Severity: Warning Alert

Health: Countries in Middle East, North Africa, and West Asia report COVID-19 cases, some with local disease transmission. Use basic precautions.

The locations affected by this alert are:

  • Turkey
  • Afghanistan
  • Pakistan
  • Algeria
  • Bahrain
  • Egypt
  • Iran
  • Iraq
  • Israel
  • Jordan
  • Kuwait
  • Lebanon
  • Libya
  • Morocco
  • Oman
  • Qatar
  • Syria
  • Tunisia
  • United Arab Emirates
  • Palestinian Territories
  • Yemen
  • Saudi Arabia

This alert began 14 Apr 2020 07:42 GMT and is scheduled to expire 14 Jun 2020 23:59 GMT.

  • Incident: Imported cases of coronavirus disease (COVID-19), limited local transmission
  • Location(s): Middle East, North Africa, West Asia (map)
  • Date: February-April 2020

Summary
Several countries in the Middle East and North Africa region and West Asia have identified imported cases of coronavirus disease (COVID-19) and, in some instances, local human-to-human transmission from those imported cases. As of April 14, the following countries have identified confirmed COVID-19 cases:

Countries reporting community transmission:

  • Iran: 71,686 cases.
  • Turkey: 56,956 cases.
  • Israel: 10,878 cases.
  • Pakistan: 5,374 cases.
  • Saudi Arabia: 4,462 cases.
  • United Arab Emirates: 4,123 cases
  • Qatar: 2,979 cases
  • Egypt: 2,065 cases
  • Algeria: 1,914 cases
  • Morocco: 1,661 cases
  • Iraq: 1,352 cases
  • Kuwait: 1,234 cases
  • Bahrain: 1,136 cases
  • Oman: 727 cases
  • Tunisia: 707 cases
  • Lebanon: 630 cases
  • Afghanistan: 607 cases
  • Jordan: 389 cases
  • Palestinian Territories: 271 cases
  • Libya: 25 cases
  • Syria: 25 cases


Countries where community transmission has not been determined:

  • Yemen: 1 case



Background and Analysis
Additional cases and locations may be added to this list at any time as disease surveillance and testing continues. On March 27, the US CDC released an "Alert-Level 3" travel health notice due to global COVID-19 transmission. This is the highest warning level and indicates authorities recommend avoiding non-essential travel. It is recommended that travelers avoid any contact with ill individuals and frequently wash their hands with soap and water for at least 20 seconds. If soap and water are unavailable, alcohol-based hand sanitizer (minimum 60 percent alcohol) should be used. Older adults and those with chronic medical conditions are at increased risk of developing severe complications. Health authorities expect imported cases of this disease as disease surveillance continues globally. Older individuals, infants, and those with chronic illness are more susceptible to infection and are at increased risk for severe complications. Human-to-human transmission is occurring, though it remains unclear how easily the virus spreads between people.

On March 11, the WHO declared the ongoing coronavirus outbreak a pandemic. This shift in posture from an earlier briefing indicating the WHO would no longer use the term "pandemic" to describe disease transmission is reflective of the current COVID-19 global impact. Per the March 11 statement, "Describing the situation as pandemic does not change WHO's assessment of the threat posed by this virus. It doesn't change what WHO is doing, and it doesn't change what countries should do."

Coronavirus disease 2019 (COVID-19) is a viral respiratory disease caused by infection with the SARS-CoV-2 virus (previously known as 2019-nCoV). Symptoms occur 1-14 days following exposure (average of 3-7 days). These symptoms include fever, fatigue, cough, difficulty breathing, sometimes worsening to pneumonia and kidney failure - especially in those with underlying medical conditions.

Advice
Emphasize basic health precautions, especially frequent handwashing with soap and water, or an alcohol-based hand sanitizer if soap and water are unavailable. Practice good coughing/sneezing etiquette (i.e., covering coughs and sneezes with a disposable tissue, maintaining distance from others, and washing hands). There is no evidence that the influenza vaccine, antibiotics, or antiviral medications will prevent this disease, highlighting the importance of diligent basic health precautions.

Resources
WHO coronavirus knowledge base: www.who.int/emergencies/diseases/novel-coronavirus-2019

US CDC: Guidance for Businesses and Employers: www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response

US CDC: Preventing COVID-19 Spread in Communities: www.cdc.gov/coronavirus/2019-ncov/community

Mental Health Considerations during COVID-19 Outbreak: www.who.int/docs/default-source/coronaviruse/mental-health-considerations

US CDC: Manage Anxiety and Stress: www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety

US CDC Global COVID-19 Travel Health Notice: wwwnc.cdc.gov/travel/notices/warning/coronavirus-global

WHO: Getting your workplace ready for COVID-19: www.who.int/docs/default-source/coronaviruse/getting-workplace-ready-for-covid-19

WHO advice for international travel: www.who.int/news-room/articles-detail/updated-who-recommendations-for-international-traffic-in-relation-to-covid-19-outbreak