Evidence for significant COVID-19 community transmission in Somalia using a clinical case definition.

• Current COVID-19 surveillance strategies, as recommended by the World Health Organization (WHO), may be underestimating the real burden of the disease. • A clinical definition taking into account anosmia as a diagnostic symptom increases the sensitivity of the WHO clinical definition. • The proposed clinical definition can complement existing COVID-19 surveillance measures particularly in resource-poor settings where testing and contact tracing capacities are limited.