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WHO EMRO COVID-19 situation updates for week 38 (13 - 19 September 2020)

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The coronavirus disease COVID-19 continues to spread at the regional and global levels. As of 19 September 2020, the global cumulative incidence reached 30 369 778 reported cases and 948 795 associated deaths with a case fatality ratio (CFR) of 3.1%. Meanwhile, the 22 countries of the Eastern Mediterranean Region (EMR) have reported a total of 2 215 733 cases, which represent about 7.3% of the global count, with 57 641 associated deaths (CFR 2.6%). 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 (419 043 cases; 18.9% of the Region’s total), followed by Saudi Arabia (329 271; 14.9%) and Iraq (315 597; 14.2%). Islamic Republic of Iran also reported the highest number of total associated deaths (24 118; CFR 5.8%) followed by Iraq (8491; CFR 2.7%) and Pakistan (6416; CFR 2.1%). The highest CFRs were reported by Yemen (28.9%) followed by Sudan (6.2%), while the lowest CFRs were reported by Qatar (0.2%) followed by Bahrain (0.3%).

During epidemiological week 38, the Region reported a 6.6% increase in cases when compared to the previous week (112 740 cases compared to 105 767 cases). Similarly, a 12.9% increase was observed for associated deaths (2608 deaths compared to 2310 deaths). The weekly trend per capita showed a slight increase as compared to the previous week (303/100 000 compared to 287/100 000).

Jordan, Tunisia and Libya reported a relative increase in COVID-19 activity. The cumulative number of cases in Jordan increased from 3062 to 4540 (48% increase compared to the previous two weeks), Tunisia from 7382 to 9736 (23% increase) and Libya from 22 781 to 27 234 (20% increase). Jordan had the largest relative increase in deaths (36%) followed by occupied Palestinian territory (22%) then Lebanon, Libya and Tunisia (18% each).

In terms of testing, a total of 32 652 849 laboratory PCR tests were conducted since the start of the outbreak across the Region including 2 068 348 tests in week 38, which shows a 9% decrease compared to the previous week (2 264 062). The highest number of PCR tests were reported from United Arab Emirates (8.6 million), followed by Saudi Arabia (6 million) and Islamic Republic of Iran (3.7 million). The United Arab Emirates and Bahrain are performing the highest rate of testing per capita (87 616/100 000 and 77 810.4/100 000, respectively). The average positivity rate for the Region is 6.8%. 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.

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, points of entry according to the International Health Regulations (2005), research, health system, essential health services among others. Activities this week included:

  • providing technical support to Libya and Tunisia to scale up their testing capacities for COVID-19 and strengthening their national laboratory networks to allow timely access to testing in all parts of the countries and develop procurement and distribution plans for testing kits, reagents and other supplies for 6 months;
  • delivering the 11th webinar of the COVID-19 Laboratory Community of Practice which focused on antigen-detection in the diagnosis of COVID-19 using rapid tests, with insights from the newly published WHO interim guidance on the topic, and on the oral fluid alternative to COVID-19 diagnostics;
  • conducting technical guidance and virtual meetings to support Afghanistan, Lebanon, Sudan, United Arab Emirates and Egypt to support and maintain reproductive, maternal, newborn, child and adolescent health services; completing the surge deployment mission sent to Beirut in the aftermath of the explosion along with COVID-19 clinical management support;
  • and releasing the updated Emergency Global Supply Chain System (COVID-19) catalogue that lists all medical devices, including personal protective equipment, medical equipment, medical consumables, single use devices and laboratory and test-related devices that may be requested through the COVID-19 Supply Portal.