, in Europe and North America; pandemic unfold, wondering if and
and Cuba, the US has crippled the two-thirds are headquartered in how imaging could be useful for
ability of other countries to respond, Switzerland, the UK, and the USA. 4 diagnosis. Perhaps imaging could aid
continuing to block medical supplies More than 80% of global health in screening or accelerate the speed of
and other humanitarian aid.2 leaders are nationals of high-income diagnosis, especially with shortages of
Meanwhile, Asian countries, including countries, and half are nationals of RT-PCR.
China, South Korea, Singapore, and the UK and the USA. Some radiology literature suggests
Taiwan, have provided rapid, effective, Global health will never be the a pivotal role for CT. Ai and colleagues1
and often innovative responses, thanks same after COVID-19—it cannot be. report on 1014 patients who received
in part to their recent experience with The pandemic has given the lie to the both RT-PCR and CT in Wuhan, China,
outbreaks of Middle East respiratory notion that expertise is concentrated during their epidemic. They found
syndrome in 2015 and the 2002–03 in, or at least best channelled by, that 97% of cases with RT-PCR-con­
severe acute respiratory syndrome legacy powers and historically rich firmed diagnoses had CT findings of
epidemic. China has convened hundreds states. We must move quickly, for pneumonia, and conclude, “CT imaging
of foreign officials to share lessons, and our own security, beyond the rhetoric has high sensitivity for diagnosis of Submissions should be
made via our electronic
dispatched experts, masks and other of equality to the reality of a more COVID-19”. Other investigators are submission system at
supplies to Italy and other affected democratic, more multipolar, more less optimistic. Inui and colleagues2 http://ees.elsevier.com/
countries. Cuba has also sent doctors to networked, and more distributed reviewed CT scans of 112 cases of thelancet/

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