Transcript
Page 1: #COVIDEastMedNorthAf · 2020-07-01 · Wafaa El-Sadr, ICAP. #COVIDEastMedNorthAf. PRESENTATION. Rana Hajjeh, WHO/EMRO. #COVIDEastMedNorthAf. ICAP Webinar for MENA: Update on COVID-19

#COVIDEastMedNorthAf

Page 2: #COVIDEastMedNorthAf · 2020-07-01 · Wafaa El-Sadr, ICAP. #COVIDEastMedNorthAf. PRESENTATION. Rana Hajjeh, WHO/EMRO. #COVIDEastMedNorthAf. ICAP Webinar for MENA: Update on COVID-19

HOUSEKEEPING

This session is being recorded

Attendees may not unmute

Chat is off, Q&A is on and moderated

Only host and panelists can screen share

#COVIDEastMedNorthAf

Page 3: #COVIDEastMedNorthAf · 2020-07-01 · Wafaa El-Sadr, ICAP. #COVIDEastMedNorthAf. PRESENTATION. Rana Hajjeh, WHO/EMRO. #COVIDEastMedNorthAf. ICAP Webinar for MENA: Update on COVID-19

AGENDA

Welcome

Youssef Cherif, CGC | Tunis

Introduction

Wafaa El-Sadr, ICAP

Panelists

Rana Hajjeh, WHO/EMROHechmi Louzir, Institut Pasteur in TunisGerardo Noto, UNDP Libya

Q&A

#COVIDEastMedNorthAf

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WELCOMEYoussef Cherif, CGC | Tunis

#COVIDEastMedNorthAf

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INTRODUCTIONWafaa El-Sadr, ICAP

#COVIDEastMedNorthAf

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PRESENTATIONRana Hajjeh, WHO/EMRO

#COVIDEastMedNorthAf

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ICAP Webinar for MENA:

Update on COVID-19 Situation and Response in the EMR

3 June 2020

Rana A. Hajjeh, M.D.Director, Program ManagementRegional Eastern Mediterranean Office, WHO Cairo, Egypt

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Cumulative Total confirmed: 6 057 853 Total deaths: 371 166 (6.1%)

USA: 1 734 040 (deaths: 102 640)Brazil: 498 440 (deaths: 28 834)Russia: 414 878 (deaths: 4 855)

33 274 new cases reported in Brazil

Global update of COVID-19 outbreak 01 June 2020 (6:00 pm)

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Epidemic curve by region (cases reported to WHO as of 31 May 18H)

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Daily distribution of cases of COVID-19 in EMR countries29 January – 01 June 2020 (6:00 PM)

Cumulative:Total cases: 529 163Total deaths: 12 752 (CFR 2.4%)Countries reported cases: 22

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Date of reporting

Afghanistan

Bahrain

Djibouti

Egypt

Iran

Iraq

Jordan

Kuwait

Lebanon

Libya

Morocco

occupied Palestinian territory

Oman

Pakistan

Qatar

Saudi Arabia

Somalia

Sudan

Syrian Arab Republic

Tunisia

United Arab Emirates

Yemen

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Regional update of COVID-19 outbreak31 May, 2020 (6:00 PM)

Country New cases New deaths Total cases Recovered Total deaths CFR Tests/100,000 Positivity %

Afghanistan ` 9 15205 1328 257 1.7 122 39.5Bahrain 548 3 11288 6673 18 0.2 20974 3.6Djibouti 160 2 3354 1504 24 0.7 3129 12.5Egypt 1367 34 23449 5693 913 3.9 170 15.0Iran 2516 63 151466 118848 7797 5.1 1171 16.2Iraq 260 10 6439 3156 205 3.2 597 2.8Jordan 5 739 522 9 1.2 1824 0.4Kuwait 851 7 27043 11386 212 0.8 6428 9.2Lebanon 29 1 1220 712 27 2.2 1863 1.5Libya 12 130 50 5 3.8 105 1.9Morocco 43 2 7783 5412 205 2.6 584 3.8oPt 1 627 523 5 0.8 1188 1.1Oman 1014 4 11437 2400 46 0.4 1346 18.5Pakistan 3039 88 69496 25271 1483 2.1 263 12.7Qatar 1648 2 56910 30290 38 0.1 8046 25.6Saudi Arabia 1877 23 85261 62442 503 0.6 2528 10.4Somalia 60 5 1976 348 78 3.9 36 44.6Sudan 279 29 4800 1272 262 5.5 20 58.2Syria 122 43 4 3.3 18 4.3Tunisia 1 1077 960 48 4.5 454 2.1UAE 1387 4 34557 17932 264 0.8 24151 1.5Yemen 27 12 314 15 78 24.8

TOTAL 15886 298 514693 296780 12481 Med= 2.2 Med= 884 Med= 9.2

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Daily distribution of COVID-19 cases and cumulative CFR% in EMR countries 29 January – 30 May 2020 (6:00 PM) (n= 505 001)

0

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CFR%

Num

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es

Date of reporting

Eid vacation?

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0%

1%

2%

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4%

5%

0

200

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600

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100024

-Feb

1-M

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13-M

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25-M

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r12

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pr24

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pr6-

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12-M

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Axis

Title

Axis

Title

Axis Title

AfghanistanCases

Cumulative CFR

0%

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020406080

100120140160180200220240260280300

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ay12

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27-M

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CFR%

No.

of c

ases

Date (2020)

Djibouti

31 May, 2020

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CFR%

No.

of c

ases

Date (2020)

Egypt

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CFR%

No.

of c

ases

Date (2020)

Iran

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ases

Date (2020)

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ases

Date (2020)

Jordan

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of c

ases

Date (2020)

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No.

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ases

Date (2020)

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02468

10121416182022242628

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ases

D t (2020)

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100150200250300350400450

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ay24

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ay

CFR5

No.

of c

ases

Date (2020)

Bahrain

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pr26

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ay20

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ay

CFR%

No.

of c

ases

Date (2020)

Morocco

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ay21

-May

28-M

ay

CFR%

No.

of c

ases

Date (2020)

occupied Palestinian territory

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0%

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CFR%

No.

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ases

Date (2020)

Oman

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0500

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CFR%

No.

of c

ases

Date (2020)

Pakistan

31 May, 2020

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CFR%

No.

of c

ases

Date (2020)

Qatar

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25-M

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CFR%

No.

of c

ases

Date (2020)

KSA

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10%

0

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16-M

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15-A

pr20

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25-A

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-Apr

5-M

ay10

-May

15-M

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25-M

ay30

-May

CFR%

No.

of c

ases

Date (2020)

Somalia

0%

20%

40%

60%

80%

100%

0

100

200

300

400

500

13-M

ar17

-Mar

21-M

ar25

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29-M

ar2-

Apr

6-Ap

r10

-Apr

14-A

pr18

-Apr

22-A

pr26

-Apr

30-A

pr4-

May

8-M

ay12

-May

16-M

ay20

-May

24-M

ay28

-May

CFR%

No.

of c

ases

Date (2020)

Sudan

0%

5%

10%

15%

20%

25%

30%

35%

02468

10121416182022

22-M

ar26

-Mar

30-M

ar3-

Apr

7-Ap

r11

-Apr

15-A

pr19

-Apr

23-A

pr27

-Apr

1-M

ay5-

May

9-M

ay13

-May

17-M

ay21

-May

25-M

ay29

-May

CFR%

No.

of c

ases

Date (2020)

Syria

0%1%2%3%4%5%6%7%8%9%10%

0

50

100

2-M

ar7-

Mar

12-M

ar17

-Mar

22-M

ar27

-Mar

1-Ap

r6-

Apr

11-A

pr16

-Apr

21-A

pr26

-Apr

1-M

ay6-

May

11-M

ay16

-May

21-M

ay26

-May

31-M

ay

CFR%

No.

of c

ases

Date (2020)

Tunisia

0%

1%

2%

3%

4%

5%

0

200

400

600

800

1000

1200

29-Ja

n5-

Feb

2-Fe

b9-

Feb

6-Fe

b4-

Mar

1-M

ar8-

Mar

5-M

ar1-

Apr

8-Ap

r15

-Apr

22-A

pr29

-Apr

6-M

ay3-

May

0-M

ay7-

May

CFR%

No.

of c

ases

D t (2020)

UAE

0%

10%

20%

30%

40%

50%

0

10

20

30

40

10-A

pr13

-Apr

16-A

pr19

-Apr

22-A

pr25

-Apr

28-A

pr1-

May

4-M

ay7-

May

10-M

ay13

-May

16-M

ay19

-May

22-M

ay25

-May

28-M

ay31

-May

CFR%

No.

of c

ases

Date (2020)

Yemen

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Epidemiology Summary

• No explosive outbreaks• all countries with local / community transmission• 3 countries with >20,000 cases • One country in “top 10” – Iran (45% cases)

• Range of epidemiological trends• Difficult to interpret without additional data

• Amplifying events and settings• Religious events, e.g. Iran• Migrant workers, e.g. Gulf• Hospitals, e.g. Egypt

• Window of opportunity to intervene remains –urgency to scale up proven PH measures

Page 17: #COVIDEastMedNorthAf · 2020-07-01 · Wafaa El-Sadr, ICAP. #COVIDEastMedNorthAf. PRESENTATION. Rana Hajjeh, WHO/EMRO. #COVIDEastMedNorthAf. ICAP Webinar for MENA: Update on COVID-19

WHO’s overall strategySlow down the transmission and reduce mortality• Mobilize all sectors and communities to ensure that

everyone takes ownership of and participates in the response

• Control sporadic cases and clusters and prevent community transmission by rapidly finding and isolating all cases, and tracing, quarantining, and supporting all contacts

• Suppress community transmission through physical distancing measures and restrictions on travel

• Reduce mortality by providing clinical care for those affected by ensuring the continuity of essential health services, and protecting frontline workers and vulnerable populations

• Develop safe and effective vaccines and therapeutics that can be delivered at scale and that are accessible based on need

17

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Response Pillars

IMST

Partnership and

Coordination

Health Information/ Surveillance

Health Operations

and technical expertise

IHR/Points of Entry

Operations Support and

Logistics

Knowledge ManagementOther Supportive

Functions:

Finance and Administration

Resource Mobilization

Country Support

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Key Areas of WHO/EMRO Support

Country Offices• Planning & Coordination• Technical assistance• Epi analysis and information

management• Logistics support• Resource mobilization• Research & development

Regional Office• 7 technical support missions• 22 country support teams• Epidemiological analysis • Adaption of tech guidance• Political engagement• Partnership network – daily

updates and weekly calls• Essential health services

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Infection Prevention and Control - 10/22 EMRO countries do not have national IPC programs IPC programs • Early on, HCWs over-reacting & using full

attire PPEs (global shortage of PPE)

• IPC restricted to just PPE use which is the most visible intervention

• Policies, staff/patient ratio, infrastructure, environmental cleaning, distancing, HH, waste management, triage, ventilation, isolation facilities, standard precautions

• 10 countries have no national and hospital IPC focal point to lead the response

• Many infections among HCWs

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Impact of COVID on Health WorkersIncreased workload, leading the

shortages

Need for updated knowledge, skills

High risk for contracting infection

Fatigue and psychosocial stress

Violence and stigma against health workers

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COVID-19 infections in healthcare workforce in EMR

Countries Infected HWs% of infected

HWsTotal deaths among

HWsDate

AFG 876 6 13 01/06/2020

EGY 1230 8 13 20/05/2020

IRQ 100 2 3 27/05/2020

JOR 6 1 unknown 13/05/2020

LEB 68 6 0 01/06/2020

oPT 11 2 0 01/06/2020

OMN 60 3 unknown 29/04/2020

QAT 6 unknown 19/05/2020

PAK 2193 3 23 31/05/2020

TUN 143 14 1 28/05/2020

YEM 9 4 1 26/05/2020

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Infected healthcare workers by profession

10%

25% 25%

56%

11%

59% 60%

15%

0% 2% 4%0

4% 4% 2% 0

74%

10% 10%

29%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Afghanistan Egypt Iraq Pakistan

Physicians Nurses Pharmacists Laboratory Staff Other

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Research Updates – EMRO - Solidarity trial

24

Country status update

Patients recruited since

No of hospitals Patient recruited so far

Weekly average

Iran 7 April 25 >900 ~150Saudi Arabia 1 May 7 100 ~40Lebanon 4 May 1 10 ~1Kuwait ExpectedPakistan Expected

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Weekly FB overview50 million people reached895,000 post engagements452,000 video views

Weekly Twitter overview3M impressions1.3K retweets3.1K likes

Topics covered:o Walk the Talko FB Live on physical distancingo Myth busters o World Health assemblyo Physical activity at homeo Feeding young children during COVID-19o Photo essay: gathering & testing sampleso Joint tweets showing #WHOImpacto Donor visibility: KSA/Yemen 1.1 M people reached

235,000 views

Facebook Live with RD

ORGANIC Facebook post with highest interactions in last 7 days Walk the Talk

326,700 people reached28,000 engagements

Twitter post with highest interaction in last 7 days

Physical activity at home

225,700 impressions3,600 engagements

Communications and Community Engagement

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Logistics & Supply Chain

• 102 Countries across all 6 WHO Regions have received support.

• EMR (18): Afghanistan, Djibouti, Egypt, Iran, Iraq, Jordan, Lebanon, Kuwait, Morocco, Oman, Pakistan, Saudi Arabia, Somalia, Syria, Sudan, Tunisia, Yemen

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Special Considerations in the region•Humanitarian emergencies, including countries with territorial divisions – political, operational, reporting problems, etc.

•Migrant workers in the Gulf countries

•Refugee camps – vulnerabilities, but also represent opportunities to prevent and control

•Managing mass gatherings across the region – vital role of religious and community leaders

•Acceptability of social distancing measures- with considerations for social and economic impact

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Access essential supplies, medicines and equipment is limited because of global market collapse

Ongoing humanitarian crisis operations outside of COVID-19 will be affected

Continuity of non COVID-19 health services such as immunization activities

Weak health systems and limited capacity to offset the economic and social costs of population-level shut-downs

Vulnerable populations with poor nutrition, underlying conditions and disease prevalence which complicate the diagnosis and treatment High-risk groups include those displaced, living in camps, overcrowded sites such as slums have restricted movement and cannot physically distance

Risks in Humanitarian/Low Capacity Settings

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Mass Gatherings

• Major religious gatherings in the region

• Can amplify epidemic

• Initial outbreak in Iran started in Qom

• Early interventions focused on limiting mass gatherings, in particular in religious sites and houses of worship

• Ramadan Guidance, including Eid Holiday

• Hajj Pilgrimage?

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Main Challenges – COVID-19 response• Deficiencies in epidemiological data

collection, analysis and use

• Testing capacities

• Availability of PPE and Lab supplies

• Poor IPC - infections among HCWs

• Divided governments and politicization of response

• Gaps in other elements of response• Risk communications and community

engagement • Capacities to isolate, quarantine, contact

trace• Adherence to social and physical distancing

• International travel – pause on tech support missions

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Additional Challenges•Weak/disrupted health systems in a high number of countries in the region•Disruption in supply chain: difficulties for patients to get medicines •Limited capacity: staffing during the pandemic and limited public resources to be allocated to the health sectors

•Unemployment and impoverishment resulting in increased burden on public facilities, and reduced capacity for mobilizing public resources.

•Limited attention to critical health conditions/services and increased morbidity and mortality (NCDs, EPI, CDs, etc)

•Efforts have focused primarily on hospital settings, with less attention given to PHC, particularly that around 80% of COVID-19 patients are expected to experience mild illness

•Limited peer reviewed literature

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How to Adjust Public Health Control Measures?

1. Control community transmission to a level that the health system can manage cases

2. Capacity to find, test, isolate and care for cases and identify, trace, quarantine and support contacts are in place

3. Risks in high-vulnerability settings such as health care facilities and residential care settings are minimized

4. Risks in work and public places are reduced through infection prevention and control and physical distancing

5. Risks of imported cases are reduced by identifying likely transit routes and measures to rapidly detect and manage suspected cases among travelers

6. Communities are fully engaged and understand that there is a need for a managed to transition to a “new” normal

32

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Overall Strategic Opportunities and Success Stories

Global & Regional Leadership

Pandemic Preparedness

Effective Diagnostic Capacities

Working with GOARN partners

Service continuity

Solidarity and partnership

Strong Risk Communication

Digital Innovations and Tele-Medicine

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Thank Youشكراً جزیالً

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PRESENTATIONHechmi Louzir, Institut Pasteur in Tunis

#COVIDEastMedNorthAf

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Data from Tunisia

• The first phase of COVID-19 pandemic was achieved by slowing down the progression of SARS-CoV-2 avoiding overshooting the health system.

• Since May 04, Tunisia began a transition to a new phase in the management of the COVID-19 pandemic: progressive target containment.

• We have to avoid a rebound by the ability of detect, isolate and treat all new cases early (imported).

• As of June 01, 2020, the cumulative number of confirmed COVID-19 cases is 1,086 cases (out of a total of 52,874 samples)

• cumulative is 9.16 / 100,000 inhabitants. Among the screening cases, 73 (6.7%) are still active.

• New cases registered in recent days are imported cases diagnosed among returnees and placed directly in compulsory confinement.

All data are actualized by June 1st, and obtained from Dr Ben Alaya, ONMNE, MoH

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Why Tunisia has been relatively spared• The Tunisian health system is among the most developed in

the region (basic health care centers that cover the country, preventive medicine, good immunization program)

• Previous vaccinations• The climate• The circulation of other members of the Coronavirus family• The relatively young population• Anticipation in relation to crisis management and the

mobilization of experienced and disciplined teams.• Team preparation through their involvement in a major flu

project funded by “the Centers for Disease Control and Prevention”, USA (Grant number 1U51IP00822).

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PRESENTATIONGerardo Noto, UNDP Libya

#COVIDEastMedNorthAf

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Q&AModerated by Wafaa El-Sadr

#COVIDEastMedNorthAf


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