The coronavirus disease COVID-19 continues to spread at the regional and global levels. As of 19 November 2022, the global cumulative incidence reached 635 137 563 reported cases and 6 616 313 associated deaths at a case-fatality ratio (CFR) of 1.04%. Meanwhile, the 22 countries of the Eastern Mediterranean Region (EMR) have reported a total of 23 184 461 cases representing about 3.67% of the global count, with 348 858 associated deaths (CFR 1.50%). 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 (7 559 258; 32.60% of the Region’s total), followed by Iraq (2 462 969; 10.62%) and Jordan (1 746 997; 7.54%). Islamic Republic of Iran also reported the highest number of total COVID-19 associated deaths (144 625; CFR 1.91%), followed by Pakistan (30 630; CFR 1.94 %) and Tunisia (29 268; CFR 2.55%). The highest CFRs were reported by Yemen (18.07%), followed by Sudan (7.84%) and Syria (5.51%), while the lowest CFRs were reported by United Arab Emirates (0.23%), Bahrain (0.22) and Qatar (0.14%).

During epidemiological week 46, the Region reported a decrease in cases by 13% when compared to the previous week (9 273 cases compared to 10 663 cases). A decrease by 13% was also observed for associated deaths (49 deaths in the current week compared to 56 deaths in the previous week).

The weekly number of cases have decreased in all countries except in 6 out of 22 countries of the Region as compared to the previous week. This week the number of COVID-19 associated deaths also decreased in all countries except in one out of 22 countries of the Region as compared to the previous week.*

In terms of testing, a total of 440 070 951 laboratory tests were conducted since the start of the outbreak across the Region including 427 487 tests in week 46, which shows a 45% decrease as compared to the previous week when 780 611 tests were conducted. The highest number of PCR tests were reported from United Arab Emirates (196 616 451), followed by Islamic Republic of Iran (54 502 566) and Saudi Arabia (44 762 310). The average positivity rate for the Region is 5.27%. WHO recommends a positivity rate of around 3% to 12% as a general benchmark indicating adequate testing, which was achieved in most countries of the Region.

Meanwhile, COVID-19 vaccination continues across the Region. The total number of doses administered so far in the 22 countries is 838 741 079. Pakistan has administered the highest number of doses at 314 087 995, followed by Islamic Republic of Iran at 154 729 353 and Egypt at 100 740 657. On the other hand, Bahrain (3 475 783), Yemen (1 239 152) and Djibouti (319 920) administrated the lowest number of COVID-19 vaccine doses in the Region.**

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.

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

*Reporting on weekly relative difference instead of cumulative difference to better reflect the extent of the COVID-19 pandemic as we witness a decline in reported cases. This decline could be partially due to the change in the frequency and quality of data being shared by some countries as they moved to reporting through weekly aggregated data.

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

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