29 July 2020 – Today, 29 July, marks exactly 6 months since the first COVID-19 case was reported in WHO's Eastern Mediterranean Region. We saw slow initial progress after the first cases were identified in February, but then witnessed an acceleration in May and a peak in cases by the end of June – most likely due to countries relaxing social measures during the period of Ramadan and Eid al Fitr.
Over the past 2 weeks, however, the overall regional trend of reported cases and deaths appears to have stabilized and is even decreasing.
Although this marks a glimmer of hope, a mixed picture is observed at individual country level. Some countries are reporting a decrease in cases and stabilization in deaths; some are reporting a sharp increase in cases and others a more gradual increase; while some are reporting plateauing or stabilizing of cases.
The overall regional stabilization of cases over the past 2 weeks shows that we can turn around the course of this pandemic. But today, the risk of further resurgence and spread of COVID-19 in the Region is still considered high if countries fail to sustain effective public health measures.
Many countries in the Region are in the process of easing social measures because of their significant economic and social impacts, with the International Monetary Fund projecting that gross domestic product across the Region could decrease by 4.4% in 2020.
In deciding when to lift lockdowns, open borders, reopen schools and businesses, governments should do so in a manner that mitigates the likely associated rise in COVID-19 cases. WHO recommends that these decisions are based on an objective risk assessment, that is evidence-based.
Ideally, easing of social measures should be phased over time and targeted. Communities should be engaged in this process. When managed incorrectly, easing of social measures has been associated with a resurgence of COVID-19 cases, even in some of the most developed countries. WHO has issued clear guidance to countries on how to adjust public health and social measures in the context of the COVID-19 pandemic.
In its guidance for controlling the spread of COVID-19 at ground crossings, WHO provides recommendations on how to identify priority ground crossings and plan key preparedness activities for those crossings and nearby communities. As public health authorities consider lifting measures, it is critical that robust surveillance is in place or put in place to control the spread of COVID-19 and guide ongoing implementation of control measures.
In fact, in our Region we are already seeing new travel-related cases since countries began opening airports and other points of entry for international travellers, and some countries are showing a resurgence of new community-transmitted cases after an initial dip.
The outbreak in some countries has also spread to migrant workers, and health authorities are employing aggressive mass laboratory testing to target migrants or expatriates.
As we approach the Eid Al Adha feast, there is also increased risk of transmission as a result of social and religious mass gatherings. WHO recently released guidance to countries and communities on public health measures for Eid Al Adha in the context of the pandemic.
WHO recommends that cancelling social and religious mass gatherings should be seriously considered by countries when making decisions related to Eid Al Adha. Any decision to restrict, modify, postpone, cancel, or proceed with holding a mass gathering should also be based on a standardized risk assessment, and should be part of a comprehensive approach taken by national authorities to respond to the pandemic.
If social or religious events do take place, authorities and individuals should follow the basic measures needed to suppress transmission and save lives: find, isolate, test and care for cases; protect health workers; and trace and quarantine contacts. Keep your distance from others, clean your hands, avoid crowded and enclosed areas, and wear a mask where recommended.
While the source of the virus that causes COVID-19 has not yet been identified, countries should take strict measures around the selling and slaughtering of animals and the distribution of meat, while ensuring that national food safety and hygiene regulations are enforced.
While distributing meat, physical distancing measures must be in place and one household member may be nominated to perform and order the sacrifice. To avoid the crowded gatherings associated with distribution of meat, consider using centralized entities, agencies and institutions, which should adhere to physical distancing throughout the whole cycle of collecting, packaging, storing and distributing meat.
Let me repeat here that WHO also welcomes the decision of Saudi Arabia to protect pilgrims’ safety and promote health security in the country and beyond by holding hajj with a limited number of pilgrims of different nationalities residing within the country. This decision was made based on a sound risk assessment and analysis of different scenarios as per WHO guidelines to protect the safety of the pilgrims and to minimize the risk of transmission inside the country and beyond.
COVID-19 is now part of our lives, and we all know by now the measures that need to be taken to protect ourselves and our communities. As we celebrate religious holidays, travel, and visit friends and families, let us remember that every action we take in the coming weeks can determine the course of the pandemic in our Region.
It has taken us 6 months to see a stabilization of cases, and we must remain vigilant for the foreseeable future. This virus continues to surprise us – it has surged back in some of the countries with the most sophisticated health care systems. Therefore, we must continue with our comprehensive approach to its control. Let us not destroy the fragile progress we have made so far.
