Preparedness for COVID-19 in Saudi Arabia: Learnings from the MERS-CoV experience

We explore how the learning’s and experiences of MERS-CoV have influenced and guided Saudi Arabia’s response to the COVID-19 pandemic and examine the long-term benefits of implementing a national biosafety and biosecurity system in the Kingdom, to help manage any future outbreaks.

By GHE Team | June 15, 2020

In 2012, a novel zoonotic CoV known as the Middle East respiratory syndrome-CoV (MERS-CoV) emerged in Saudi Arabia and spread to 27 countries causing 2,500 confirmed infections and 860 deaths with large outbreaks, mainly in healthcare facilities and mostly in Saudi Arabia. The experience learned from the MERS-CoV epidemic has undoubtedly helped the country to be better prepared for the current SARS-CoV-2 (or COVID-19) pandemic, with Saudi Arabia among the first countries to implement early and unprecedented precautionary measures to prevent the introduction of COVID-19 into the country or to mitigate its impact when it arrived.

These early measures included establishing a national committee to follow global updates and to prepare for the possible introduction and spread of the virus, banning of inbound travel of individuals from SARS-CoV-2 affected countries, the suspension of entry of all international Umrah pilgrims and tourists and monitoring of all entry points to Makkah and Madinah. Upon reporting its first case of COVID-19 on 2nd March 2020, digital health was quickly activated and utilised to allow people to seek medical help and receive medical prescriptions without the need to visit medical centres. A mobile laboratory was also set up by the Ministry of Health, which, at full capacity, can analyse 10,000 samples daily, with the results available in 12 hours.

The lessons learned from the discovery of the MERS-CoV meant that the Saudi Ministry of Health (MoH) had already established a command and control centre and accelerated the establishment of the Saudi Center for Disease Control and Prevention (SCDC), which are now in the frontline of the country response to COVID-19. The Kingdom has also donated US$150 million to the Global Alliance for Vaccines and Immunization (GAVI) for its efforts combat the coronavirus pandemic.

In addition, the MoH launched the National Health Laboratory (NHL) as a reference laboratory to provide diagnostic support to the infectious and non-infectious diseases related to public health, serve as a reference centre to the advanced clinical laboratory tests, and conduct medical and scientific research related to public health.

Prior to the NHL becoming fully functional, the World Health Organisation (WHO) outlined a target for Saudi Arabia to establish a whole-of-government national biosafety and biosecurity system with especially dangerous pathogens identified, held, secured and monitored in a minimal number of facilities according to best practices. This targeted the setting up of biological risk management training and educational outreach and country-specific biosafety and biosecurity legislation, laboratory licensing and pathogen control measures.

Recommendations were also made for Saudi Arabia to review and clearly define the terms of reference of the National Committee on Biosafety and Biosecurity to strengthen coordination and ensure unified biosafety and biosecurity across all relevant sectors and service providers. Saudi Arabia was also encouraged to develop a national strategy identifying a prioritised plan of action for the implementation of the national biosafety and biosecurity guidelines and legislation and well as developing a unified, comprehensive training programme related to public health.

According to Algaissi, A.  et al (2020), the MERS-CoV epidemic helped Saudi Arabia to establish a public health system that was more alert as well as better infection control policies and measures. The Kingdom has undoubtedly improved in terms of clinical and scientific research on epidemics, and we can expect to see the building and establishment of appropriate biocontainment laboratories and moving into better governance of research and development.