MENA Crisis Tracker – 12/6/2021 The MENA Crisis Tracker is a weekly newsletter that provides information on public health indicators, expected economy-wide losses, and social consequences of the ongoing COVID-19 crisis in the Middle East and North Africa. COVID-19's spread, fatality, and economic costs are particularly difficult to ascertain when testing is far from universal. Data transparency is key to facilitate context-specific policy responses, which require tradeoffs between public health outcomes and socio-economic conditions in the short run. But publicly available data must be interpreted with caution because testing is far from universal. In addition to presenting COVID-19 related indicators with caveats, the Tracker provides links to publicly available research on the economics of the pandemic and potential policy responses. Highlights from this edition1: • Missing Data Alert: In the absence of universal testing, general mortality rates during 2021 can be compared to pre-pandemic mortality as a proxy for the public health consequences of the pandemic. Unfortunately, MENA countries do not offer publicly available data on deaths. • High-income MENA countries lead in testing per capita – see Public Health Tracker. Testing data for Algeria, Yemen, and Syria has been updated using Worldometer data, but WB staff cannot corroborate the information using official government sources. Many MENA countries have positivity rates above the WHO’s recommendation of 5% or lower. • The Tracker presents information on vaccination efforts across MENA. See last section under Public Health Tracker. • Global evidence indicates that testing per person tends to rise with income per capita, after controlling for population size and the quality of public health systems. This finding confirms that developing economies are at a disadvantage relative to rich countries. See What Is Correlated with Testing per Capita. • Expected macroeconomic losses due to the pandemic have surged since March 2020, reaching 6.3% of MENA’s 2019 GDP as of November 30th, 2021 relative to the counterfactual scenario of no crisis. The expected GDP losses are highest for Lebanon, with an expected accumulated loss in 2021 equivalent to 10.2% of its 2019 GDP. See Macroeconomic Costs. • The economic losses have increased poverty relative to the counterfactual scenario without the crisis. Yet estimates of increases in the number of poor people might be underestimated. See Poverty and Social Costs. • In many MENA countries, food prices have risen by more than 20 percent since February 14th, 2020. See Insights from the MENA Welfare Observatory. 1 The editor for this edition is Christina A. Wood, Senior Economist, Office of the Chief Economist for MENA. Excellent data assistance provided by Rana Lotfi. Our thanks to Minh Cong Nguyen for providing the poverty estimates in Table 8, and to Ifeanyi Nzegwu Edochie for providing the food prices heat map (figure 4). This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. 1 • Insights from Academia includes a new paper that assesses the link between the pandemic and food security status in MENA. Table of Contents I. Public Health Tracker 3 II. What Is Correlated with Testing per Capita? 10 III. Macroeconomic Costs 12 IV. Poverty and Social Costs 15 V. Insights from the MENA Welfare Observatory (Poverty Team) 18 VI. Insights from Academia 19 VII. Useful Resources for Information on COVID-19 21 2 I. Public Health Tracker Under the hypothetical of universal testing, the spread of the virus is measured by the number of COVID-19 cases per capita, and its fatality rate is tracked by the number of deaths per capita. Given that the incidence of testing around the world and in MENA is far from universal, indicators of the spread are neither strictly reliable nor comparable across countries. In fact, it is likely that countries with more widespread testing will present higher rates of spread and fatality. Hence the degree of testing itself must be tracked to put the indicators of the spread and deaths in perspective. Testing is tracked by two indicators: the number of tests per capita and the test positivity rate (number of positive cases over total tests) which tends to decline with the incidence of testing. Table 1 provides a summary of the indicators and their caveats. Table 1: Summary of Public Health Indicators Indicator Caveats Testing Tests per capita Testing data is sparse for some economies Test positivity rate (number of Emerging rule-of-thumb: Test-positivity rate positive cases over total tests) should be below 5 percent Number of COVID-19 cases per Testing is not universal; many cases may be Spread capita missed COVID-19 deaths may be misattributed, or at- Deaths due to COVID-19 per Fatality home deaths may be missed; deaths may be capita underestimated Missing data alert: Given that testing is not universal, an arguably more trustworthy indicator of the fatality rate is the difference between total deaths reported during the spread and pre-pandemic mortality trends. Currently, most MENA countries do not provide readily accessible historical or recent data on the number of deaths (due to any cause). This alone indicates that MENA faces a transparency challenge. Another caveat to keep in mind is that each country may be at a different stage of the pandemic. A country may seem to be faring better than another, although at the peak of the outbreak it may suffer more. Without universal testing, the true spread of the virus can only be understood by random population testing.[1][2] Notably, reported numbers are susceptible to selection bias, since it is common for only those with symptoms to be tested. Random population testing has only been undertaken in a few places. In New York State, random testing of 3000 individuals revealed that 14 percent were carriers of the COVID-19 antibody as of April 23.[3] In Indiana, random population [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138654/ [2] https://www.medrxiv.org/content/10.1101/2020.04.09.20059360v2 [3] https://www.reuters.com/article/us-health-coronavirus-usa-new-york-idUSKCN2252WN 3 testing in April suggested that the virus had a 2.8% prevalence rate in the state, implying that for every officially reported case of COVID-19, 10 cases were unreported.[4] In a state in southern Brazil, a program was launched to randomly test 18,000 people. A significant upward trend was observed over the course of three surveys, with an increase in seroprevalence from 0.135% in the first round to 0.222% in the third during the early days since the arrival of the virus in southern Brazil. [5] In the MENA Region, few studies have tried to assess the seroprevalence of antibodies against SARS-CoV-2. In Al-Madinah, Saudi Arabia, after studying samples from 1,212 healthy blood donors between mid-May and mid-July, 2020, a study showed a seroprevalence of 19.3%.[6] In Iran, and based on a larger sample size of 8,902 individuals, random testing conducted between April and June 2020 showed a seropositivity rate of 17.1%.[7] A second study conducted in Iran’s Guilan province during April 2020, based on 551 individuals, exposed an even higher seroprevalence of 22%.[8] However, it is important to notice that seropositivity rates may largely vary depending on the population and the surrounding circumstances. In Jordan, after studying 746 healthy blood donors living under strict lockdown measures between January and June 2020, it was found that none of the individuals carried COVID-19 antibodies. Still, it is possible that the spread of the virus could be much higher than reported by official statistics. News Highlights: ❖ Innovation drives healthcare in the UAE. ❖ COVID Omicron: How are Middle Eastern countries responding to the variant? ❖ Egypt is one step away from its first national COVID-19 vaccine. ❖ Iraq braces for new coronavirus wave 'at any moment'. ❖ 47% of MENA energy professionals plan job switch. ❖ Oil price falls 3% on jitters over vaccine efficacy. [4] https://www.medrxiv.org/content/10.1101/2020.04.09.20059360v2 [5] https://www.nature.com/articles/s41591-020-0992-3 [6] https://www.sciencedirect.com/science/article/pii/S1319562X20306641 [7] https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30858-6/fulltext [8] https://www.medrxiv.org/content/10.1101/2020.04.26.20079244v1 4 The information below covers data for the date ending: December 6, 2021. 1. Testing as of December 6, 2021. Table 2 presents each country’s tests per million of population and the test-positivity rate. Test positivity rates have improved slightly in a few countries yet remained largely unchanged in most countries since January 2021. Last week showed no change in test positivity rate of the MENA average (6%) or of almost all countries relative to the preceding week—one country showed a marginal improvement, whereas another showed a marginal decrease in that ratio. A low test- positivity rate in cases of low tests per million, or a high test-positivity rate suggests that testing is selective and insufficient relative to the spread of the disease. Based on last week’s data, Arabian gulf countries continue to lead the region in terms of having the highest tests per million in the region, specifically the UAE (10,187,878), Oman (4,724,600) and Bahrain (4,197,413). These three, joined by Saudi Arabia, Djibouti, and Yemen, also have the lowest test-positivity rates below the 5% recommended by the WHO. Three countries, Syria, Algeria and Yemen, have consistently lacked reliable testing data over the course of the pandemic, have not been providing official updates, and have low tests per million. While the Worldometer database occasionally has updated testing data for these three countries, World Bank staff are unable to corroborate this data from the Worldometer database using official, government sources. Oman has not released new testing data since September 13th, 2021, Egypt has not released new testing data since September 20th, 2021 and Lebanon has not released new testing data since November 22nd, 2021. 5 Table 2. COVID-19 Tests per Million of Population as of December 6, 2021 Country Tests/1M Total Tests Tests last week Cases/Tests United Arab Emirates 10,187,878 102,497,410 1,677,978 1 Oman 4,724,600 25,000,000 - 1 Bahrain 4,197,413 7,495,132 127,713 4 Kuwait 1,245,830 5,432,522 164,269 8 Jordan 1,197,954 12,395,866 338,068 8 Qatar 1,076,433 3,022,415 40,178 8 Saudi Arabia 890,745 31,698,370 620,001 2 Lebanon 707,122 4,795,578 - 14 West Bank and Gaza 523,325 2,758,039 37,185 16 Iran 457,098 39,093,355 654,115 16 Iraq 395,871 16,431,593 129,195 13 Morocco 279,770 10,500,927 84,282 9 Libya 275,062 1,926,658 25,979 19 Tunisia 266,691 3,198,939 29,560 22 Djibouti 246,249 248,335 2,194 5 Egypt* 35,147 3,693,367 - 10 Yemen* 8,623 265,253 - 4 Syria* 6,250 113,162 9,596 43 Algeria* 5,133 230,861 - 92 MENA Region 589,973 270,797,782 3,940,313 6 Source: Authors’ calculations based on data from Worldometer (https://www.worldometers.info/coronavirus/). Color coordination done as follows: 0-5% Green, 6-10% Yellow, 11-19% Orange, 20% + Red. “-” means data is not currently available. Countries should aim to be below the 5 percent test positivity rate threshold, according to a May 12th advisory statement by the World Health Organization. * = World Bank staff have not been able to corroborate the data reported in the Worldometer database. 2. Spread of COVID-19 as of December 6, 2021 Table 3 presents the number of reported COVID-19 cases per million of population, cases in the past week and percentage change in cases last week compared to the preceding week. Bahrain (155,591), Lebanon (100,091), Kuwait (94,825) and Jordan (94,318) have the highest rates. Two of these countries, Lebanon and Jordan, posted moderate percentage increases in weekly cases (23% and 15% respectively) while Bahrain (26%) reported a moderately high increase in weekly cases and Kuwait (74%) reported an elevated increase. 6 In countries with ongoing conflicts such as Iraq, Libya, Syria, and Yemen, weak testing capacity could often lead to fewer reported positive cases and paint a potentially misleading picture of low spread. In this regard, Libya (-9%), Iraq (-9%) and Syria (-13%) reported moderate decreases in positive cases, whereas Yemen (19%) reported a moderate increase in positive weekly cases. Only two other MENA countries reported decreases in Covid cases last week compared to the preceding week: the UAE (-15%) and Iran (-19%). Six other countries reported zero-to-moderate increases in weekly covid cases, ranging from 0% in Saudi Arabia to 19% in Tunisia. West Bank and Gaza (35%) and Djibouti (33%) recorded moderately high increases in weekly covid cases, whereas Oman reported an elevated increase in weekly cases of 211%, from a relatively low base. Table 3. Total Cases per Million Population as of December 6, 2021 Cases last week Cases Last Country Cases/1M Total Cases relative to Week previous week Bahrain 155,591 277,831 246 26% Lebanon 100,091 678,801 10,714 23% Kuwait 94,825 413,491 225 74% Jordan 94,318 975,956 32,651 15% Qatar 86,980 244,223 1,091 4% West Bank and Gaza 81,944 431,863 2,166 35% United Arab Emirates 73,785 742,328 410 -15% Iran 71,727 6,134,465 25,583 -19% Tunisia 59,896 718,443 1,185 19% Oman 57,565 304,603 84 211% Libya 53,536 374,989 3,418 -9% Iraq 50,216 2,084,346 4,724 -9% Morocco 25,326 950,591 859 6% Saudi Arabia 15,453 549,912 217 0% Djibouti 13,395 13,508 4 33% Algeria 4,702 211,469 1,317 10% Egypt 3,456 363,162 6,444 2% Syria 2,685 48,619 654 -13% Yemen 326 10,025 38 19% MENA Region 33,831 15,528,625 92,030 1% Source: Authors’ calculations based on data from Worldometer (https://www.worldometers.info/coronavirus/). Color coordination done as follows: Any % decrease is Green, 0-24% increase is Yellow, 25-49% increase is Orange, 50%+ is Red. 7 3. COVID-19 Fatality as of December 6, 2021 Table 4 shows the deaths per million of population, and the last week’s percentage change in deaths relative to the preceding week. A limitation of this measure is that it may underreport deaths by not counting deaths that occur at home, or by misattributing COVID-19 deaths to other causes. Due to either case, the numbers reported may be underestimates. Tunisia (2,118) has the highest rate in the region, followed by Iran (1,522) and Lebanon (1,294). Iran joined four other MENA countries—Libya, Iraq, Kuwait and Egypt—in posting declines in Covid-related deaths last week relative to the preceding week, ranging from -5% to -100%. Nine other countries had zero-to- moderate increases in deaths, ranging from 0% in the UAE and Yemen to 24% in West Bank and Gaza. Bahrain, Oman, Qatar and Djibouti again had no covid-related deaths during the week. Lastly, Tunisia had elevated increases in weekly covid-related deaths, from a low base. Table 4. COVID-19 Fatality Rate – Deaths/Million population as of December 6, 2021 Deaths last week Deaths last Country Deaths/1M Total Deaths relative to week previous week Tunisia 2,118 25,401 38 100% Iran 1,522 130,200 571 -15% Lebanon 1,294 8,775 66 3% Jordan 1,137 11,761 210 11% West Bank and Gaza 863 4,549 21 24% Libya 784 5,493 55 -5% Bahrain 781 1,394 0 - Oman 777 4,113 0 - Iraq 575 23,885 92 -28% Kuwait 565 2,465 0 -100% Morocco 394 14,788 14 8% Saudi Arabia 249 8,844 11 22% Qatar 218 611 0 - United Arab Emirates 214 2,148 2 0% Egypt 197 20,727 380 -8% Djibouti 185 187 1 - Syria 153 2,777 38 9% Algeria 136 6,103 45 22% Yemen 64 1,954 8 0% MENA Region 602 276,175 1,552 -7% Source: Authors’ calculations based on data from Worldometer (https://www.worldometers.info/coronavirus/). Color coordination done as follows: Any % decrease is Green, 0-24% increase is Yellow, 25-49% increase is Orange, 50%+ is Red. “—” indicates not applicable due to change from 0 cases the previous week. 8 4. COVID-19 Vaccinations as of December 6, 2021 Countries in the MENA region face mixed prospects of vaccine rollout in 2021-22. Arabian Gulf countries such as the UAE, Qatar, and Kuwait lead the region in the percent of the population vaccinated at 88.4%, 75.7%, and 73.1%, respectively (Table 5). Data on vaccine doses administered has been inconsistent across the region. While most MENA countries have been consistently updating their vaccination numbers, other countries have been slow to release updated figures. Table 5. COVID-19 Vaccinations as of December 6, 2021 Vaccine Vaccine imports % of Cumulative COVID-19 vaccine clinical trial through Country population Vaccine Contracts doses administered participation COVAX vaccinated (Y/N) Facility (Y/N) Algeria 12.1% 12.15 million by November 29th Sputnik V, AstraZeneca, and Sinopharm N Y Pfizer and BioNTech, Sinopharm, Bahrain 66.5% 2.98 million by December 5th Y N AstraZeneca Djibouti 2.6% 104,475 by December 2nd Sputnik V N Y Egypt 14.9% 40.64 million by November 29th 40m from Sinopharm, AstraZeneca Y Y th Iran 56.6% 107.53 million by December 5 Sputnik V N N 1.5m doses – Pfizer, Sinopharm, 1m Iraq 11.5% 12.27 million by November 30th N Y Sputnik V Jordan 36.8% 7.95 million by December 5th 3m doses - Pfizer and BioNTech Y Y th Kuwait 73.1% 6.58 million by November 30 1m doses - Pfizer, BioNTech, AstraZeneca N Y th Lebanon 25.3% 3.66 million by December 5 2.1m Pfizer, AstraZeneca N Y $9.6 million of vaccines contracted with Libya 9.6% 2.38 million by December 2nd N N WHO Morocco 61.0% 48.85 million by November 29th 65 million - Sinopharm and AstraZeneca Y Y 370,000 Pfizer-BioNTech doses, Oman 54.1% 5.93 million by November 23rd N N AstraZeneca Qatar 75.7% 5.01 million by December 4th Pfizer-BioNTech and Moderna N Y Saudi Arabia 64.0% 47.70 million by December 5th Pfizer-BioNTech Y Y Syria 4.0% 1.42 million by November 28th 5,000 doses received N Y Tunisia 42.6% 10.73 million by December 5th 2m doses – Pfizer, 1m Sputnik N Y UAE 88.4% 21.55 million by November 15th Sinopharm and Pfizer Y Y 37,440 Pfizer and 24,000 AstraZeneca West Bank & Gaza 26.2% 3.02 million by November 22nd N Y delivered through COVAX Yemen 1.2% 774,953 by November 28th 2.3 million doses with COVAX N Y Source: Data on vaccination from Our World in Data (https://ourworldindata.org/covid-vaccinations). The Pfizer-BioNTech vaccine has been approved by the WHO for emergency use. Other vaccines have been approved on a national level as follows: Sinopharm in China, UAE, Bahrain, and Egypt; Sputnik V in Russia, West Bank and Gaza, Algeria, and Paraguay; AstraZeneca vaccine in the UK, India, Argentina, Morocco, Kuwait, and Mexico. 9 II. What Is Correlated with Testing per Capita? Using data on testing as of December 6, 2021 we can draw some insights about the correlates of testing across countries. The regression results reported in Table 6 below show that countries that are richer, have better health security and capabilities, or are smaller, tend to test more per capita. The regional fixed effects (not presented in Table 6) show that South Asia has the largest coefficient, followed by the Gulf Cooperation Countries group, then Europe and Central Asia. These are the only regions with statistically significant coefficients relative to East Asia and the Pacific, besides Sub-Saharan Africa reporting a negative coefficient. The conclusion is that richer countries test more, but there are no scale effects from being a larger economy. Arabian gulf countries on average appear to have more testing per capita than countries from other regions apart from South Asia after controlling for population size and GDP per capita. Table 6. Correlates of Testing per Capita – Scale vs. Per Capita Income Model OLS Outcome Variable Log of Tests per Million of Population (as of December 6, 2021) (1) (2) (3) Log of GDP per capita (constant 0.746*** 0.737*** 0.589*** 2010 US$), 2018 (0.086) (0.088) (0.088) Log of Population, 2018 -0.267*** -0.284*** -0.295*** (0.061) (0.066) (0.056) Global Health Security Index, 0.033*** 0.033*** 0.030*** 2019 (0.010) (0.010) (0.010) Days since the 100th case 0.001 0.000 (December 5, 2021) (0.001) (0.001) 9.104*** 8.999*** 10.764*** Constant (1.206) (1.199) (1.095) Region Fixed Effects NO NO YES Number of observations 163 163 163 Adjusted R2 0.732 0.731 0.770 note: *** p<0.01, ** p<0.05, * p<0.1, Robust Standard Errors. East Asia & Pacific omitted. 10 Figure 1: Change in Forecasts October ’20 - October ’19 vs Total Positivity Rates (Cases/Tests %) Growth Downgrade (Oct 2020 minus Oct 2019) -1 -2 Total positivity rate as of - Dec 7, 2020 -0.0309 0.0786*** -0.0337 -0.0277 Log of GDP per capita in 2019 -1.583*** -0.458 Tourism (% of exports in 2018) -0.126*** -0.0187 Trade (% of GDP in 2019) -0.0055 -0.0045 Note: Y axis is the difference in growth projections (using IMF Days from the first confirmed case as Nov WEO data) for year 2020, October 2020 minus October 2019. X 30 -0.0038 axis is the total positivity rate is a percentage calculated by dividing total number of cases by total number of tests (using -0.0067 Worldometer data). Sample includes all countries for which data is available. Constant -9.072*** 1.296 -0.614 -1.726 On the right, we introduce several control variables: log of GDP per capita in 2019 (in USD, October 2020 WEO), total trade value in GDP in 2019 (percent), days since first positive case Observations 139 139 until Nov. 30, 2020 (JHU), and tourism as a % of export in R-square 0.00413 0.389 2018 (WDI). Standard errors in parentheses * p<0.10, ** p<0.05, *** p<0.01 The downward trendline in Figure 1 that demonstrates the relationship between change in growth forecasts and total test positivity rate reveals a negative correlation between the two variables. Using a global sample for which data is available, regression results indicate that, even after controlling for log of GDP, tourism, and trade, a higher test positivity rate means a lower GDP growth forecast. As reported in Table 6, countries that are more developed tend to have higher incidences of testing. Figure 1 shows that countries who have maintained a low overall test positivity rate are likely to have a growth forecast. 11 III. Macroeconomic Costs Updated consensus growth forecasts by the private sector were released on November 30th, 2021 containing information available through November 28th, 2021. We compute the effect of the crisis on the level of economic activity (GDP) as the growth downgrade for 2020 plus the impact of the changes in growth forecasts for 2021. MENA’s 2021 GDP level reflects a downgrade of 6.3 percentage points on average (see Panel A of Figure 2). The largest GDP-level downgrade in 2021 is seen in forecasts for Developing Oil Importers (7.3 percentage points lower than what was implied by the forecasts of December 2019), followed by GCC (7.1 percentage points) and Developing Oil Exporters (4.5 percentage points). These GDP-level downgrades can be interpreted as the expected macroeconomic costs of the COVID-19 pandemic and oil price collapse as a percent of MENA’s 2019 GDP. The expected GDP losses for 2021 have remained substantial as more information became available. In addition, the recovery in GDP level in 2021 will not be a V-shaped recovery (Panel B of Figure 2). The 2020 GDP level downgrade for MENA, using the baseline December 2019 forecasts, was 0.5 percentage points in March, 1.8 percentage points in April, 5.1 p.p. in May, 6.4 p.p. in June, 6.9 p.p. in July, 7.3 p.p. in August, 7.5 p.p. in September, 7.7 p.p. in October, 7.4 p.p. in November, and 7.5 p.p. in December. Then, in 2021, the GDP level downgrade for MENA has been 7.6 percentage points in January of 2021, 7.3 p.p. in February, 7.5 p.p. in March, and 7.2 p.p. in April, 7.4 p.p. in May, 7.1 p.p. in June, 7.2 p.p. in July, 6.6 p.p. in August, 6.2 p.p. in September, 6.1 p.p. in November and 6.3 p.p. in December. Amid a general improving trend, on average, of private sector forecasters' views of the cost of the crisis during 2020 and into 2021, the slight downgrade in the December GDP forecast reflects forecasters’ concerns about implications of the new COVID Omicron variant. 12 Figure 2. Not a V-Shape Recovery Relative to the Counterfactual of No Crisis: The Expected GDP Losses of the Crisis Panel A: By MENA Country Groups Panel B: MENA Region by Time of Forecasts (December 2021 minus December 2019 forecasts) 0.0 1.00 0.00 -1.0 -1.00 -2.0 -2.00 -3.0 -3.00 -4.00 -4.0 -5.00 -5.0 -6.00 -6.0 -7.00 -8.00 -7.0 -9.00 -8.0 2019 2020f 2021f 2019 2020f 2021f March 2020 - December 2019 MENA June 2020 - December 2019 GCC January 2021 - December 2019 Developing Oil Exporters June 2021 - December 2019 Developing Oil Importers December 2021 - December 2019 Sources: World Bank Staff calculations based on data from Focus Economics. Notes: “GCC” includes Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and UAE. “Developing Oil Exporters” includes Algeria, Iran, Iraq, and Yemen. “Developing Oil Importers” includes Egypt, Jordan, Lebanon, Morocco, and Tunisia. “MENA” includes countries in all three groups. Data for Egypt correspond to its fiscal year, running from July 1 to June 30 in Egypt. Figure 3 presents expected GDP-level downgrades by various private sector forecasters for each country. The 2021 GDP-level forecasts for half the countries were still downgraded, though now better off than the 2020 GDP-level forecasts computed in December 2019. Lebanon has the largest downgrade. Figure 3 also reveals that the expected GDP losses during 2020 are expected to be recovered during 2021 for almost half of the countries. For the other half of MENA countries’ GDPs, the current December forecasts for 2021 are slightly worsened over the November forecasts for 2021 (except for Egypt and Oman), but the GDP forecasts remain below their no-crisis counterfactual levels. 13 Figure 3. Recovery Relative to the Counterfactual of No Crisis: Expected GDP-Level Downgrades of the Crisis by Country in 2020 and 2021 5.0 0.0 -5.0 -10.0 -15.0 -20.0 -25.0 % change in GDP Forecasts 2020 2021 Source: World Bank Staff calculations based on data from Focus Economics. Note: Data for Egypt corresponds to fiscal years (July 2019 -June 2020, and July 2020 – June 2021) not calendar years, which makes it not comparable to the data from other countries. 14 IV. Poverty and Social Costs The crisis shock will increase poverty in 2021. The uncertainty of the magnitude of the economic shock caused by the pandemic, as well as the uncertainty of the distribution of its effects on household per capita consumption, imply that any estimate of the expected percent changes in poverty due to the pandemic relies on restrictive assumptions. Tables 7 and 8 present alternative estimates of expected percent changes in poverty headcounts for 8 developing MENA economies. Both tables show estimated impacts of the pandemic by applying poverty-rate-to-growth elasticities to changes in GDP forecasts by Focus Economics. In both sets of estimates, the elasticities are based on the assumption that the economic shock is “inequality-neutral,” which means that they rely on the assumption that all households are impacted by a constant proportion of the GDP shock equal to 0.85, which is known as the “pass-through rate.” Table 7 uses a common elasticity for the eight MENA countries at each poverty threshold, which is the median elasticity for the sample of MENA countries listed in the table at each poverty line. These elasticities were estimated with pre-crisis data by Mahler, Lakner, Aguilar and Wu (2020).2 In contrast, the estimates reported in Table 8 allow for the poverty-to-GDP elasticities to vary across countries as well as across poverty thresholds. These estimates were provided to the Tracker by the World Bank’s MENA Poverty team. Lastly, please note that if a country has negligible pre-crisis poverty rates at low poverty-line thresholds, the absolute change in poverty rates (the number of poor people as a share of the population) can also be negligible. This is the case of Lebanon in Tables 7 and 8. 2 The median MENA regional inequality-neutral elasticity for the international poverty rate ($1.9 in 2011 PPP) is -4.8, for the lower middle-income poverty rate ($3.2 in 2011 PPP) is -3.3, and for upper middle-income poverty rate ($5.5 in 2011 PPP) is -2.3. All these MENA-specific elasticities are larger in absolute values than median elasticities for the world as provided by World Bank Economist, Daniel Mahler of the Development Economics Data Group (DECDG) on May 1, 2020. The median global elasticities are lower: -1.4 for the $1.9 threshold (1.4% decline in $1.90 headcount ratio per 1% increase in GDP), the median elasticity for $3.2 is -1.2, and the median elasticity for $5.5 is -0.9. 15 Table 7. Estimates of Increases in Poverty Headcounts due to the Crisis based on Private- Sector Growth Forecasts as of November 2021 and Median MENA Poverty Elasticities (percentage of pre-crisis poverty rates) % Change in Poverty Rates Due to the Crisis GDP Losses Change in Lower middle-income Upper middle-income Forecasts (%) International poverty Country poverty rate ($3.2 in poverty rate ($5.5 in rate ($1.9 in 2011 PPP) 2011 PPP) 2011 PPP) 2021 2021 2021 2021 Algeria 1.5 -7.2 -5.0 -3.5 Egypt -2.1 10.1 6.9 4.8 Iran 1.5 -7.2 -5.0 -3.5 Iraq -0.6 2.9 2.0 1.4 Jordan -0.7 3.4 2.3 1.6 Lebanon -10.2 49.0 33.7 23.5 Morocco 1.9 -9.1 -6.3 -4.4 Tunisia 0.8 -3.8 -2.6 -1.8 Source: MNACE Staff calculations based on data from Focus Economics and poverty-GDP elasticities by Daniel Mahler (World Bank, DECDG). The median MENA regional inequality-neutral elasticity for the international poverty rate ($1.9 in 2011 PPP) is -4.8, for the lower middle-income poverty rate ($3.2 in 2011 PPP) is -3.3, and for upper middle-income poverty rate ($5.5 in 2011 PPP) is -2.3. * indicates that pre-crisis poverty rates at the indicated thresholds were estimated at zero. Forecasts for Egypt are based on data from its fiscal year of 2021, which runs from July 1 st, 2020 to June 30, 2021. 16 Table 8. Estimates of Increases in Poverty Headcounts due to the Crisis based on Private- Sector Growth Forecasts as of November 2021 using Varying Elasticities (percentage of pre-crisis poverty rates) Change in % Change in Poverty Headcount Due to Expected GDP Losses from the Crisis forecasts (%) International poverty International poverty International poverty Country 2021 rate ($1.9 in 2011 PPP) rate ($3.2 in 2011 PPP) rate ($5.5 in 2011 PPP) Algeria 1.5 17.0 28.3 17.0 Egypt -2.1 14.8 10.9 3.4 Iran 1.5 -27.8 -22.1 -16.2 Iraq -0.6 130.5 65.7 27.1 Jordan -0.7 1.3 16.8 13.3 Lebanon -10.2 0.0 - 223.1 Morocco 1.9 22.1 22.9 16.2 Tunisia 0.8 53.9 41.9 28.3 Source: World Bank Staff calculations based on data from Focus Economics and varying poverty-GDP elasticities. “—" indicates 3 that pre-crisis poverty rates at the indicated thresholds were estimated at zero. As mentioned, the estimates of the impact of the crisis on the number of poor people presented in Tables 7 and 8 rely on the weak assumption that the impact is “inequality neutral.” Yet, it is likely that some individuals or households will be more severely affected than others. Across the region, those at risk of falling into poverty are probably self-employed, informal sector workers who lack social protection, and individuals working in sectors directly hit by the COVID-19 crisis. Migrant workers— for example in GCC countries—are excluded from safety nets available to citizens. In addition, the crisis is affecting some industries more than others, which implies that the economic risk of individuals depends on their sector of employment. For example, hard-hit sectors include tourism, retail, textile, and garment industries, which are particularly salient for the economies of Lebanon, Tunisia, Morocco, and Egypt. Individuals whose livelihoods are tied to these sectors are probably at a higher risk of falling into poverty. Thus, the estimates of the expected increases in the number of poor people need to be interpreted with a grain of salt. But it suffices to say that poverty is expected to rise, possibly by large numbers. 3The estimates of the increase in the number of poor people relative to the counterfactual scenario of no crisis are based on simulations. The results are sensitive to the pre-Covid distribution of household consumption per capita. In the case of Lebanon, the original data come from the 2011/2012 household survey. The poverty rates since then were estimated by applying a pass through of GDP per capita growth to household per capita consumption, assuming that all households were affected by the same proportion -- the inequality-neutral shock assumption. Earlier this month, the revised 2011 purchasing power parities data (released in May 2020 from the International Comparison Program (ICP)) was updated in the poverty calculation. The result was that measured poverty in 2011 and all subsequent years were estimated to be lower than previously thought. More importantly, the distribution of per capita consumption at the bottom tail (low levels of per capita consumption) is flat, and thus the poverty elasticity with respect to GDP shocks also fell. This explains why the current estimates in Table 8 for Lebanon and other countries are lower than those previously reported in this Tracker. 17 V. Insights from the MENA Welfare Observatory (Poverty Team) 1. Food Price Changes COVID-19 poses considerable risks to already vulnerable populations. One of these risks come from rising food prices, which have come under stress due to breakdowns in global supply chains. Food-price inflation is assessed here by analyzing changes in food prices since February 2020 (prior to COVID-19) across the MENA region, for five food categories: carbohydrates, diary, fruits, meats, and vegetables. Across the region food prices have been rising (see Figure 4). In most countries price increases have been modest (5% or less) but in Djibouti, Iran, Lebanon, Syria, Yemen, and even Malta prices of staples have increased by more than 20 percent since February 14th, 2020. Lebanon, Djibouti, Syria, and Yemen have been particularly hard hit, with prices increasing across the board between February 14, 2020 and November 16, 2021. Since food expenditures tend to account for a large share of poor households’ consumption relative to rich households, food inflation tends to be regressive. Figure 4: Food Price Changes between February 14, 2020 and as of November 16, 2021 18 Note: WB calculations based on food price data from the FAO. VI. Insights from Academia 1. Covid-19 and Food Security Challenges in the MENA Region by Dina Atef Mandour, Economic Research Forum Working Paper No. 1506, November 2021. Apart from being a health crisis in the first place, COVID-19 at its core is an economic as well as a food security potential crises. This paper assesses the link between the pandemic and food security status with special focus on the MENA region. It highlights the different channels through which the pandemic could impact the status of food security (FS), with its different pillars including affordability, availability, and utilization. Globally as well as in the MENA region, COVID has mainly affected the affordability and utilization pillars of FS, and had negligible effects on the availability pillar, at least in the interim. To understand the link between food insecurity and the pandemic, the study employs two types of datasets and correspondingly two equations were estimated using two different indicators for measuring food security and two indicators to proxy the effect of the pandemic. The two approaches confirmed that the variability in food security status across all countries is significantly negatively related to the pandemic stringency on global and MENA region levels. The empirical assessment has drawn vivid attention to the relative importance of the role of institutional and demographic prerequisites, consecutively, needed to handle the pandemic in explaining the food insecurity variability across all countries, compared to the effect of the stringency of the pandemic as measured by the number of confirmed cases. Regression results show the MENA region is at a disadvantaged situation compared to the rest of the world, regarding its coping capacity limitations as represented by the weak governance, high prevalence of corruption and fragile health systems in explaining countries’ variability in food security levels. COVID has thus the potential of being the catalyst that would intensify the urgency to undertake radical reforms in food systems and to revisit several directly and indirectly related structural and institutional rigidities that have affected accessibility and utilization pillars in MENA region. 2. The Effects of Fiscal Measures During COVID-19 by Pragyan Deb, Davide Furceri, Jonathan D. Ostry, Nour Tawk, and Naihan Yang. This paper empirically examines the effects of fiscal policy measures during the COVID-19 pandemic, using a novel database of daily fiscal policy announcements—classified by type of fiscal measure— and high-frequency economic indicators for 52 countries from January 1 to December 31, 2020. The results suggest that fiscal policy announcements have been effective in stimulating economic activity, boosting confidence, and reducing unemployment, but their effect varies by type of measure and country characteristics. Emergency lifeline measures (which form the bulk of below-the-line measures) are more effective when containment policies are stringent, providing cashflow support to firms and households. Demand-support measures (which comprise most of above-the-line measures) are more 19 effective when containment measures are relaxed. 3. Developing economy debt after the pandemic By M. Ayhan Kose, Franziska Ohnsorge, Carmen Reinhart, Kenneth Rogoff Global government debt soared in last year’s pandemic-induced global recession. It may now be tempting to rely on the post-pandemic growth and inflation rebound to reduce debt burdens. This column argues, however, that medium-term growth prospects are diming, and inflation helps reduce debt burdens only under particular circumstances. As a result, some developing economies may eventually need to resort to debt default to restore fiscal sustainability, with the associated heavy economic and political cost. The global community can help by coordinating prompt and efficient debt relief and restructuring. 4. A Mountain of Debt: Navigating the Legacy of the Pandemic by M. Ayhan Kose, Franziska Ohnsorge, and Naotaka Sugawara The COVID-19 pandemic has triggered a massive increase in global debt levels and exacerbated the trade-offs between the benefits and costs of accumulating government debt. This paper examines these trade-offs by putting the recent debt boom into a historical context. It reports three major findings. First, during the 2020 global recession, both global government and private debt levels rose to record highs, and at their fastest single-year pace, in five decades. Second, the debt-financed, massive fiscal support programs implemented during the pandemic supported activity and illustrated the benefits of accumulating debt. However, as the recovery gains traction, the balance of benefits and costs of debt accumulation could increasingly tilt toward costs. Third, more than two-thirds of emerging market and developing economies are currently in government debt booms. On average, the current booms have already lasted three years longer, and are accompanied by a considerably larger fiscal deterioration, than earlier booms. About half of the earlier debt booms were associated with financial crises in emerging market and developing economies. 5. COVID-19 uncertainty: A tale of two tails by Philip Bunn, David E. Altig, Lena Anayi, Jose Maria Barrero, Nicholas Bloom, Steven Davis, Brent Meyer, Emil Mihaylov, Paul Mizen, and Gregory Thwaites. Abstract: The onset of the COVID-19 pandemic triggered a massive spike in uncertainty. This article presents data from panel surveys of US and UK business executives to document how uncertainty over own-firm sales growth rates over the year ahead roughly doubled in reaction to the shock. Firm-level uncertainty receded after spring 2020 but remains much higher than pre-COVID levels. The nature of this uncertainty has shifted greatly since the pandemic struck, from an enormous widening in perceived downside risk to a sharp increase in upside risk. Economic uncertainty associated with the pandemic has morphed from a tale of the lower tail into a tale about the upper tail. 20 VII. Useful Resources for Information on COVID-19 COVID-19 & Government Description Link Response Trackers https://www.worldbank.org/en/about/what-we-do/brief/world-bank- World Bank World Bank COVID-19 Operations Projects group-operational-response-COVID-19-coronavirus-projects-list Daily updates of data on COVID-19 spread, Worldometer https://www.worldometers.info/coronavirus/ fatalities, and testing per capita Daily updates on COVID-19 media coverage Coronavirus News Tracker including the levels of panic and https://coronavirus.ravenpack.com/ misinformation Daily updates of new COVID-19 cases, total WHO Tracker https://covid19.who.int/ confirmed cases, and death totals Visualization and downloadable data on daily Our World in Data https://ourworldindata.org/coronavirus COVID-19 statistics COVID-19 visuals including global map of https://www.bloomberg.com/graphics/2020-coronavirus-cases-world- Bloomberg Live travel restrictions map/ Johns Hopkins Coronavirus COVID-19 totals of cases, deaths, and testing https://coronavirus.jhu.edu/map.html Research Center with visuals Visualization of COVID-19 daily deaths per Financial Times country including government response https://www.ft.com/coronavirus-latest Coronavirus Tracker stringency index https://www.bsg.ox.ac.uk/research/research-projects/coronavirus- Oxford University Government response Tracker government-response-tracker Ugo Gentilini (World Bank Social Protection Response to COVID-19 https://www.ugogentilini.net/ Social Protection Expert) 21 Worldwide Lockdown https://www.kaggle.com/jcyzag/covid19-lockdown-dates-by- Dataset of lockdowns by country Dataset country#countryLockdowndates.csv Global Fiscal Support Monitor with a https://blogs.imf.org/2020/05/20/tracking-the-9-trillion-global-fiscal- IMF breakdown of country-specific fiscal responses support-to-fight-COVID-19/ to COVID-19 https://www.theguardian.com/world/ng-interactive/2020/aug/31/covid- COVID vaccine tracker: when will a The Guardian vaccine-tracker-when-will-a-coronavirus-vaccine-be-ready coronavirus be ready? Human Mobility Data Description Link Analysis of mobility and shelter in place analysis by tracking movement of its users through their devices (mostly US so far). Cuebiq maintains direct relationships with 80+ Cuebiq https://www.cuebiq.com/visitation-insights-covid19/ apps that reach a diverse base of anonymous, opted-in users, giving the ability to collect accurate and precise SDK location data at scale on a daily basis. Facebook Disease Mobility patterns tracked using Facebook data https://dataforgood.fb.com/tools/disease-prevention-maps/ Prevention Maps Satellite Data (to capture Description Link COVID-19 effects) ESA: Sentinel 5P Air Pollution Maps https://earth.esa.int/web/guest/missions/esa-eo-missions/sentinel-5p NASA Goddard: Black Night Lights maps https://blackmarble.gsfc.nasa.gov/#home Marble 22 Social media and Crowd- Description Link sourced data Custom questions as part of on-going micro- surveys, for example perceptions of social Premise https://www.premise.com/ distancing measures, government support, livelihood impacts High frequency data COVID-19 related Google Trends https://trends.google.com/trends/story/US_cu_4Rjdh3ABAABMHM_en searches Crowd-sourced data on quarantine-related road Waze closures, medical testing centers, and https://www.waze.com/covid19 emergency food distribution centers 23