The coronavirus disease COVID-19 has been spreading for more than 7 months, and it continues to accelerate at regional and global levels. As of 15 August 2020, the global cumulative incidence reached 21 026 758 reported cases, with 755 786 associated deaths at a case-fatality ratio (CFR) of 3.6%. The 22 countries of the Eastern Mediterranean Region (EMR) have reported a total of 1 724 084 cases, which represent about 8.2% of the global count, with 45 710 associated deaths (CFR 2.7%). Most countries in the Region are in the community transmission phase.

Since the beginning of the outbreak, the country that has reported the highest number of total cases in the Region is Islamic Republic of Iran (341 070 cases; 19.8% of the Region’s total), followed by Saudi Arabia (297 315; 17.2%) and Pakistan (288 717; 16.7%). Islamic Republic of Iran also reported the highest number of total associated deaths (19 492; CFR 5.7%) followed by Pakistan (6168; CFR 2.1%) and Iraq (5785; CFR 3.4%). The highest CFR was reported by Yemen (28.4%) followed by Sudan (6.5%), while the lowest CFR was reported by Qatar (0.2%) followed by Bahrain (0.4%).

During epidemiological week 33, the Region reported an 11.5% increase when compared to the cases reported during the previous week (88 910 cases compared to 79 481 cases), while a 3% reduction was observed for associated deaths (2610 deaths compared to 2690 deaths). On the other hand, the weekly trend per capita showed slight increase as compared to the previous week (235.9 compared to 223.7/100 000).

While 61% of cases were reported from Iraq, Iran and Saudi Arabia (28.4%, 18.4% and 11.3% respectively), Libya, Syria and Lebanon reported relative increase in COVID-19 activity. The number of cases in Libya increased from 5232 to 7327 (40% increase compared to the previous week), Syria from 1125 to 1515 (35% increase) and Lebanon from 6223 to 8045 (29% increase). Lebanon, Morocco and Libya had the largest relative increase in deaths (27%, 27% and 23% respectively).

In terms of testing, a total of 22 669 012 laboratory PCR tests were conducted since the start of the outbreak across the Region including 1 837 868 tests in week 33, which showed an 25% increase as compared to the tests performed the previous week (1 473 933). The highest number of PCR tests were reported from United Arab Emirates (5.9 million), followed by Saudi Arabia (4.2 million) and Islamic Republic of Iran (2.8 million). The United Arab Emirates and Bahrain are performing the highest rate of testing per capita (59 947/100 000 and 56 555/100 000, respectively). The average positivity rate for the Region is 7.6%. 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.

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 (2005), research, health system, essential health services and others.

A surge mission to Yemen is currently underway and has developed a patient flow algorithm to organize screening, triage and referral pathways. The algorithm has been distributed and implemented across all facilities (including non-COVID-19 facilities) in the south of Yemen. The national treatment protocol for COVID-19 has also been reviewed with the ministry of health in line with WHO recommendations. To build their capacity in the systematic management of suspected COVID-19 cases, a training-of-trainers was conducted in Aden starting 9 August on screening and triage targeting non-COVID-19 health facilities. Ongoing training on ICU critical care is being conducted jointly by WHO and the ministry, which will take place next in Taizz. Gaps in current capacities and supplies have been assessed as well. In the meantime, a critical care training workshop has been developed for Afghanistan and Jordan tailored to the needs for each country.

WHO has updated the guidance on “Home care for patients with suspected or confirmed COVID-19 and management of their contacts”. The new version has considerations for clinicians when identifying and supporting patients who could receive care at home, especially with regards to infection prevention and control requirements. Clinical monitoring and waste management in those settings are also addressed. The guidance is available at this link.

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

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