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Therefore, its appropriateness for the LMIC context remains unknown.

This framework has not been used to analyze physical distancing policy approaches in low and middle-income countries (LMICs). A recently published Social Distancing Policy Intensity Coding Framework addresses policy specification by organizing social distancing policies according to 16 physical distancing policy domains.( 4) The framework was used to describe the physical distancing policy responses in 12 U.S. This nuanced understanding may also help guide future COVID-19 response partners identify the optimal package (or set of packages, depending on the epidemiological circumstance) of physical distancing approaches that maximizes public health benefit while minimizing social and economic harm. Understanding the differences in the timing and composition of physical distancing policies, as they were implemented in different countries in the first half of 2020, is an important first step in efforts to evaluate the early global pandemic response to COVID. The first mass physical distancing policy was implemented in Wuhan, China on January 23, 2020.( 2) On March 13, the Director General of the WHO delivered a press briefing in which he stated “The experience of China, the Republic of Korea, Singapore and others clearly demonstrates that aggressive testing and contact tracing, combined with social distancing measures and community mobilization, can prevent infections and save lives.”( 3) By the end of March, dozens of countries around the world had implemented mass physical distancing as part of a broader policy response to COVID-19, which has been referred to as “the great pause.”

On 30 January 2020, the World Health Organization (WHO) declared COVID-19 a Public Health Emergency of International Concern and six weeks later on 11 March declared COVID-19 a pandemic.( 1) In the weeks preceding the declaration, multiple countries proactively implemented various levels of mass physical distancing combined with other measures to interrupt COVID-19 transmission.