Promoting health and safety in traditional food markets to fight COVID-19 in Peru and Bolivia

Traditional food markets are important for the welfare and livelihoods of thousands of families in low and middle-income countries (LMICs). During the current COVID-19 pandemic, these markets have been identified as important locations for the spread of COVID-19. The establishment of control measures to reduce risk of infection in traditional food markets is an urgent need. However, it is also important that these measures are developed collaboratively with those that may be affected, taking into account the adverse effects that strict controls may have on thousands of families whose lives depend on the markets. In this proposal we build on ongoing projects in two localities of Bolivia and Peru and on requests to members of the research team to support COVID-19 response in these localities, particularly in relation to controls in markets. Our strategy to tackle this complex issue uses research methods from different disciplines such as epidemiology, microbiology and the social sciences. We will provide a program to reduce COVID-19 transmission in food markets applicable to different countries, a computer tool to simulate, in a virtual market, how changing the way the market operates can reduce risk of infection and data on the presence of antibodies and of the virus itself in people at high risk, which could help answer important pending questions about COVID-19 infection. We will also build local capacity of market sellers, regulators and university students, which will be important not only in the current COVID-19 pandemic but to face future public health emergencies.

Technical Summary

In this project we address COVID-19 control in traditional food markets, which are important hubs of community spread of COVID-19 in Peru and Bolivia and likely to play a similar role in other LMICs. Our overall aim is to prevent COVID-19 transmission in traditional food markets and we do this building on ongoing projects working with food markets of Peru and Bolivia and on recent engagements of the research team in support of COVID-19 response in these countries that have strengthened links with stakeholders. Traditional food markets are central to livelihoods in LMICs, where they play important economic and socio-cultural roles. Therefore, there is a need for risk mitigation strategies that are not only technically sound but also equitable, culturally sensitive and sustainable. We aim to design and implement such strategies through transdisciplinary collaboration that integrates local knowledge and technical expertise. Our approach includes the development and use of a risk assessment framework to identify market-specific risk mitigation strategies, the incorporation of an early detection and follow-up system to existing health services and the implementation of the risk mitigation strategies identified

in parallel to a health promotion program for sellers and their families. The program will be implemented in four markets and will include periodic clinical, serological and virological follow-up. We will also develop a probabilistic model to simulate impact of changes of market operation on risk of COVID-19 infection for buyers and sellers. Central to our work are extensive interactions with all actors transversally supported by social sciences during all stages of the project. This will allow us to agree upon the activities, develop a shared vision and a participative diagnosis and ensure effective follow up and monitoring of the integrated mitigation program.We will make extensive use of visual communication and education to display the project in mass media.