Jordan, Cyprus Lead MENA Region in New COVID-19 Cases

Under-testing in Jordan suggests spread of COVID may be far greater than official numbers indicate

With Jordan entering a third wave of the coronavirus pandemic and Cyprus in the midst of a fourth wave, the two countries are worst in the Middle East and North Africa for COVID-19 cases per million people.

On Wednesday, Jordan reported 5,180 new confirmed cases of infection – about 504 per million people. In Cyprus, there were 576 new cases on Wednesday – about 472 per million.

As of December 8, the seven-day rolling average of daily new infections per million people stood at about 601 in Cyprus and 478 in Jordan. The total number of new cases for the previous seven days was 4,205 per million people in Cyprus and 3,345 per million in Jordan.

Jordan now leads the MENA region in COVID-19 deaths per million people. For the week ending December 8, it reported 21.13 deaths per million people from the virus, and its seven-day rolling average of daily deaths stood at 3.02.

Despite the higher number of daily new cases per million people in Cyprus, deaths from COVID-19 remain higher in Turkey (2.3 per million, as a seven-day rolling average) and Lebanon (1.46 per million) than in Cyprus (1.12 per million).

The better outcome despite higher levels of COVID infection reflects Cyprus’ high rate of full vaccination (65.8%), compared to Turkey (59.71%) and Lebanon (25.54%). Jordan also has a relatively low rate of full vaccination (37.01%), which contributes to the higher risk of death among COVID patients there.

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Jordan shows a worryingly high test positivity rate of 10% (as of December 5). The World Health Organization says that positivity rates over 5% indicate severe under-testing, which suggests that the number of people who actually have COVID-19 in Jordan may be far greater than the official numbers indicate. This concern is bolstered by Jordan’s reported testing rate, which, on December 5, stood at only 4.52 tests per day per 1,000 people.

In Cyprus, the test positivity rate is now only 0.6%. The testing rate has steadily increased from about 53 tests per day per 1,000 people at the end of October to more than 90 today, which gives high confidence that there isn’t much “hidden COVID” in the population.

The effective reproduction rate (R) – the average number of new infections caused by a single infected individual – is worryingly high in both countries. As of Dec. 5, it stood at 1.57 in Cyprus and 1.25 in Jordan. Rates greater than 1 show the infection spreading in the population.

Early in the pandemic, Jordan gained a reputation for stringent measures against the coronavirus, including a strict lockdown and a monthslong ban on the entry of incoming visitors in 2020, which took a high toll on the country’s economy. Cyprus also adopted a policy of strict measures, though not quite as much as Jordan, early in the pandemic. Since then, both countries have loosened their COVID restrictions.

Jordan’s COVID response, which, from March 18 to April 20, 2020, rated 100 out of 100 on the Stringency Index, a composite measure based on nine response indicators including school closures, workplace closures, and travel bans, now rates a rather low 34.26.

Cyprus, whose COVID restrictions between April 16 and May 3, 2020 gave it a 94.44 on the Stringency Index, now (as of November 29) is rated 46.3 on the same index.

The US Centers for Disease Control and Prevention on Monday added Cyprus and Jordan to its list of Level 4 (“very high”) risk travel destinations, its highest-risk category.

Middle Eastern and North African countries already at Level 4 include Iraq, Saudi Arabia, Somalia, and Turkey.

In addition, the CDC includes Afghanistan, Algeria, Syria and Yemen in its “Level Unknown” category, for lack of reliable information about the disease.

Regarding both Level 4 and Level Unknown countries, the CDC recommends on its website that people “avoid travel to these destinations. If you must travel to these destinations, make sure you are fully vaccinated before travel.”

Here are the latest COVID-19 numbers for the Middle East and North Africa as of 2:45 pm Greenwich Mean Time (UTC±0) on Thursday.