The World Health Organization is urging Middle East and North African governments to "seize the opportunity" to combat the coronavirus while numbers of cases in the region are still relatively low. "We have to seize the opportunity to act in the region because the rise in cases was not so rapid," Yvan Hutin, director of the communicable diseases department at WHOs Eastern Mediterranean office in Cairo, told AFP in an interview. In the region at large, which for WHO stretches to Afghanistan, around 111,000 cases of the novel coronavirus have been recorded and more than 5,500 deaths. That accounts for a small proportion of the more than two million cases and over 140,000 deaths declared worldwide from the pandemic. The exception is Iran, the hardest hit in the region and where the official toll stands at 78,000 cases and nearly 5,000 deaths. Hutin said it is hard to pinpoint a specific reason for the discrepancy. "There may be demographic factors at play because we are dealing with youthful populations" in the region, he said, referring to the heavier death toll from COVID-19 among the elderly. In conflict-ridden countries or "emergency situations" such as Libya, Syria and Yemen, low numbers have been reported. But according to the epidemiologist, "just because we avoided a difficult situation the first time around, that doesnt mean that it will stay like this". In Egypt, where Hutin led an assessment team last month, "it is clear that we have more transmissions now than a few weeks ago. But it still hasnt reached an exponentially proliferating rate of transmission". Avoiding explosion To avoid a situation comparable to Europe or the United States with tens of thousands of deaths, Hutin said several inter-related responses were needed. These include "community engagement, mobilizing entire health systems and preparation of hospitals for the arrival of severe cases". "The things that can be done are not necessarily very complicated," he said, such as isolating patients with mild symptoms "in hotels, schools or army dormitories". For severe cases, "there is a lot that can be done such as transforming conventional hospital beds into intensive care ones". Another measure to avoid an explosion of COVID-19 cases in the region would be to increase the capacity for testing. This can be done with "small machines that can give quick test results". Last week, WHO warned of a shortage of health workers in the region and of underreporting of coronavirus cases, as elsewhere across the globe. Hutin stressed "the potential seriousness and ability of this virus to bring the healthcare system to its knees" if the region fails to take action. Middle East and North African governments must prepare "for the possibility of things going wrong". With the Muslim holy month of Ramadan starting next week, when people gather to break daytime fasts, WHO has published a string of recommendations urging that social distancing be maintained.