Comparative evaluation of COVID-19 public health interventions and management in older populations: a scoping review and swot analysis of Cameroon and the United States

Abstract

Abstract Background The COVID-19 pandemic disproportionately affected older adults (aged 65 years and older) due to age-related physiological vulnerabilities and forced social isolation. This study systematically evaluates the public health response and management strategies executed for older populations across two highly contrasting macroeconomic and governance structures: Cameroon, a Lower-Middle Income Country (LMIC), and the United States, a High-Income Country (HIC). Methods A scoping review and structured SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis were conducted in strict accordance with the PRISMA-ScR guidelines. We systematically queried PubMed/MEDLINE, Scopus, and African Journals Online (AJOL) for peer-reviewed literature, legal acts, and official institutional frameworks published between January 2020 and February 2026. Results Twenty-two unique sources met all predefined inclusion criteria. Cameroon’s operational response drew heavily from highly decentralized, resilient community/kinship networks and immediate, government-mandated financial cushions, such as a 20% expansion in state pensions. However, these baseline mitigation efforts were severely restricted by deep structural healthcare weaknesses, a 73% fear-driven clinical avoidance rate, extreme diagnostic deficits (10.02 tests per 1,000 population), and resource constraints inside active conflict zones. Conversely, the United States leveraged massive technological capital, real-time molecular surveillance networks, and rapid mRNA vaccine rollouts that effectively averted an estimated 92% of potential deaths among older adults’ post-implementation, alongside a massive expansion of telehealth serving 59% of isolated seniors. Nevertheless, the United States response suffered from profound, catastrophic infection control failures within long-term care facilities, intense socio-political policy polarization and deep-seated institutionalized racial health inequities. Conclusion Future global pandemic preparedness frameworks must systematically integrate targeted “healthy aging” strategies directly into statutory national health policy architectures. This study demonstrates that isolated country analyses mask systemic vulnerabilities: HICs fail due to decentralization and polarization despite high GDP, while LMICs can innovate social resilience but remain strictly bottle-necked by material supply chains. Global preparedness metrics must abandon static spending indices in favor of structural equity and operational flexibility frameworks. Trial Registration Clinical trial number: not applicable.