As of 9 September 2023, the global cumulative incidence of COVID-19 reached 770,699,648 reported cases and 6,974,827 associated deaths with a case-fatality ratio (CFR) of 0.90%. Meanwhile, the Eastern Mediterranean Region (EMR) has reported a total of 23,391,147 cases representing 3.04% of the global count, with 351,434 associated deaths (CFR 1.5%). Most countries in the Region are in the community transmission phase. This report doesn’t represent an accurate COVID-19 situation in the EMR given that updates are not received from all 22 Member States regularly.

During epidemiological week 36 of 2023, a total of 1,462 lab-confirmed COVID-19 cases and 26 associated deaths were reported from 4 Member States (CFR: 1.78%). This indicates a 112% and 271% increase in the number of cases and deaths compared to week 35. No updates were received from 18 Member States during week 36. The weekly number of cases has increased in all the reporting Member States except in Afghanistan which reported a 13% decrease in the number of cases compared to the previous week. The number of COVID-19-associated deaths increased in IR Iran (67%) however, Afghanistan reported no change in the number of COVID-19-associated deaths in week 36. A total of 85,663 COVID-19 laboratory tests were conducted in week 36 in 3 Member States (Positivity Rate: 1.71%) which indicates a 209% increase in the number of tests compared to the previous week. This brings the cumulative number of COVID-19 laboratory tests in EMR to 449,383,944 since the start of the outbreak. The highest number of PCR tests were reported from the United Arab Emirates (200,761,593; 44.7%), followed by the Islamic Republic of Iran (IR Iran) (57,111,210; 12.7%), and Saudi Arabia (45,484,848; 10.1%). The average positivity rate for the Region in 2022 is 4.1% (ranging from 0.3%-10.9%). WHO recommends a positivity rate of around 3–12% as a general benchmark indicating adequate testing, which was achieved in most countries of the Region.

Since the beginning of the outbreak, the country that has reported the highest number of total cases in the Region is IR Iran (7614729; 32.55% of the Region’s total), followed by Iraq (2,465,545; 10.54%) and Jordan (1,746,997; 7.47%). IR Iran also reported the highest number of total COVID-19-associated deaths (146,356; CFR 1.92%) followed by Pakistan (30,656; CFR 1.94 %) and Tunisia (29,423; CFR 2.55%). The lowest CFRs were reported by the United Arab Emirates (0.22%), Bahrain (0.22), and Qatar (0.13%) while the highest CFRs were reported by Yemen (18.07%) followed by Sudan (7.89%) and Syria (5.51%) respectively.

Figure 1: Epidemiological curve of COVID-19 laboratory confirmed cases and CFR, EMR, February 2020- September 2023

Supporting countries in the Region

The regional incident management support team continues to coordinate the response and provide technical support to countries and partners in the Region in the areas of coordination and partnership, surveillance, laboratory capacity, clinical management, infection prevention and control, risk communication, and community engagement, points of entry according to the International Health Regulations (2005), research, health systems, and essential health services among others. Furthermore, COVID-19 vaccination continues across the Region. The total number of doses administered so far in the 22 countries is 900,577,081 and the average coverage of the fully vaccinated population in the Region is 51%. The United Arab Emirates (98%), Qatar (97%), and Kuwait (77%) have reported the highest number of completed primary series while Libya (18%), Syria (13%), and Yemen (3%) are the lowest number of in the Region (Figure 2).

Figure 2: COVID-19 vaccine coverage by EMR Member States, September 2023

For more data from the Region, please visit the COVID-19 dashboard.

*The data on vaccination is obtained from several sources including media reports and country websites for ministries of health.

* We are currently reporting on weekly relative differences instead of cumulative differences to better reflect the extent of the COVID-19 pandemic as we are witnessing a decline in the reported cases. In addition, to a change in the frequency and quality of data sharing, countries started to move to weekly aggregate data, and less information is shared by countries. Subscribe to the monthly infectious hazard preparedness newsletter of WHO’s Health Emergencies Programme for the latest data and analysis on epidemic- and pandemic-prone diseases, as well as news on outbreak preparedness and response within WHO’s Eastern Mediterranean Region.