Updated Surveillance Metrics and History of the COVID-19 Pandemic (2020-2023) in the Middle East and North Africa: Longitudinal Trend Analysis.

Publisher: JMIR Publications Country of Publication: Canada NLM ID: 101669345 Publication Model: Electronic Cited Medium: Internet ISSN: 2369-2960 (Electronic) Linking ISSN: 23692960 NLM ISO Abbreviation: JMIR Public Health Surveill Subsets: MEDLINE

Original Publication: Toronto : JMIR Publications, [2015]-

COVID-19*/epidemiology ; SARS-CoV-2* ; Pandemics*; Humans ; Africa, Northern/epidemiology ; Middle East/epidemiology ; Longitudinal Studies

Background: This study updates the COVID-19 pandemic surveillance in the Middle East and North Africa (MENA) we first conducted in 2020 with 2 additional years of data for the region.
Objective: The objective of this study is to determine whether the MENA region meets the criteria for moving from a pandemic to endemic. In doing so, this study considers pandemic trends, dynamic and genomic surveillance methods, and region-specific historical context for the pandemic. These considerations continue through the World Health Organization (WHO) declaration of the end of the public health emergency for the COVID-19 pandemic on May 5, 2023.
Methods: In addition to updates to traditional surveillance data and dynamic panel estimates from the original study by Post et al, this study used data on sequenced SARS-CoV-2 variants from the Global Initiative on Sharing All Influenza Data (GISAID) to identify the appearance and duration of variants of concern. We used Nextclade nomenclature to collect clade designations from sequences and Pangolin nomenclature for lineage designations of SARS-CoV-2. Finally, we conducted a 1-sided t test to determine whether regional weekly speed of COVID-19 spread was greater than an outbreak threshold of 10. We ran the test iteratively with 6 months of data from September 4, 2020, to May 12, 2023.
Results: The speed of COVID-19 spread for the region had remained below the outbreak threshold for 7 continuous months by the time of the WHO declaration. Acceleration and jerk were also low and stable. Although the 1- and 7-day persistence coefficients remained statistically significant and positive, the weekly shift parameters suggested the coefficients had most recently turned negative, meaning the clustering effect of new COVID-19 cases became even smaller in the 2 weeks around the WHO declaration. From December 2021 onward, Omicron was the predominant variant of concern in sequenced viral samples. The rolling t test of the speed of spread equal to 10 became entirely insignificant from October 2022 onward.
Conclusions: The COVID-19 pandemic had far-reaching effects on MENA, impacting health care systems, economies, and social well-being. Although COVID-19 continues to circulate in the MENA region, the rate of transmission remained well below the threshold of an outbreak for over 1 year ahead of the WHO declaration. COVID-19 is endemic in the region and no longer reaches the threshold of the pandemic definition. Both standard and enhanced surveillance metrics confirm that the pandemic had transitioned to endemic by the time of the WHO declaration.
(©Alan G Soetikno, Alexander L Lundberg, Egon A Ozer, Scott A Wu, Sarah B Welch, Maryann Mason, Yingxuan Liu, Robert J Havey, Robert L Murphy, Claudia Hawkins, Charles B Moss, Lori Ann Post. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 12.06.2024.)

Keywords: 7-day lag; Algeria; Arellano-Bond; Bahrain; COVID-19; COVID-19 transmission; Djibouti; Egypt; Iran; Iraq; Israel; Jordan; Kuwait; Lebanon; Libya; Middle East; Morocco; North Africa; Oman; Qatar; SARS-CoV-2; Saudi Arabia; Syria; Tunisia; Yemen; acceleration; deceleration; dynamic panel; generalized method of moments; jerk; pandemic history; speed; the United Arab Emirates

Date Created: 20240403 Date Completed: 20240612 Latest Revision: 20240612

20240612

10.2196/53219

38568184