Coronavirus disease 2019 (COVID-19) has continued spreading for almost 7 months, and the case numbers continue to increase at the regional and global levels. As of 25 July 2020, 15 581 009 cases and 635 173 associated deaths with a case-fatality rate (CFR) of 4.2% have been reported globally. The 22 countries of the Eastern Mediterranean Region (EMR) have reported 1 469 983, which represent around 9.4% of the global count, with 37 483 associated deaths (CFR 2.5%). Most countries in the Region are in the community transmission phase.

During epidemiological week 30, more than 1.6 million cases were reported globally, with a new global daily record reached on Friday (286 271). The EMR reported 95 476 cases, which represents a 7% decrease when compared to the 103 165 cases reported during the previous week. The number of associated deaths showed a decrease of 9%, with 3256 deaths recorded during week 30 as compared to 3574 deaths during week 29. The majority of new cases recorded this week (73%) were reported from Saudi Arabia, Pakistan, Islamic Republic of Iran, Oman and Iraq, while the occupied Palestinian territory, Libya and Lebanon recorded the largest relative increase in deaths.

Since the beginning of the outbreak, the country in EMR that has reported the highest total number of cases is Islamic Republic of Iran (288 839 cases; 19.6% of the Region’s total), followed by Pakistan (273 113; 18.6%) and Saudi Arabia (264 973; 18%). Oman, Bahrain, Kuwait and Qatar reported the highest weekly incidence per capita (183.1, 161.2, 103.1 and 94.7 per 100 000 respectively).

Islamic Republic of Iran, which had reported a record number of daily deaths on 21 July with 229 deaths, also reported the highest number of total (cumulative) associated deaths up to week 30 (15 484; CFR 5.3%) followed by Pakistan (5822; CFR 2.1%) and Egypt (4558; CFR 4.9%). The highest CFR was reported by Yemen (28.3%) followed by Sudan (6.3%), while the lowest CFR was reported by Qatar (0.2%) followed by Bahrain (0.4%).

The estimated reproductive rate (Rt) was less than 1 during the past 2 weeks in Afghanistan, Jordan, Pakistan, Qatar and Somalia.

In terms of testing, 1 600 324 laboratory PCR tests were conducted in week 30 across the Region, which represents a 1% increase when compared to the number of tests performed during the previous week. The highest total number of PCR tests were reported from United Arab Emirates (4.8 million), followed by Saudi Arabia (2.9 million) and Islamic Republic of Iran (2.3 million). The United Arab Emirates and Bahrain are performing the highest rate of testing in terms of testing per capita (48 298/100 000 and 45 844/100 000 respectively). The average positivity rate for the Region is 8.3%. 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.

WHO has identified different indicators that would support countries to adjust the implemented public health and social measures to contain the spread of COVID-19, including indicators related to whether the epidemic is controlled, the health systems’ capacities and the maintaining of comprehensive surveillance for the disease. In week 30, Jordan reported having a comprehensive surveillance system that detected ≥50% decline in COVID-19 incidence and deaths over the last 3 weeks, with a proportion of less than 5% positive tests.

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, points of entry according to the International Health Regulations (IHR 2005), research, health systems, essential health services and others. Capacity building activities continued with the delivery of the 7th webinar for the COVID-19 Laboratory Community of Practice that focused on laboratory information management systems. A training workshop on COVID-19 clinical management with a focus on secondary bacterial infection was held for the Pakistan National Institute of Health and was attended by more than 100 medical experts. WHO has also developed and disseminated technical documents to help guide countries’ strategies and policies to manage this pandemic. Testing strategies and procurement plans were finalized for some countries including Syria and Yemen. A surge support mission to Yemen to support COVID clinical management, surveillance and response activities is underway.

Technical support and guidance on the treatment of COVID-19 waste in North East Syria was provided through the WHO Health Cluster. Rapid assessment of the impact of COVID-19 on mental health service delivery was completed for 20 countries in the Region. The mental health and psychosocial support (MHPSS) component was integrated in the national response plan in 19 countries, and a hotline/platform for remote MHPSS services was established in 17 countries to ensure continuity of specialized services.

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

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