As of 21 October 2023, the global cumulative incidence of COVID-19 reached 771,605,835 reported cases and 6,993,755 associated deaths with a case-fatality ratio (CFR) of 0.91%. Meanwhile, the Eastern Mediterranean Region (EMR) has reported a total of 23,400,274 cases representing 3.03% of the global count, with 351,614 associated deaths (CFR 1.5%). Most countries in the Region are in the community transmission phase. This report does not represent the accurate COVID-19 burden in the EMR given that updates are not regularly received from all 22 Member States (Table 1).

Table 1: COVID-19 cases, deaths, and CFR, global and EMR, as of 21 October 2023

During the epidemiological week 42 of 2023, a total of 1,488 lab-confirmed COVID-19 cases and 50 associated deaths (CFR: 3.4%) were reported from 4 Member States: Afghanistan (283 cases and 0 death), IR Iran (1,059 cases and 50 deaths), Kuwait (28 cases and 0 death), and Morocco (136 cases and 0 death). This indicates 13% decrease and 11% increase in the number of cases and deaths respectively compared to week 41.

A total of 92,032 COVID-19 PCR tests were conducted this week in the 3 Member States (Positivity Rate: 1.62%) in week 42 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 449,879,758 (positivity rate 5.2%) since the start of the pandemic. The highest number of PCR tests were reported from the United Arab Emirates (UAE) (200,761,593; 44.7%), followed by IR Iran (57,715,428; 12.8%), and Saudi Arabia (45,484,848; 10.1%). 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 pandemic, the highest number of total cases in the Region was reported by IR Iran (7,619,981; 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 (146,480; 41.67% of the Region’s total) followed by Pakistan (30,656; 8.72%) and Tunisia (29,423; CFR 8.37%). The lowest CFRs in the region were reported by Qatar (0.13%), Bahrain (0.22), and the UAE (0.22%), while the highest CFRs were reported by Yemen (18.07%) followed by Sudan (7.89%) and Syria (5.51%) respectively.

Graph 1: Epidemiological curve of COVID-19 laboratory confirmed cases and CFR, EMR, January- October 2023

WHO Support to the Member States of the Region

The regional incident management support team (IMST) continues to coordinate the response and provide technical support to the Member States 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 to be provided across the Region. The total number of doses administered as of 21 October 2023 in the 22 Member States is 901,540,251and the average coverage of fully vaccinated population in the Region is 51%. The highest coverage rate of complete primary series was reported from the UAE (98%), followed by Qatar (97%), and Kuwait (77%) while the lowest coverage rate was reported by Yemen (3%) followed by Syria (13%) and Libya (18%), (Figure 2).

Graph 2: COVID-19 vaccine coverage by EMR Member States, October 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.