The coronavirus disease COVID-19 continues to spread at the regional and global levels. As of 28 November 2020, the global cumulative incidence reached 61 036 793 reported cases and 1 433 316 associated deaths with a case fatality ratio (CFR) of 2.3%. Meanwhile, the 22 countries of the Eastern Mediterranean Region (EMR) have reported a total of 4 045 906 cases, which represent about 6.6% of the global count, with 102 160 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 (935 799 cases; 23.1% of the Region's total), followed by Islamic Republic of Iraq (548 821; 13.6%) and Pakistan (392 356; 9.7%). Islamic Republic of Iran also reported the highest number of total associated deaths (47 486; CFR 5.1%) followed by Iraq (12 200; CFR 2.2%) and Pakistan (7942; CFR 2%). The highest CFRs were reported by Yemen (29.1%) followed by Sudan (7.1%), while the lowest CFRs were reported by Qatar (0.2%) followed by United Arab Emirates (0.3%) and Bahrain (0.4%).
During epidemiological week 48, the Region reported a 3% decrease in cases when compared to the previous week (243 786 cases compared to 251 530 cases). Similarly, a 10.6% decrease was observed for associated deaths (5639 deaths compared to 6309 deaths). The weekly trend per capita showed a slight increase as compared to the previous week (553.6/100 000 compared to 519/100 000).
Jordan, the occupied Palestinian territory (oPt) and Islamic Republic of Iran reported a relative increase in COVID-19 activity. The cumulative number of cases in Jordan increased from 178 161 to 210 709 (18% increase compared to the previous weeks), oPt from 82 780 to 94 861 (15% increase) and Islamic Republic of Iran from 841 308 to 935 799 (11% increase). Jordan had the largest relative increase in deaths (21%) followed by oPt (13%), Tunisia (12%) and Lebanon (11%).
In terms of testing, a total of 56 745 170 laboratory PCR tests were conducted since the start of the outbreak across the Region including 2 544 657 tests in week 48, which shows a 1% increase compared to the previous week (2 523 367). The highest number of PCR tests were reported from United Arab Emirates (16.5 million), followed by Saudi Arabia (9.5 million) and Islamic Republic of Iran (6 million). The United Arab Emirates and Bahrain are performing the highest rate of testing per capita (166 859/100 000 and 119 530/100 000, respectively). The average positivity rate for the Region is 7.1%. 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.
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:
conducting a technical mission to support COVID-19 in Tunisia;
holding the fifteenth webinar of the COVID-19 Laboratory Community of Practice which introduced the participants to the SARS-CoV-2 Antigen RDT training package;
bringing together 56 participants from 14 countries for the phase II virtual meeting on addressing infection prevention and control (IPC) for reproductive, maternal, neonatal, child and adolescent health (RMNCAH) services in the context of COVID-19 in the Region;
bringing together 108 participants for the UNFPA/UNICEF/WHO joint virtual meeting with ministers of health from nine countries to discuss maintaining RMNCAH services during and beyond COVID-19 pandemic; and
conducting the first certified IPC training course in Sindh province in collaboration with Indus University, where 25 participants will be certified as IPC master trainers.