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WHO EMRO COVID-19 situation updates for week 43 (18-24 October 2020)

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The coronavirus disease COVID-19 continues to spread at the regional and global levels. As of 24 October 2020, the global cumulative incidence reached 42 055 863 reported cases and 1 141 567 associated deaths with a case fatality ratio (CFR) of 2.7%. Meanwhile, the 22 countries of the Eastern Mediterranean Region (EMR) have reported a total of 2 908 574 cases, which represent about 6.9% of the global count, with 73 848 associated deaths (CFR 2.5%). 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 (562 705 cases; 19.3% of the Region’s total), followed by Iraq (449 153; 15.4%) and Saudi Arabia (327 056; 11.2%). Islamic Republic of Iran also reported the highest number of total associated deaths (32 320; CFR 5.7%) followed by Iraq (10 568; CFR 2.4%) and Pakistan (6727; CFR 2.1%). The highest CFRs were reported by Yemen (29.1%) followed by Sudan (6.1%), while the lowest CFRs were reported by Qatar (0.2%) followed by Bahrain and United Arab Emirates (0.4% each).

During epidemiological week 43, the Region reported a 10.3% increase in cases when compared to the previous week (157 714 cases compared to 143 044 cases). Similarly, a 13.5% increase was observed for associated deaths (3981 deaths compared to 3508 deaths). The weekly trend per capita showed a slight increase as compared to the previous week (398/100 000 compared to 376/100 000).

Jordan, Tunisia and Lebanon reported a relative increase in COVID-19 activity. The cumulative number of cases in Jordan increased from 36 053 to 50 750 (41% increase compared to the previous weeks), Tunisia from 40 542 to 48 799 (20% increase) and Lebanon from 60 947 to 69 906 (15% increase). Jordan had the largest relative increase in deaths (64%) followed by Tunisia (31%) and Morocco (11%).

In terms of testing, a total of 43 877 133 laboratory PCR tests were conducted since the start of the outbreak across the Region including 2 280 651 tests in week 43, which shows a 2% decrease compared to the previous week (2 336 857). The highest number of PCR tests were reported from United Arab Emirates (12.3 million), followed by Saudi Arabia (7.7 million) and Islamic Republic of Iran (4.7 million). The United Arab Emirates and Bahrain are performing the highest rate of testing per capita (124 845/100 000 and 98 664/100 000, respectively). The average positivity rate for the Region is 6.6%. 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.

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. Activities this week included:

  • holding the 13th webinar of the COVID-19 laboratory community of practice that took place on 14 Oct 2020 to discuss biosafety considerations for testing of SARS-CoV-2 infections with a special focus on the implementation of Antigen based RDTs;

  • presenting on infection prevention and control (IPC) in the context of COVID-19 to the United Arab Emirates International Virtual Conference on antimicrobial resistance attended by 1000 participants from the Region;

  • providing IPC training to Jordan as well as to 16 IPC team members from two major hospitals in Tunisia;

  • conducting assessment for laboratories implementing SARS-CoV-2 testing using interim guidance and tool released on 23 of October.