Journal of Community Medicine & Health Care Open Access Citation: Bin-Ghouth AS and Alsheikh GYM. The COVID-19 Pandemic and Health Inequalities in Yemen. J Community Med Health Care. 2020; 5(2): 1042. J Community Med Health Care - Volume 5 Issue 2 - 2020 Submit your Manuscript | www.austinpublishinggroup.com Alsheikh et al. © All rights are reserved Abstract Background: Inequality has emerged through the nature of COVID-19; it interacts with and exacerbates existing social variations in relation to chronic disease and social determinants of health. In Yemen, data related to COVID-19 collected through the existing surveillance system has produced scarce studies impact of social inequalities and chronic diseases on pandemic outcomes. Objective: To examines how these inequalities in COVID-19 mortality, and how critical care outcomes are related to existing inequalities in relation to chronic diseases and social determinants of health in Yemen. Methods: A retrospective analysis of the available surveillance data of Yemen for the period form 10th April to 31st May 2020 which includes data of 419 confrmed COVID-19 cases. Results: Case Fatality Rate (CFR) among patients over 15 years (22.8%) was more than CFR among children but the difference is not highly signifcant; gender is not a determinant for death. CFR among COVID patients has at least one chronic disease (38.8%) which is signifcantly higher than patients who have no chronic diseases (18.6%). CFR% is varied from 42,6% in Hadramout- Mukalla to 0% and 3.8% in Al-Maharah and Aden respectively (P-value=0.000). Admission to ICU also shows geographic variations from 61.5% in Mareb to 0% in Al-Maharah, Aden, Abyan and Shabwah (P-value=0.000). Only in fve governorates respiratory ventilation was used in managing the critical cases with signifcant variations from 45% in Mareb to 3.4% in Hadramout-Mukalla. Conclusion: Chronic diseases and geographical locations are main determinants to death and critical care of COVID-19 in Yemen. Keywords: COVID-19; Health inequalities; Yemen Research Article The COVID-19 Pandemic and Health Inequalities in Yemen Bin-Ghouth AS 1 and Alsheikh GYM 2 * 1 Depatment of Community Medicine, Hadramout University College of Medicine (HUCOM), Mukalla, Hadramout, Yemen 2 WHO Collaborating Center for Public Health Education and Training, Imperial College London, UK; Former Dean of Hadramout University College of Medicine (HUCOM), Mukalla, Yemen *Corresponding author: Alsheikh GYM, WHO Collaborating Center for Public Health Education and Training, Imperial College London, UK; Former Dean of Hadramout University College of Medicine (HUCOM), Mukalla, Hadramout, Yemen Received: August 08, 2020; Accepted: September 01, 2020; Published: September 08, 2020 Abbreviations COVID-19: Coronavirus Disease 2019; HUCOM: Hadramout University College of Medicine; CFR: Case Fatality Rate; PCR: Polymerase Chain Reaction; SPSS: Statistical Package for the Social Sciences; OR: Odds Ratio; ICU: Intensive Care Unit; P- value: Probability; 2019-nCoV: 2019 Novel Coronavirus; Chronic Obstructive Pulmonary Disease (COPD); 95% CI: 95% Confdence Interval Introduction Historically, pandemics have been experienced unequally with higher rates of infection and mortality among the most disadvantaged communities and in particular, in more socially unequal countries [1,2]. In the COVID-19 pandemic, there have been claims made by politicians and the media that we are ‘all in it together’ and that the COVID-19 virus ‘does not discriminate’ [3]. Te inequalities emerge through the nature of COVID-19 as it interacts with and exacerbates the existing social inequalities in regard to the chronic disease and the social determinants of health which include age, gender and geographic location of patients. No doubt, inequalities are presented in terms of poor outcomes and in order to identify groups who are most likely to have poor outcomes, high-quality data on socioeconomic factors will have important implications in the development of public health measures. Yemen is experiencing COVID pandemic since 10th of April 2020 when the frst case was reported in Shihir near Mukalla, Hadramout [4]. Ten, cases started to spread to record a fgure of 979 suspected cases and 419 confrmed by PCR test by 31 st May 2020. As of to-date, and as far as we could trace, the impact of social inequalities and co- existing chronic diseases on the outcome of the pandemic in Yemen [5]. Te aim of this study is to examines how these inequalities related to the COVID-19 mortality, critical care outcomes in Yemen. Methods Tis is a retrospective analysis of the available surveillance data from 10 th April to 31 st May 2020. It includes data of 419 confrmed COVID-19 cases. Due to the continuing armed confict in Yemen, the southern and eastern governorates, under the control of the Yemeni government, include 10 governorates with the temporary capital of the country being stationed in Aden. A specialized COVID surveillance system has been initiated and is continuously developing and supported by the rapid response teams in an intense efort to follow the contacts [5]. Te diagnostic capacity is based on four new Polymerase Chain Reaction units (PCR units) in four main cities,