Week ending 26 September 2020

  REGIONAL OVERVIEW  

More than 2.2 million Covid-19 infections have now been recorded in the Middle East and North Africa and the situation continues to worsen. The total of new cases across the region, which was averaging around 15,000 a day at the start of this month, has now risen to more than 22,000 a day according to the official figures.

Most countries in the region took swift action when the virus first arrived and for a while seemed to be having some success in slowing its spread. Six months on, though, many of them are struggling to hold the line, partly because of the economic effects of preventive measures.

Among the 20 countries monitored, 13 have reported an increase in the level of new infections over the past four weeks. The biggest increase has been in Israel.

Detailed statistics for the region, based on official figures, can be found in this spreadsheet.

Previous situation reports: September 19; September 12; September 5; August 29; August 22; August 15; August 8; August 1; July 25; July 18; July 11; July 4; June 27; June 20.

---

  ALGERIA  

Algeria's outbreak peaked towards the end of July when more than 600 new infections were being recorded each day. Since then the trend has been downwards, with new cases averaging 192 a day during the past week according to official figures.

For more information see: Covid-19 in Algeria

Confirmed cases: 50,754
New cases in past week: 1,341
Active cases: 13,393
Deaths: 1,707
Tests carried out: (unknown)

  BAHRAIN  

Since the outbreak began Bahrain has recorded more than 39,000 cases per million inhabitants. This makes it the world's second most infected country after Qatar. However, Bahrain is also one of the world leaders in Covid-19 testing. So far, about two-thirds of its 1.7 million population have been tested.

Until recently Bahrain's epidemic appeared to be gradually subsiding but new infections have risen again during September. This week's average was 616 a day – slightly below the peak recorded during the previous week.

In the early stages of the outbreak almost half of Bahrain's known cases were among expatriate workers but they now account for a much smaller proportion: 145 out of 650 cases reported on Tuesday and 111 out of 612 on Wednesday.

Cafes and restaurants reopened for outdoor dining earlier this month and on Thursday the authorities in Dubai issued a seven-page set of safety regulations for eating establishments.

Six weeks ago Bahrain began trials of a Covid-19 vaccine on behalf of the Chinese company Sinopharm, and this week reached its target of vaccinating 6,000 volunteers.

For more information see: Covid-19 in Bahrain

Confirmed cases: 68,190
New cases in past week: 4,311
Active cases: 6,479
Deaths: 236
Tests carried out: 1.4 million

  EGYPT  

According to the Egyptian authorities, new infections this week averaged 122 a day compared with almost 1,600 a day at the peak in June. The official figures are surprisingly low considering Egypt's large population (103 million) and the often crowded living conditions.

It's also unclear how many tests are being carried out because the government has not issued any figures since May when the total stood at 135,000 tests.

Whether or not the official statistics are true, anecdotal evidence does suggest the number of new cases has dropped considerably. 

In a video posted on Facebook, traveller Drew Binsky talks to Egyptians about their apparent lack of concern regarding the virus. He comments:

"About 1% of people on the streets are wearing masks. Nobody is social distancing. Many people are shaking hands, hugging, kissing and touching each other. I see public gatherings everywhere – weddings, parties, markets and concerts. Even in Cairo airport and on domestic flights, I'm seeing the majority of people wrapping their masks around their chins."

In Damietta province four members of one family – a husband and wife, plus the husband's father and brother – are reported to have died after contracting Covid-19. They are said to have become infected after the wife attended a wedding.

Internet use in Egypt has doubled as a result of the pandemic, according to communications minister Amr Talaat. 

For more information see: Covid-19 in Egypt

Confirmed cases: 102,625
New cases in past week: 853
Active cases: 3,241
Deaths: 5,853
Tests carried out: 135,000

  IRAN  

Iran was the first country in the region to be seriously affected by the virus. Government figures show an initial wave of infections which peaked at the end of March. It subsided during April, briefly dipping below 1,000 new cases per day but then rose again. This week's average was 3,383 a day – the highest level so far.

Iran continues to report more coronavirus-related deaths than any other country in the region.

Confirmed cases: 439,882
New cases in past week: 23,684
Active cases: 44,818
Deaths: 25,222
Tests carried out: 3.9 million

  IRAQ  

Iraq's official figures are widely believed to understate the scale of the epidemic. Many cases go unreported because of social stigma. Compliance with preventive measures appears to be low and health services are inadequate.

For the last three weeks new cases have been averaging more than 4,000 a day. This is said to be partly a result of increased testing. 

For more information see: Covid-19 in Iraq

Confirmed cases: 341,699
New cases in past week: 30,009
Active cases: 59,566
Deaths: 8,867
Tests carried out: 2.2 million

  ISRAEL  

After coming close to bringing the epidemic under control, Israel has been hit by a second wave much larger than the first. The first wave peaked at around 600 new cases a day in early April. Efforts to control it were intially successful and by the second half of May new cases had dropped to about 15 a day.

However, the virus surged back when lockdown restrictions were lifted. New infections this week were the highest so far, averaging 5,547 a day. Israel's infection rate is the highest in the region, with a daily average this week of 60 new cases per 100,000 inhabitants.

On September 18 Israel began its second nationwide lockdown, which is due to last for three weeks. The restrictions were tightened further on Friday. Full details of the rules are here.

The lockdown is taking place amid disagreements over what should be done, plus considerable resistance from the public – especially religious elements. The Jerusalem Post reports that 400 yeshiva students became infected after attending collective prayers during Rosh Hashanah. On Thursday, the paper says, police issued 4,239 penalty tickets to people violating the regulations.

For more information see: Covid-19 in Israel

Confirmed cases: 217,899
New cases in past week: 38,828
Active cases: 62,913
Deaths: 1,412
Tests carried out: 3.3 million

  JORDAN  

For several months Jordan appeared to be the most successful Arab country in controlling the virus. Transmission within Jordan had virtually ceased and almost all the new cases were detected among people arriving from abroad.

Since then, however, community transmission has returned with a spate of locally-occurring infections. New cases this week averaged 410 a day – the highest level so far.

The government has again denied plans for another nationwide lockdown, though on Thursday a local lockdown was imposed in the Eil district of Maan province.

The reopening of universities has been postponed to October 11 and tuition will be a mixture of distance learning and classroom teaching.

For more information see: Covid-19 in Jordan

Confirmed cases: 7,211
New cases in past week: 2,867
Active cases: 3,137
Deaths: 39
Tests carried out: 1.1 million

  KUWAIT  

New infections peaked in late May at just over 1,000 cases a day. The numbers have fluctuated since then, but at a lower level. New cases this week averaged 559 a day.

For more information see: Covid-19 in Kuwait

Confirmed cases: 102,441
New cases in past week: 3,913
Active cases: 9,172
Deaths: 595
Tests carried out: 729,000

  LEBANON  

Political and economic turmoil, plus the devastating explosion in Beirut on August 4, have diverted attention from the coronavirus.  Lebanon's outbreak is still relatively small, but growing. New cases this week averaged 921 a day – the highest level so far.

Assem Araji, head of the Lebanese parliament’s health committee, said on Wednesday that the country has "lost control" and complained about a lack of coordination between government ministries regarding preventive measures.

Dr Firass Abiad, director of Rafik Hariri University Hospital, also expressed frustration: “You go into lockdown – two weeks – you get some measure of control but then you have to open up again. If you open up and you go back to where you were before, the same behaviour, the same contact, the same compliance, you’ve really not done anything.”

The start of the school year has been postponed until October 12.

Current rules for travellers arriving in Lebanon are explained here.

For more information see: Covid-19 in Lebanon

Confirmed cases: 33,962
New cases in past week: 6,444
Active cases: 8,284
Deaths: 333
Tests carried out: 782,000

  LIBYA  

Libya is in its tenth year of internal conflict. The UN-backed Government of National Unity in Tripoli is challenged by Field Marshall Haftar's forces based in the east of the country. There are also numerous militias. This leaves the country ill-equipped to cope with a major epidemic.

Growing levels of insecurity, political fragmentation and weak governance have led to a deterioration of basic services, particularly in the health system. At least 27 health facilities have been damaged or closed by fighting and some have been attacked directly. There are 870,000 people – refugees, asylum seekers and displaced persons – who the UN regards as especially vulnerable.

According to the official figures Libya's outbreak is still relatively small but the total of confirmed Covid-19 cases has more than doubled over the past month. New infections recorded this week averaged 693 a day.

A recent UN report said the true scale of Libya's outbreak is likely to be much higher than the official figures indicate, partly because of low testing capacity and lack of contact tracing.

For more information see: Covid-19 in Libya

Confirmed cases: 31,290
New cases in past week: 4,852
Active cases: 13,291
Deaths: 491
Tests carried out: 199,000

  MOROCCO  

By early June a strict lockdown had reduced new cases in Morocco to around 40 a day. Since then, though, there has been a severe setback and new cases are running at record levels. This week's average was 2,223 a day.

For more information see: Covid-19 in Morocco

Confirmed cases: 112,822
New cases in past week: 15,558
Active cases: 18,592
Deaths: 1,998
Tests carried out: 2.5 million

  OMAN  

Infections peaked in mid-July with just under 1,600 cases a day. The numbers dropped back considerably in August but have since been rising again. This week's average was 593 new cases a day compared with 218 a day during the first week of September.

For more information see: Covid-19 in Oman

Confirmed cases: 95,907
New cases in past week: 4,154
Active cases: 8,257
Deaths: 885
Tests carried out: 377,000

  PALESTINE  

The Palestinian enclave of Gaza is densely populated, with limited medical facilities, and there have long been fears about the likely consequences of a major epidemic. Until recently, however, Gaza had been relatively free of Covid-19, with only 117 confirmed cases.

That changed in the last week of August when 75 new cases were reported and the Hamas authorities imposed a lockdown. Transmission within the community has now clearly taken hold and this week saw a further 435 infections, bringing the total to 2,658.

Meanwhile, a further 6,555 new cases were reported in the West Bank this week. Hebron has previously been the most seriously affected area but on Tuesdaythe UN Office for the Coordination of Humanitarian Affairs (OCHA) reported a substantial decline in the number of active cases there. The OCHA added:

"This may be partially attributable to a decline in the number of tests performed in that area, following inconsistencies in the testing policy by the Ministry of Health, alongside an increasing tendency, particularly among the asymptomatic, to avoid testing due to the social stigma associated with infection. By contrast, the number of active cases in East Jerusalem and in the Nablus governorate doubled, while in Ramallah it increase by nearly 50%."

For more information see: Covid-19 in Palestine

Confirmed cases: 48,282 (West Bank 35,305, Gaza 2,658, East Jerusalem 10,319)
New cases in past week: West Bank 6,555; Gaza 435
Active cases: 10,502
Deaths: 278
Tests carried out: 402,000

  QATAR  

In population terms Qatar has more known cases than any other country – 44,000 per million inhabitants. Migrant workers have been disproportionately affected. Qatar's epidemic reached a peak in the first week of June but infections have fallen since then. New cases this week averaged 248 a day – well below the peak of more than 1,800 a day.

For more information see: Covid-19 in Qatar

Confirmed cases: 124,650
New cases in past week: 1,733
Active cases: 2,926
Deaths: 212
Tests carried out: 751,000

  SAUDI ARABIA  

Saudi Arabia has the largest number of recorded cases among the Arab countries. New infections reached an initial peak in the fourth week of May, then dropped back slightly before rising to a higher peak in the third week of June. Since then, though, there has been a substantial improvement.

New cases this week averaged 516 a day – the lowest level since April.

For more information see: Covid-19 in Saudi Arabia

Confirmed cases: 332,329
New cases in past week: 3,609
Active cases: 12,068
Deaths: 4,625
Tests carried out: 6.3 million

  SUDAN  

The coronavirus struck Sudan in the midst of a political transition following a popular uprising against the regime of President Bashir and the country is ill-equipped to cope with a major epidemic. Testing is very limited and official figures don't reflect the full scale of the outbreak. The health ministry appears to have stopped issuing daily reports.

For more information see: Covid-19 in Sudan

Confirmed cases: 13,592
New cases in past week: 57
Active cases: 5,992
Deaths: 836
Tests carried out: (unknown)

  SYRIA  

According to official figures only 4,001 cases have been recorded in areas controlled by the Assad regime.

The authorities' lack of transparency fuels suspicions that many cases are being concealed. There is also some evidence that people with Covid-19 symptoms are reluctant to contact the authorities. While there are plenty of signs that the true figures are higher than those issued by the regime, it is unclear how high they really are.

Earlier this month the Covid-19 Response Team at Imperial College London issued a 46-page report which estimated that only 1.25% of Covid-related deaths in Damascus during July and August were officially reported.

According to the Assad regime, since the outbreak began there have been 185 deaths in areas that it controls. 

For more information see: Covid-19 in Syria

The following figures relate to regime-controlled areas only:

Confirmed cases: 4,001
New cases in past week: 270
Active cases: 2,788
Deaths: 185
Tests carried out: 26,572 (by 24 August)

  TUNISIA  

In June, Tunisia appeared to be almost free of the virus and began promoting itself as a safe holiday destination. Since then, though, there has been a setback.

Tunisia's outbreak remains small but the number of new cases continues to rise. This week's average of 832 a day was the highest so far, and more than double the previous week's average.

For more information see: Covid-19 in Tunisia

Confirmed cases: 14,392
New cases in past week: 2,311
Active cases: 9,169
Deaths: 191
Tests carried out: 218,000

  UNITED ARAB EMIRATES  

The UAE's epidemic peaked in the last week of May when new infections were running at more than 900 a day. Numbers of new cases declined through June, July and August but have been rising again recently. This week's average of 872 a day is not far below the May peak.

The UAE has carried out more tests per head of population than any other Arab country and ranks twelfth worldwide in terms of tests carried out.

For more information see: Covid-19 in the UAE

Confirmed cases: 89,540
New cases in past week: 6,107
Active cases: 10,312
Deaths: 409
Tests carried out: 9.2 million

  YEMEN  

Because of the ongoing war, Yemen already faced a humanitarian crisis before the coronavirus arrived. Millions are malnourished and vulnerable to disease, and health services are inadequate.

There have almost certainly been a lot more Covid-19 cases than the 2,000 shown by official figures. It's difficult to get tested for Covid-19 in Yemen and because of social stigma attached to the disease there are also many people who don't want to be tested. 

However, fluctuations in the figures suggest the outbreak peaked in May and June. Since then the daily number of officially-reported new cases has dropped to single figures. 

This is contrary to expectations because preventive measures have been minimal. However, anecdotal evidence supports the view that Yemen's epidemic has declined very substantially.

This has led to the suggestion that previous exposure to other diseases may have given Yemenis some protection against the coronavirus. Diseases that are rare in better-off countries, such as cholera, diphtheria, dengue fever and chikungunya, are common in Yemen.

For more information see: Covid-19 in Yemen

Confirmed cases: 2,032
New cases in past week: 5
Active cases: 187
Deaths: 588
Tests carried out: (unknown)