medRxiv preprint doi: https://doi.org/10.1101/2020.07.01.20144113; this version posted July 2, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license . 1 Community vulnerability to epidemics in Nepal: A high-resolution 2 spatial assessment amidst COVID-19 pandemic 3 Laxman Khanal1 | Binod Kumar Paudel2 | Bipin Kumar Acharya31 4 1 Central Department of Zoology, Institute of Science and Technology, Tribhuvan University, 5 Kathmandu, Nepal 6 2 Communication University of China, Beijing, PRC 7 3 Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 8 China 9 * Correspondence:
[email protected] 10 Abstract 11 The coronavirus disease 19 (COVID-19), the biggest health problem at present, doesn’t have 12 uniform transmission and severity among the countries and communities therein. Knowledge 13 of community vulnerability to the disease would facilitate interventions aimed at transmission 14 control by the efficient deployment of available limited resources. Therefore, we assessed 15 spatial variations and heterogeneity of disease vulnerability among the population in 753 16 municipal units of Nepal. We collected geospatial indicators representing the domain of 17 socioeconomic inequalities, population dynamics, heterogeneity in accessibility and the 18 information related to underlying health condition which potentially affect the severity of 19 COVID-19 transmission. Those indicators were assembled to create three vulnerability indices 20 using Geographic Information System (GIS); Social Vulnerability Index (SVI), 21 Epidemiological Vulnerability Index (EVI) and a composite of the two- Social and 22 Epidemiological Vulnerability Index (SEVI).