As of 23 September 2023, the global cumulative incidence of COVID-19 reached 770,878,957 reported cases and 6,976,049 associated deaths with a case-fatality ratio (CFR) of 0.90%. Meanwhile, the Eastern Mediterranean Region (EMR) has reported a total of 23,394,156 cases representing 3.03% of the global count, with 351,465 associated deaths (CFR 1.5%). Most countries in the Region are in the community transmission phase. This report doesn’t not represent accurate COVID-19 situation in the EMR given that updates are not received from all 22 Member States regularly.

During epidemiological week 38 of 2023, a total of 1,391 lab confirmed COVID-19 cases and 23 associated deaths were reported from 3 Member States (CFR: 1.65%). This indicates a 14% decrease and 188% increase in the number of cases and deaths compared to week 37. No updates were received from 19 Member States during week 38. The weekly number of cases has decreased in all the reporting Member States except in Afghanistan which reported 12% increase in the number of cases compared to the previous week. The number of COVID-19 associated deaths increased in the two reporting states IR Iran (175%) and Afghanistan (100%) in week 38. A total of 74,197 COVID-19 laboratory tests were conducted in week 38 in 3 Member States (Positivity Rate: 1.87%) which indicates 1% increase in the number of tests compared to the previous week. This brings the cumulative number of COVID-19 laboratory tests in EMR to 449,531,579 since the start of the outbreak. The highest number of PCR tests were reported from United Arab Emirates (200,761,593; 44.7%), followed by the Islamic Republic of Iran (IR Iran) (57,388,208; 12.8%), 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 (7,616,791; 32.56% 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 (146,386; 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 as of 31 August 2023 in the 22 countries is 900,577,081 and the average coverage of fully vaccinated population in the Region is 51%. The United Arab Emirates (98%), Qatar (97%) and Kuwait (77%) has reported the highest number of completed primary series while Libya (18%), Syria (13%), and Yemen (3%) the lowest number of in the Region (Figure 2).

Figure 2: COVID-19 vaccine coverage by EMR Member States, August 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 the epidemic- and pandemic-prone diseases, as well as news on outbreak preparedness and response within WHO’s Eastern Mediterranean Region.