The Kingdom vs. COVID-19







How Saudi Arabia acted swiftly and coordinated a global response to fight the coronavirus, preventing a far worse crisis at home and around the world

'This is the story of Saudi Arabia’s hard-won victory over an unseen killer — a killer vanquished in a war fought not only for the Kingdom but for all people everywhere.'

Health workers prepare to carry out nose swab tests in Diriyah hospital, Riyadh, on May 7. (AFP)

Health workers prepare to carry out nose swab tests in Diriyah hospital, Riyadh, on May 7. (AFP)

Even as it became clear that the new coronavirus disease that emerged in the dying days of 2019 could not be contained in China, many countries were slow to take seriously the threat COVID-19 posed to the lives of their citizens and the health of their economies.

Among those that did act quickly was Saudi Arabia, a nation keenly aware of the consequences — not only for itself and the region but for the entire planet — if it failed to tackle the pandemic effectively.

The Kingdom had not forgotten the harsh lessons it learned following the eruption within its borders in 2012 of Middle East Respiratory Syndrome (MERS), an experience that revolutionized Saudi Arabia’s understanding of public-health priorities during a large-scale outbreak of a communicable disease. It also emerged with the vital understanding that when humankind is faced with a global health crisis, each nation has a responsibility to act in the best interests not only of its own citizens but of the whole world.

Upon the outbreak of COVID-19, this responsibility was felt particularly intensely in Saudi Arabia, by far the biggest Arab state in the Gulf and, as custodian of Islam’s holiest sites, responsible every year for the well-being of millions of pilgrims from countries around the world.

As bad as the global impact of the pandemic has been, how much worse might it have been had Saudi Arabia allowed Hajj to go ahead as normal, risking the possibility of untold numbers of pilgrims returning infected to dozens of countries around the world?

These were the realities that underpinned Saudi Arabia’s swift response to COVID-19 and have driven its efforts throughout its presidency of the G20 to bring the world together to fight the virus in a coordinated way.

This is the story of Saudi Arabia’s hard-won victory over an unseen killer — a killer vanquished in a war fought not only for the Kingdom but for all people everywhere.

How MERS helped the Kingdom prepare for COVID-19

Saudi Arabia urged residents to wear masks when dealing with camels to avoid spreading MERS. (AFP)

Saudi Arabia urged residents to wear masks when dealing with camels to avoid spreading MERS. (AFP)

On June 13, 2012, a 60-year-old Saudi citizen with no previous health problems was admitted to a hospital in Jeddah suffering from a fever, cough and shortness of breath. Within 11 days, and despite intensive care, he was dead, killed by the progressive failure of his lungs and kidneys.

MERS-CoV, the sixth coronavirus known to infect humans, had made its deadly debut.

MERS, as the disease caused by this virus was named in May 2015, would be the last infectious disease named for a place or region. That same year, the World Health Organization (WHO) adopted a new protocol for naming human diseases, designed to “avoid causing offense” to any cultural, national or ethnic groups.

Keiji Fukuda, assistant director-general for the WHO, during a press conference on MERS in 2014. Ninety percent of all MERS cases were in Saudi Arabia. (AFP)

MERS, its predecessor Severe Acute Respiratory Syndrome (SARS) in 2002-2003 and now COVID-19, are zoonoses — infectious diseases that have jumped from animals to human beings. MERS is thought to have originated in camels.

Since 2012, there have been more than 2,500 cases of MERS in 27 countries, claiming the lives of 876 people, but 90 percent of all cases have been in Saudi Arabia.

With a mortality rate of about 35 percent, MERS-CoV kills a far higher proportion of people it infects than SARS-CoV-2, the virus that causes COVID-19. Ironically, it is this lethality that has prevented MERS from becoming as globally devastating as COVID-19; only a live host can continue to spread the disease.

But the virus that causes MERS, for which a vaccine has yet to be developed, remains a threat. The most recent serious outbreak in Saudi Arabia occurred between December 2019 and the end of January this year. Nineteen cases were recorded among residents from six regions, and eight of the patients, seven of whom were men, died.

The impact of MERS on those families affected by it has been as equally horrific as that of COVID-19. But there is no doubt that the severe shock to the Saudi public health system brought with it lessons that have proved invaluable in the battle against COVID-19.

“Each epidemic, each challenge for the system, serves as a lesson for the leadership of the health sectors in Saudi Arabia,” Dr. Riyad Qainan Al-Ghamdi, deputy chief executive officer of the Saudi Center for Disease Prevention and Control.

Dr. Al-Ghamdi said MERS had given the Kingdom “a very good chance to put in place a very good communication plan within the healthcare system and between other governmental stakeholders.”

The policies and procedures that were put in place in response to MERS, he added, “were very helpful in accelerating a lot of decisions for this time and a lot of experiences in policies and procedures and guidelines translated immediately to the response of the current challenge.” 

Similarly, he said, battling COVID-19 has put Saudi Arabia in a very good place for any future epidemics or pandemics.

Each epidemic, each challenge for the system, serves as a lesson for the leadership of the health sectors in Saudi Arabia.
Dr. Riyad Qainan Al-Ghamdi, Saudi Center for Disease Prevention and Control

Dr. Riyad Qainan Al-Ghamdi, deputy chief executive officer of the Saudi Center for Disease Prevention and Control, explains how MERS helped the Kingdom to prepare for COVID-19.

Dr. Riyad Qainan Al-Ghamdi, deputy chief executive officer of the Saudi Center for Disease Prevention and Control, explains how MERS helped the Kingdom to prepare for COVID-19.

Just how dramatically the Kingdom’s healthcare system was transformed by MERS was summed up in the paper “Preparedness and Response to COVID-19 in Saudi Arabia: Building on MERS Experience,” published in the Journal of Infection and Public Health in June this year. 

The authors, from several Saudi medical institutions, concluded that the emergence of MERS “put Saudi Arabia on a high sense of alert and readiness to take whatever measures (necessary) to curb the spread of COVID-19.”

Since 2012, there have been more than 2,500 cases of MERS in 27 countries.

For example, after the discovery of MERS, the Ministry of Health established a command and control center and the Saudi Center for Disease Prevention and Control, which are now operational and on the front line of the Kingdom’s response to the current virus.

The ministry also founded the National Health Laboratory, set up to provide advanced diagnostic services for the detection and control of infectious diseases, while “the biosafety in diagnostic laboratories and the application of strict infection prevention and control systems in all hospitals across the country improved substantially.”

More than 25 regional hospitals were designated for the isolation and treatment of MERS patients, and subsequently these hospitals were well prepared to deal with COVID-19 patients.

A nurse walks toward the King Fahad Hospital in Hofuf, east of Riyadh, in 2013. MERS outbreaks were most concentrated in the east of Saudi Arabia. (AFP)

Furthermore, the authors wrote, Saudi Arabia’s medical and scientific research community “demonstrated marvelous efforts in the understanding and control of MERS-CoV in the past few years, as evidenced by more than 480 publications to date, covering both translational and clinical research.”

One of the research efforts triggered by MERS may be close to fruition. In December 2019, the King Abdullah International Medical Research Center, in collaboration with the University of Oxford’s Jenner Institute, started a Phase 1 clinical trial of a potential vaccine for MERS-CoV. This trial, to determine whether the vaccine is safe and tolerable, began recruiting healthy volunteers in Saudi Arabia in November and could be completed by January 2021.

Alongside this is the ongoing MIRACLE study, the first randomized controlled trial of a treatment for MERS, evaluating the effectiveness of a combination of antiviral drugs. The trial, being carried out by Saudi researchers recruiting patients across 14 institutions, is funded by the King Abdullah International Medical Research Center. This work, the paper’s authors suggested, “now could be expanded to include COVID-19 patients.”

This and other research triggered by the MERS crisis has been supported by new and improved regulations produced by the Saudi Food and Drug Authority, the Ministry of Health and other regulators working in close harmony — regulations that have paved the way for swift research responses to the COVID-19 pandemic.

Keiji Fukuda, assistant director-general for the WHO, during a press conference on MERS in 2014. Ninety percent of all MERS cases were in Saudi Arabia. (AFP)

Keiji Fukuda, assistant director-general for the WHO, during a press conference on MERS in 2014. Ninety percent of all MERS cases were in Saudi Arabia. (AFP)

Since 2012, there have been more than 2,500 cases of MERS in 27 countries.

Since 2012, there have been more than 2,500 cases of MERS in 27 countries.

A nurse walks toward the King Fahad Hospital in Hofuf, east of Riyadh, in 2013. MERS outbreaks were most concentrated in the east of Saudi Arabia. (AFP)

A nurse walks toward the King Fahad Hospital in Hofuf, east of Riyadh, in 2013. MERS outbreaks were most concentrated in the east of Saudi Arabia. (AFP)

How COVID-19 spread in Saudi Arabia

Saudi Arabia’s first COVID-19 patient had traveled from Iran via Bahrain, over the King Fahd Causeway, pictured here. (Shutterstock)

Saudi Arabia’s first COVID-19 patient had traveled from Iran via Bahrain, over the King Fahd Causeway, pictured here. (Shutterstock)

The first case of COVID-19 in Saudi Arabia was announced on Twitter by the Ministry of Health on March 2. The Saudi patient, who had travelled from Iran via Bahrain over the King Fahd Causeway, was immediately quarantined, and the ministry dispatched infection-control teams to trace and test anyone with whom he had been in contact.

As Arab News noted at the time, until that moment “the Kingdom had been free of the virus for more than three months as it spread from China to 66 countries.”

Arab News reports on the Kingdom’s first COVID-19 case, a Saudi patient who had returned from Iran.

Two days later, the Kingdom identified its second patient, another Saudi citizen who had travelled with the first case. Both had failed to disclose that they had been in Iran.

The following day, Saudi Arabia publicly rebuked Tehran for allowing Saudi citizens to enter the country during the outbreak and urged any citizens who were still in Iran or who had returned from there recently to come forward within 48 hours, promising immunity from prosecution.

But by then the genie was already out of the bottle. 

By March 9, the Kingdom had recorded 15 confirmed cases of COVID-19, of whom seven had come from Iran and three from Iraq.

It was, in other words, apparent early on that Iran would be the weak link in the region’s defenses against COVID-19. By March 2, the day Saudi Arabia had its first case, Tehran had already admitted to 978 cases and 54 deaths. By the time the Kingdom’s second case emerged two days later, Iran’s caseload had more than doubled to 2,336, with 77 declared deaths.

Even that, it seems, may have been a willful gross underestimate of the true impact of the disease. Internal Iranian government documents leaked to the BBC’s Persian service at the beginning of August revealed that the true scale of the pandemic in the country was almost twice as bad as Tehran had admitted.

On March 25, just over three weeks after the Kingdom’s first case, COVID-19 claimed its first victim in Saudi Arabia, a 51-year-old Afghani who died in Madinah.

After that, the toll of cases and deaths began to climb.

The number of new daily cases in Saudi Arabia would see three distinct peaks, hitting a high on June 17, when 4,919 were reported in one day.

Reported daily cases in Saudi Arabia would see three peaks, with a high on June 17.

Many feared Saudi Arabia was on the brink of losing control of the pandemic. There would be a third uptick, with 4,387 cases reported on June 30, but the record high of 4,919 cases would not be seen again.

Slowly but surely, Saudi Arabia was winning the battle. After July 6, the number of daily cases began to fall steadily, dropping below 1,000 on Aug. 29 to 987 — a figure not seen since the middle of April. On Sept. 15, it was 672. Similarly, the number of daily deaths peaked at 58 on July 5, falling to 33 by Sept. 15 after dipping to 24 on Sept. 11. 

The number of daily deaths peaked at 58 on July 5, falling to 33 by Sept. 15.

As Saudi Arabia begins to emerge from the worst days of the pandemic and as life gradually returns to something closer to normal, it is time to begin counting the cost.

By Sept. 15, there had been a total of 326,930 cases in the Kingdom, and 4,338 lives had been lost. The global toll by then was 29.7 million cases and almost 940,000 deaths.

By Sept. 15, there had been a total of 326,930 cases in the Kingdom. The global toll by then was 29.7 million cases.  

It is now possible to compare Saudi Arabia’s performance in the battle against COVID-19 with that of other countries. The best resource for doing so is Our World in Data, a collaboration between researchers at Oxford University’s Oxford Martin Programme on Global Development and the non-profit organization Global Change Data Lab, and analysis of this data by the Worldometer initiative.

Looking only at total numbers of cases and deaths gives a distorted impression. With 326,930 cases by Sept. 15, Saudi Arabia was the 16th worst-affected country in the world. On a table measuring global mortality, its 4,338 deaths put it in 31st position overall. 

But in isolation these figures are misleading; it is important to look at the number of cases, deaths and other statistics per head of population.

With a total of 9,361 cases per one million population as of Sept. 15, Saudi Arabia was in 33rd position, rather than 16th, with a better record than most of the other Gulf Cooperation Council (GCC) states. With 43,527 cases per million as of Sept. 15, for example, neighbor Qatar had the worst infection ratio in the world.

Bahrain, with 35,982 cases per million, was the second worst. Kuwait (22,482 cases per million) was 7th and Oman (17,768) was 14th. Only the UAE, in 39th position with 8,248 per million by Sept. 15, was slightly outperforming Saudi Arabia in this respect.

But another factor has to be taken into account — the sheer size of Saudi Arabia compared with the other GCC states and the fact it shares lengthy borders with no fewer than seven countries. With a population of almost 35 million, spread over a vast area, the Kingdom has faced a task far more daunting than the other, smaller GCC states: the UAE (population 9.9 million), Oman (5.1 million), Kuwait (4.27 million), Qatar (2.8 million) and Bahrain (1.7 million). 

With a population of almost 35 million, spread over a vast area, the Kingdom has faced a task far more daunting than the other, smaller GCC states.

The number of deaths should also be seen in relation to the size of the population. The Kingdom’s total of 4,338 deaths by Sept. 15 represented a rate of 124 deaths per million head of population, placing Saudi Arabia close to the global average of 120.5. By this measure, it was performing better than a basket of 54 other countries, including the UK, Canada, the US, Spain, Italy, Sweden, France, the Netherlands and Switzerland. 

Also in that basket were two other GCC states — Oman (157 deaths per million) and Kuwait (133) — plus regional neighbors Iran (281) and Iraq (202).

Taking into consideration statistics per head of population, Saudi Arabia showed a better record than most Gulf Cooperation Council states.

Saudi Arabia’s total number of deaths represented a rate of 124 deaths per million head of population — close to the global average and better than 54 other countries.

But when the all-important post-crisis analysis takes place, answers must be found to some difficult questions. One of these relates to the Kingdom’s case fatality rate (CFR). This is the ratio between the number of cases and deaths — in other words, what percentage of those people who contracted the disease went on to die from it.

As our graph shows, after an initial rapid climb and spike on April 7, the Kingdom’s CFR improved dramatically, even as that of Kuwait and the UAE was still climbing.

While Saudi Arabia’s case fatality rate of 1.3 percent was the worst among Gulf Cooperation Council countries, it compared highly favorably with the global average of 3.2 and with that of a range of countries, including the UK (11.2) and the US (3).

By the end of May, however, the situation had begun to reverse. As of Sept. 15, Saudi Arabia’s CFR of 1.3 percent — meaning that more than one out of every 100 COVID-19 patients had died — was the worst in the GCC (compared with 0.9 in Oman, 0.6 in Kuwait, 0.5 in the UAE, 0.4 in Bahrain and 0.2 in Qatar). 

On the other hand, by Sept. 15, the Kingdom’s CFR of 1.3 percent compared highly favorably with the global average of 3.2 and that of a range of selected countries with supposedly cutting-edge healthcare systems, including the UK (11.2) and the US (3).

Dr. Al-Ghamdi, the deputy chief executive officer of the Saudi Center for Disease Prevention and Control, said most of the differences in CFR rates could be attributed to variations in population characteristics.

“For example,” he said, “the percentage of elderly people in Western countries is much higher than the percentage in Saudi Arabia, and we know now from all evidence that the elderly are more at risk of complications from COVID-19, and that the risk of dying is high among them.”

Similarly, he added, “in comparison with other countries in the region, the same will apply. We have different percentages of chronic diseases, and that will affect the outcome. But in general, the outcome of COVID-19 cases in Saudi Arabia is among the best in the world.”

Credit for this, he said, must be given to the royal decree that “enabled everybody in Saudi Arabia, whether they are Saudi or non-Saudi, whether they are legal or illegal, to access healthcare services if they are positive for COVID-19. This has provided a huge advantage for Saudi Arabia and has led to a very good outcome.”

Arab News reports on the Kingdom’s first COVID-19 case, a Saudi patient who had returned from Iran.

Arab News reports on the Kingdom’s first COVID-19 case, a Saudi patient who had returned from Iran.

Reported daily cases in Saudi Arabia would see three peaks, with a high on June 17.

Reported daily cases in Saudi Arabia would see three peaks, with a high on June 17.

The number of daily deaths peaked at 58 on July 5, falling to 33 by Sept. 15.

The number of daily deaths peaked at 58 on July 5, falling to 33 by Sept. 15.

By Sept. 15, there had been a total of 326,930 cases in the Kingdom. The global toll by then was 29.7 million cases.  

By Sept. 15, there had been a total of 326,930 cases in the Kingdom. The global toll by then was 29.7 million cases.  

Taking into consideration statistics per head of population, Saudi Arabia showed a better record than most Gulf Cooperation Council states.

Taking into consideration statistics per head of population, Saudi Arabia showed a better record than most Gulf Cooperation Council states.

Saudi Arabia’s total number of deaths represented a rate of 124 deaths per million head of population — close to the global average and better than 54 other countries.

Saudi Arabia’s total number of deaths represented a rate of 124 deaths per million head of population — close to the global average and better than 54 other countries.

While Saudi Arabia’s case fatality rate of 1.3 percent was the worst among Gulf Cooperation Council countries, it compared highly favorably with the global average of 3.2 and with that of a range of countries, including the UK (11.2) and the US (3).

While Saudi Arabia’s case fatality rate of 1.3 percent was the worst among Gulf Cooperation Council countries, it compared highly favorably with the global average of 3.2 and with that of a range of countries, including the UK (11.2) and the US (3).

Watch what the streets of Saudi Arabia looked like as it joined the world in a lockdown to prevent the spread of COVID-19 — a haunting yet beautiful stillness.

What Saudi Arabia did to keep COVID-19 at bay

A man crosses an empty street in Makkah on April 3. A day earlier, Saudi Arabia extended curfew restrictions on Islam’s two holiest cities to 24 hours to stem the spread of COVID-19. (AFP)

A man crosses an empty street in Makkah on April 3. A day earlier, Saudi Arabia extended curfew restrictions on Islam’s two holiest cities to 24 hours to stem the spread of COVID-19. (AFP)

The new COVID-19 Follow-up Committee, formed to monitor and coordinate the national response to the disease in Saudi Arabia, held its first meeting on Feb. 1. Just how seriously the Kingdom was taking the new threat was reflected in the broad membership of the group, chaired by Minister of Health Dr. Tawfiq bin Fawzan Al-Rabiah.

Around the table were representatives from 13 ministries: Health, Defense, Energy, Interior, National Guard, Foreign Affairs, Finance, Media, Commerce and Investment, Hajj and Umrah, Education and Tourism. Also present was the General Authority of Civil Aviation, the Saudi Red Crescent Authority, the Saudi Food and Drug Authority, the General Authority of Customs and the Saudi Center for Disease Prevention and Control.

From the outset, as the WHO would shortly acknowledge, Saudi Arabia was determined to be as ready as possible to confront the horror that was edging ever closer to its borders.

For Dr. Al-Ghamdi, the deputy chief executive officer of the Saudi Center for Disease Prevention and Control, the extent to which the Kingdom has weathered the COVID-19 storm was a product of effective leadership and a nationally coordinated response. 

“It was a very good exercise for the government and for the public health and healthcare system to see the gaps and to address them immediately,” he said. Furthermore, “it has given us a chance to reflect in the coming months and years and to implement any necessary changes that will put Saudi Arabia in the best position to meet any future challenges to the system.”

In a statement on March 25, Dr. Ahmed Al-Mandhari, the WHO’s regional director for the Eastern Mediterranean, praised the Kingdom’s rapid response. Its experience with MERS had not been forgotten, he said, and the country was “also drawing from its unique expertise in managing mass gatherings and emergency preparedness during the annual Hajj pilgrimage.”

On March 17, Saudi Arabia temporarily closed all places of worship but for the Two Holy Mosques in Makkah and Madinah. Three days later, these too were shut. (AFP)

At its 10th meeting, on Feb. 29, the COVID-19 committee cautiously noted that, even as the wider world was reeling under the impact of over 88,000 cases and nearly 3,000 deaths, Saudi Arabia still remained virus-free. 

But in the span of two days, all that would change.

It took a little over two months for COVID-19 to make its way to Saudi Arabia. By the time the Kingdom had its first case on March 2, the world had recorded 91,000 cases and 3,118 deaths.

The majority of those cases were still in China, but it was already clear that efforts to contain the virus within that country had failed; more than 10,000 infections and 172 deaths had already been recorded beyond China’s borders.

From the beginning, Saudi authorities realized that the tidal wave that was rapidly engulfing the world would inevitably sweep through the Kingdom but, thanks to the two-month period during which the virus was held at bay, they had time to plan for the worst.

“We were luckier than many other countries because our cases started a little bit later,” said Dr. Hani Jokhdar, deputy minister for public health, speaking in August at the virtual Riyadh Global Digital Health Summit. “This gave us a small opportunity to develop our systems, watching and observing what was happening in the rest of the world.”

Saudi Arabia’s breathing space was not down solely to luck. On Jan. 28, more than a month before the Kingdom saw its first case, the Ministry of Health had launched a public information campaign. At the same time, plans were being laid for the introduction of widespread testing, the tracing of contacts of confirmed cases and the introduction of systems for quarantining.

Saudi Arabia took early precautions to confront the pandemic, including launching awareness campaigns, closing public venues, and securing laboratory testing. (AFP)

It was not a moment too soon. On Feb. 2, 10 Saudi students were evacuated from Wuhan and flown to Riyadh on a private aircraft sent by the government. All tested negative for COVID-19 but were nevertheless quarantined for two weeks.

But the disease, assisted by still largely unrestricted global air travel, was moving fast. On Feb. 4, a day on which China’s number of infections passed 20,000, with 426 deaths, the WHO was still failing to recommend that countries should impose travel restrictions.

In fact, on Feb. 4, Dr. Tedros Adhanom Ghebreyesus, the WHO’s director-general, took the extraordinary step of urging countries not to ban flights from Wuhan, as this would “have the effect of increasing fear and stigma, with little public health benefit.”

WHO Director-General Tedros Adhanom Ghebreyesus wears a mask after leaving a ceremony in Geneva. King Salman authorized $10 million to help the WHO in Yemen combat COVID-19. (AFP)

Regardless, two days later, on Feb. 6, Saudi Arabia banned citizens and residents from traveling to China. It would be March 11 before the WHO finally declared the outbreak to be a pandemic, a state of affairs already blindingly obvious to the 114 countries which by then were in the grip of the virus.

As governments around the world reacted to the threat with little cohesion, it was remarkable that the Kingdom had held it off for as long as it did. It was the last of the six GCC states to be hit.

As governments around the world reacted to the threat with little cohesion, it was remarkable that the Kingdom had held it off for as long as it did – it was the last of the six GCC states to be hit.

Throughout February, as health and security teams were mobilized and trained, a series of measures were taken in response to the rapidly evolving global picture.

Some of those steps were reported in a paper published in the Saudi Pharmaceutical Journal in May, with the title “Importance of Early Precautionary Actions in Avoiding the Spread of COVID-19: Saudi Arabia as an Example.”

Saudi Arabia, wrote the authors from the Saudi Food and Drug Authority, King Saud University, King Khalid Hospital and the Regional Drug Information and Pharmacovigilance Center in Tabuk, “was one of the countries that took very early precautionary actions … before any cases occurred and before the WHO declared that COVID-19 was an epidemic.”

From the outset of the pandemic, precautionary measures had been tightened at health surveillance centers at all ports of entry, with all passengers coming from countries stricken by COVID-19 screened and isolated and their health monitored.

One aspect of the nation’s preparedness — its self-sufficiency in essential medical equipment throughout the crisis — was covered by Arab News, which on Aug. 12 reported that some 50 industrial units in the Kingdom had been busy producing essential medical goods. One of them, Enayah, had even had sufficient capacity to export its products to GCC neighbors, other Arab countries and the European Union. 

Saudi Arabia was also one of the first countries in the world to set up secure laboratory testing for COVID-19. On March 5, testing was introduced for anyone with symptoms. By July 13, more than 2 million COVID-19 tests had been carried out, and by Aug. 31, the total had exceeded 5 million.

On Feb. 19, citizens and residents were asked to postpone travel to Singapore, which had recorded 80 cases. It was the beginning of a series of travel restrictions culminating on March 15, when Saudi Arabia became only the second GCC state to impose a ban on all international flights. Simultaneously, shipping services with 50 countries, excluding cargo-carrying vessels, were suspended, and on March 21 bans were imposed on internal air, train and bus travel.

On Feb. 27, Saudi Arabia took the unprecedented step of suspending Umrah visas for foreign pilgrims. 

On March 5, dozens of events, including the Riyadh International Book Fair and the Saudi Arabian International Horse Festival, were cancelled. Three days later, the entire population of Qatif, the city in the Eastern Province where the majority of the Kingdom’s early cases had emerged, was placed under quarantine, and schools and universities across the nation were closed. Bans on gatherings and wedding ceremonies would follow on March 13.

Saudi authorities announced on March 8 the closure of all public and private universities and schools across the country. (AFP)

Focused though it was on its own looming crisis, on March 9 the Kingdom responded to the WHO’s plea for nations to do more to combat COVID-19 by donating $10 million to the organization’s regional fighting fund. At home, SR 50 billion ($13 billion) was allocated to support the Kingdom’s banking sector, financial institutions and small to medium businesses.

On March 19, demonstrating that the entire leadership of Saudi Arabia was focused on preparing for the pandemic, King Salman gave a rare public address on television, appealing to the nation’s “heightened sense of collective responsibility.”

The Kingdom, he said, “continues to take all precautionary measures to confront this pandemic and limit its effects. We depend on the aid of God Almighty, then on deploying our full capabilities, supported by your strong determination in the face of adversity.”

He added: “The strength, steadfastness, and determination that you have demonstrated during…this difficult phase, and your full cooperation with relevant government agencies, are the most important contributing factors and pillars of the success of the state’s efforts.”

On March 23, the King authorized a further $10 million to provide the WHO in Yemen with essential equipment and supplies, and Saudi Arabia began airlifting medical equipment and supplies from the WHO’s logistics hub in Dubai to Aden to boost Yemen’s readiness for COVID-19. 

“This funding will help the WHO intensify its efforts as it takes regional and global action to combat the spread of the disease,” commented Dr. Al-Mandhari, the WHO’s regional director for the Eastern Mediterranean.

On March 22, King Salman ordered a 21-day curfew from 7 p.m. to 6 a.m. across the whole of the country. The only exceptions would be for workers in vital industries, including food shops, pharmacies and medical services, and those working in water, energy and transportation. Three days later, the curfew in Makkah and Madinah was extended to start at 3 p.m.

It was also clear that, in the interests of preventing the spread of the disease, nothing should be allowed to stand in the way of any citizen or resident seeking medical help, and on March 30, King Salman ordered that all COVID-19 patients in the Kingdom should be treated free of charge.

The order applied to everyone, including violators of residence, labor or border security laws, who “shall all be treated at the public and private hospitals and healthcare centers free of charge, and without any legal liability whatsoever.”

On April 6, as the number of cases grew in specific regions, a 24-hour curfew was imposed on the cities of Riyadh, Tabuk, Dammam, Dhahran and Hofuf and the governates of Jeddah, Taif, Qatif and Alkhobar. Residents were allowed to leave their homes between 6 a.m. and 3 p.m., but only for essential needs within their own areas.

The following day, April 7, Dr. Al-Rabiah, Saudi Arabia’s minister of health, warned that the rate at which COVID-19 infections increased in Saudi Arabia over the coming weeks would depend “primarily on the cooperation of all and their commitment to the instructions and guidelines issued by the authorities.”

The state was doing its part. SR 8 billion had already been allocated to the fight against the virus, and following a virtual meeting on April 6, Crown Prince Mohammed bin Salman approved an additional cash injection of SR 7 billion. Over the next three months, more than 2,800 intensive care unit beds were added, increasing the Kingdom’s stock by 30 percent.

But some individuals, said Dr. Al-Rabiah, were “not dealing seriously with the pandemic and [were] not complying with the measures banning close contact and gatherings.”

Dr. Al-Rabiah also revealed the results of four studies that had been carried out by epidemiologists, predicting that the total number of cases over the next few weeks could range from at least 10,000 to 200,000. “Non-compliance,” he added, “will lead to a huge increase in the number of cases.”

The message got through. As revealed at the ministry’s daily COVID-19 briefing on July 2, Assistant Minister of Health Dr. Mohammed Al-Abdulaali noted that it had taken 90 days, instead of the predicted 30, to reach the 200,000 cases. The Kingdom, he said, had successfully bought time “to better manage the crisis.”

Similarly to its GCC neighbors, on April 26 Saudi Arabia temporarily relaxed daytime restrictions ahead of the start of Ramadan everywhere, except for Makkah and a few isolated districts, allowing people to leave their homes between 9 a.m. and 5 p.m. On May 13, the 24-hour curfew was reimposed on the whole country for the duration of the Eid Al-Fitr holiday.

At the end of May, the Ministry of Interior announced precautionary measures and preventive protocols for several sectors in preparation for a relaxing of the nationwide curfew from June 21. Restrictions remained in place, however, for religious pilgrimages, international travel and gatherings of more than 50 people. 

Speaking at a press conference, Minister of Finance Mohammed bin Abdullah Al-Jadaan, also the acting minister of economy and planning, said the gradual lifting of curfews represented “a new stage in the face of the global pandemic crisis and towards a gradual return to economic activities in the Kingdom to its normal levels.”

As Minister of Health Dr. Al-Rabiah explained at the Riyadh Global Digital Health Summit in August, technology — some new, some already in use and rapidly adapted — would be the main weapon in the Kingdom’s battle against COVID-19.

“During the Kingdom’s presidency of the G20 and prior to the emergence of the pandemic, we have introduced pandemic preparedness and digital health as key priorities,” the minister told the summit.

The emphasis on digital health, he said, “was critical as it plays a fundamental role in supporting health emergency management by strengthening existing response mechanisms.” Digital tools, he added, “also enable innovative, equitable access to health services, data sharing and improved coordination.”

Also speaking at the summit, Dr. Jokhdar, the deputy minister for public health, described how, as Saudi Arabia had watched and waited for the inevitable arrival of COVID-19, “(it) saw countries with good healthcare systems hit by numbers of cases that exceeded their capacity to handle public health strategy and defense mechanisms.”

The lesson quickly taken on board was that existing public-health technology, designed primarily for use in hospital settings, “was not up to allowing countries to handle such a big pandemic.”

At that point, said Dr. Jokhdar, ministers took a long hard look at Saudi Arabia’s own preparedness. “We thought, okay, let’s set up our team, let’s look at our technology and how we can benefit from what we already have on the ground. 

“We have our command and control center and our emergency operations center functioning for a few years. Let’s ask them what they want in order to make our technology team ready to help us with this pandemic if it happens in Saudi Arabia.

“Then we looked at our National Health Command Center (NHCC) dashboard, which was in preparation for the past two years and launched about a year ago, focused on hospital and primary healthcare operations, and we asked: Can we utilize that, can we transform that into something else?”

The answer was yes.  

In a remarkably short period of time, the NHCC, which had been set up primarily to monitor the day-to-day operations of hospital and primary healthcare facilities, was adapted to allow ministry staff to keep tabs on every development in the battle against COVID-19. It became “an early-warning system … of great added value.”

Feeding into the NHCC and informing all the decisions that were taken on a daily basis in the battle against COVID-19 was a continuous stream of data harvested by a series of apps and other digital systems, some already in existence and adapted for the crisis and others developed quickly to deal with it.

They included Mawid, a centralized appointments-booking system for primary healthcare, and Seha, an app through which people can consult a doctor by text, telephone or video conference, book COVID-19 test appointments, and carry out COVID-19 self-assessments.

The app Tabaud allows users to know if they have been in contact with anyone confirmed to be positive for COVID-19, while Takasi is an online platform allowing healthcare workers to enter patient data and organize mass testing, active target surveillance and contact tracing.

A nurse checks a patient’s temperature at a mobile clinic in Makkah on April 7. Through a series of apps, the Kingdom was able to facilitate health care for its residents. (AFP)

Launched on April 11, Tetamman (“Rest Assured”) was developed as a smartphone “digital caring system” through which users can, among other services, easily access accurate educational material and upload their symptoms, prompting a call, if necessary, from a 937 adviser. When it came to mass testing, Tetamman proved to be priceless, allowing people to take advantage of the drive-through testing stations set up by the ministry in 17 cities.

The number of new daily cases peaked in Saudi Arabia on June 17, when a record 4,919 were reported. A month later, as the nation made what officials described as a “cautious return to normality,” it was clear that the number was dropping almost daily. At the daily briefing on July 21, Assistant Minister of Health Dr. Al-Abdulaali attributed the fall in cases to “the involvement of all people.”

Judging objectively how any nation has coped with the pandemic is fraught with confounding social, cultural and economic factors and a complex, ever-changing global picture, all of which is hard to factor into any assessment and which make comparisons with other nations especially problematic.

That, however, was the task taken on by researchers at the Blavatnik School of Government at the University of Oxford, who at the beginning of the crisis set out to monitor and document the policy responses to COVID-19 of governments around the world.

A team of more than 100 Oxford University students and staff from every part of the world has been painstakingly collecting publicly available information on 17 indicators of government responses, including containment and closure policies (such as school closures and restrictions in movement) and economic and health-system policies (such as testing regimes). The result is the Oxford Coronavirus Government Response Tracker, in which the higher the score the stricter a government’s response is deemed to have been.

It is reassuring to note that throughout the pandemic, Saudi Arabia’s response has been rated as consistently tougher than that of many other nations, including the UAE, the UK and the US. 

In countries where governments have hesitated to act or have allowed internal politics to derail public health strategies, COVID-19 has run rampant. As a comment article on the Euronews website put it on April 3, “while some governments have been paralyzed by the confusion, fear and uncertainty surrounding the pandemic, Riyadh has taken tough decisions for the greater good — and continues to do so.” 

In the Kingdom, added Euronews, there had been “a mass mobilization of government, media and civil society to create the kind of overnight awareness, focus and solidarity that is essential during a global pandemic … mobilization that is sorely lacking in some Western capitals.”

Saudi Arabia has not, of course, escaped the curse of the virus — nowhere has. But the truly catastrophic experience of many nations, such as the US and the UK, has shown that without the sort of decisive governance exercised in the Kingdom this year, the price paid by the citizens of Saudi Arabia could have been much higher.

And, on Sept. 15, as the number of daily new cases in Saudi Arabia continued to tumble, hitting a low not seen for five months, the Kingdom made a hugely symbolic announcement, raising the prospect of a full return to normality in the new year.

Six months after travel restrictions were first imposed, Saudi Arabia was partially lifting the suspension of international flights, aiming to end all restrictions on travel by land, sea and air after Jan. 1, 2021.

On March 17, Saudi Arabia temporarily closed all places of worship but for the Two Holy Mosques in Makkah and Madinah. Three days later, these too were shut. (AFP)

On March 17, Saudi Arabia temporarily closed all places of worship but for the Two Holy Mosques in Makkah and Madinah. Three days later, these too were shut. (AFP)

Saudi Arabia took early precautions to confront the pandemic, including launching awareness campaigns, closing public venues, and securing laboratory testing. (AFP)

Saudi Arabia took early precautions to confront the pandemic, including launching awareness campaigns, closing public venues, and securing laboratory testing. (AFP)

WHO Director-General Tedros Adhanom Ghebreyesus wears a mask after leaving a ceremony in Geneva. King Salman authorized $10 million to help the WHO in Yemen combat COVID-19. (AFP)

WHO Director-General Tedros Adhanom Ghebreyesus wears a mask after leaving a ceremony in Geneva. King Salman authorized $10 million to help the WHO in Yemen combat COVID-19. (AFP)

Saudi authorities announced on March 8 the closure of all public and private universities and schools across the country. (AFP)

Saudi authorities announced on March 8 the closure of all public and private universities and schools across the country. (AFP)

A nurse checks a patient’s temperature at a mobile clinic in Makkah on April 7. Through a series of apps, the Kingdom was able to facilitate health care for its residents. (AFP)

A nurse checks a patient’s temperature at a mobile clinic in Makkah on April 7. Through a series of apps, the Kingdom was able to facilitate health care for its residents. (AFP)

An extraordinary Hajj, free of COVID-19

Footage from this year’s unprecedented Hajj captured the spirit of Saudi Arabia’s determination to tackle the pandemic effectively. (AFP)

Footage from this year’s unprecedented Hajj captured the spirit of Saudi Arabia’s determination to tackle the pandemic effectively. (AFP)

'Every precaution was taken, from screening and isolating pilgrims prior to Hajj to fitting them with the electronic bracelets.'

A pilgrim prays on Mount Arafat, also known as Jabal Al-Rahma (Mount of Mercy), southeast of Makkah, on July 30. (Saudi Ministry of Media)

A pilgrim prays on Mount Arafat, also known as Jabal Al-Rahma (Mount of Mercy), southeast of Makkah, on July 30. (Saudi Ministry of Media)

Of all the extraordinary images beamed around the world from this year’s unprecedented Hajj, it was the time-lapse footage of pilgrims circumambulating the Kaaba with carefully choreographed, socially distanced precision that best captured the spirit of Saudi Arabia’s determination to tackle the pandemic effectively, efficiently and on its own terms.

For months after the virus first emerged, it was uncertain that Hajj would go ahead, even in the much-reduced form that it would eventually take.

What quickly became clear, however, was that with responsibility for the millions of pilgrims who visit each year, and by extension for the well-being of the nations from which they came, Saudi Arabia was not going to take any chances on their behalf.

On Feb. 27, before a single case of COVID-19 had been detected in the Kingdom and while the WHO was still urging countries not to ban flights from Wuhan, Saudi Arabia announced that it was suspending overseas visitors’ visas for Umrah, the lesser pilgrimage, and closing the holy sites to foreigners.

On March 17, even as other Muslim countries hesitated to act, Saudi Arabia took the unprecedented but necessary step of temporarily closing all places of worship but for the Two Holy Mosques in Makkah and Madinah. Three days later, these too were shut.

Such bold decisiveness was in contrast to Iran’s perverse decision to shut its mosques but to keep open holy sites that attract millions of pilgrims every year in the cities of Qom and Mashhad. Early in March, disturbing footage emerged on social media of Shiite pilgrims touching, kissing and even licking shrines.

In Saudi Arabia, the decision on whether to go ahead in July with Hajj, an event of vital importance to Muslims everywhere, could not be rushed.

In Saudi Arabia, the decision on whether to go ahead in July with Hajj, an event of vital importance to Muslims everywhere, could not be rushed.

Much was at stake. For Hajj in 2019, 2.5 million pilgrims had converged on Makkah. Of these, 634,000 were from within the Kingdom itself, and it was clear that welcoming a similar number in 2020 would risk spreading the disease like wildfire.

Even worse, more than 1.85 million pilgrims had come from overseas, including 60 percent from Asian countries and 22 percent from other Arab states.

The prospect of potentially sending large numbers of pilgrims home with the virus to dozens of countries around the world was unthinkable and, in the end, Saudi Arabia settled on a historic and symbolic compromise.

Hajj would go ahead in 2020, but with only 1,000 representative pilgrims, selected from nationals and foreigners already resident in the country. 

Even 1,000 was a challenging number at a time when the entire world, including Saudi Arabia, was working hard to limit transmission of the disease by restricting social gatherings. But the way the complex series of Hajj rituals was managed by the authorities earned praise from across the globe.

As Minister of Health Dr. Al-Rabiah explained at the Riyadh Global Digital Health Summit in August, it was the use of digital tools, “along with the implementation of exceptional health and safety measures,” that had “assisted (Saudi Arabia) in successfully navigating what is typically one of the largest religious gatherings in the world under extraordinary circumstances.”

“Pilgrims arriving in the holy cities were electronically tagged with bracelets designed to monitor and record their health status and track individuals quarantined upon their return home,” Dr. Al-Rabiah explained. “And as a result, we have been very fortunate to have had zero cases of COVID-19 during Hajj this year.”

Every precaution was taken, from screening and isolating pilgrims prior to Hajj to fitting them with the electronic bracelets. Groups of 50 pilgrims were each led by a medically qualified guide. Face masks were mandatory, only pre-bottled Zamzam water could be drunk and even the pebbles used for the symbolic stoning of the devil, normally collected from the ground at Muzdalifah by the pilgrims themselves, were gathered for them beforehand, sterilized and issued in bags.

As a result, not a single case of COVID-19 emerged during Hajj, a public-health victory for the state that belonged also to the pilgrims, whose behavior and adherence to the new rules was exemplary.

By observing rigorous precautionary measures, 1,000 representative pilgrims were able to proceed with Hajj. (All images from Saudi Ministry of Media)

By observing rigorous precautionary measures, 1,000 representative pilgrims were able to proceed with Hajj. (All images from Saudi Ministry of Media)

New rules stipulated face masks.

New rules stipulated face masks.

Grounds were sterilized.

Grounds were sterilized.

Medically qualified guides led groups.

Medically qualified guides led groups.

Strict social distancing measures were put in place.

Strict social distancing measures were put in place.

Pilgrims were screened and isolated.

Pilgrims were screened and isolated.

Electronic bracelets were distributed.

Electronic bracelets were distributed.

By observing rigorous precautionary measures, 1,000 representative pilgrims were able to proceed with Hajj. (All images from Saudi Ministry of Media)

By observing rigorous precautionary measures, 1,000 representative pilgrims were able to proceed with Hajj. (All images from Saudi Ministry of Media)

New rules stipulated face masks.

New rules stipulated face masks.

Grounds were sterilized.

Grounds were sterilized.

Medically qualified guides led groups.

Medically qualified guides led groups.

Strict social distancing measures were put in place.

Strict social distancing measures were put in place.

Pilgrims were screened and isolated.

Pilgrims were screened and isolated.

Electronic bracelets were distributed.

Electronic bracelets were distributed.

Moving forward with global partners

Saudi Arabia is a partner in the clinical trials of the COVID-19 vaccine being developed in Russia. (AFP)

Saudi Arabia is a partner in the clinical trials of the COVID-19 vaccine being developed in Russia. (AFP)

Right now, nobody knows where the COVID-19 pandemic will end. The most likely finale is the development of a vaccine, or vaccines, which will grant humans immunity to the virus.

But although work is currently under way on more than 160 potential vaccines, with Saudi Arabia involved in the development of three of the frontrunners, driving the virus into extinction is unlikely to be a quick or easy process.

COVID-19 is far from done. Although many countries, such as Saudi Arabia, appear to be winning the fight against it, the number of global cases continues to rise, passing 30 million by Sept. 16, while an all-time high of over 315,000 daily cases was reported on Sept. 18.

COVID-19 is far from done. Although many countries, such as Saudi Arabia, appear to be winning the fight against it, the number of global cases continues to rise, passing 30 million by Sept. 16, while an all-time high of over 315,000 daily cases was reported on Sept. 18.

The number of global daily deaths peaked at 8,513 on April 17 but remains stubbornly high, with more than 6,000 on Sept. 15.

One of the realities that has emerged over the course of the pandemic is that the global response has been poorly coordinated, with countries introducing different policies at varied times.

As the holder of the presidency of the G20, Saudi Arabia has been at the forefront of initiatives to ensure that the global battle against the virus is better coordinated, effective and fair — and that the world is better prepared for the next onslaught.

As early as March 18, Saudi Arabia called for an extraordinary virtual summit of G20 leaders “to put forward a coordinated set of policies to protect people and safeguard the global economy.”

At the meeting, hosted by King Salman a week later, presidents, prime ministers and heads of state committed to spending $5 trillion on measures to combat the infection and the economic and financial fallout.

At the virtual G20 summit in March, hosted by King Salman, world leaders committed to spending $5 trillion on measures to combat the pandemic. (SPA)

In May, Saudi Arabia helped to organize a global donor conference hosted by European leaders that raised more than $7 billion toward efforts to find a COVID-19 vaccine. And in July, the Kingdom hosted an emergency virtual meeting of G20 finance ministers and central bankers, who pledged “to continue to use all available policy tools to safeguard people’s lives, jobs and incomes, support global economic recovery, and enhance the resilience of the financial system” in the battle to help the world recover from the economic impact of the pandemic.

Meanwhile, active collaborative efforts are under way in Saudi Arabia to develop cures and a vaccine for COVID-19.

On Aug. 9, the Saudi Ministry of Health announced that Chinese company CanSino Biologics was set to launch a Phase 3 clinical trial of a COVID-19 vaccine in the Kingdom, recruiting 5,000 volunteers in Riyadh, Dammam and Makkah for a randomized controlled trial that will compare the effectiveness of Ad5-nCOV (the vaccine candidate) to that of a placebo.

As medical journal The Lancet reported in June, Phase 1 and 2 trials conducted in Wuhan — the first “first-in-human” clinical trial of a COVID-19 vaccine — had already shown the candidate to be safe and potentially effective.

Saudi health officials have also been in contact with the British developers of the AZD1222 vaccine, a collaboration between a University of Oxford spin-out company and pharmaceutical giant AstraZeneca. The vaccine has shown great promise among 18,000 individuals who have taken part in Phase 3 trials in the UK, US, South Africa and Brazil and could go into production by the end of this year.

Saudi Arabia is also a partner in the clinical trials of Sputnik V, a COVID-19 vaccine being developed in Russia with funding from the Russian Direct Investment Fund (RDIF), which plans to conduct Phase 3 clinical trials involving 2,000 people in several different countries, including Saudi Arabia.

A nurse inoculates a volunteer in Moscow with Russia’s new COVID-19 vaccine. (AFP)

The RDIF, which says it hopes to start mass production in September in partnership with countries including Saudi Arabia, predicts it will be able to produce 200 million doses of Sputnik V by the end of 2020.

Responding to criticism that Russia was moving too fast, in August RDIF chief executive officer Kirill Dmitriev told Arab News that Russian law permitted Phase 3 trials to be conducted simultaneously with the administration of a vaccine during a pandemic emergency.  

“Once you have a technology that you know is effective, there’s an ethical responsibility to make it available to people in a safe manner,” he said. “It’s irresponsible to delay something that you know works and then deny it to people who need protection.”

Russian Direct Investment Fund (RDIF) CEO Kirill Dmitriev. Saudi Arabia is a partner in the clinical trials of a COVID-19 vaccine being developed in Russia. (AFP)

Drugs are only part of a country’s armory when it faces a pandemic, and Saudi Arabia has been honing its ability to respond rapidly and monitor and control the spread of disease — both now and in the case of any future outbreak.

The Kingdom has attributed much of its success in stemming the tide to its early adoption of digital technology to help it monitor the spread of COVID-19 and shape its response. The Riyadh Global Digital Health Summit, a two-day virtual conference organized by the Ministry of National Guard and the G20 Saudi Secretariat in collaboration with the Saudi Center for International Strategic Partnerships, was held on Aug. 11 and 12 and attracted more than 135,000 registered participants from 110 countries. 

Speaking on the last day, the summit’s president, Dr. Bandar Al-Knawy, CEO at Health Affairs, Ministry of National Guard and president of the King Saud bin Abdul Aziz University for Health Sciences, said the organizers had been “really overwhelmed with the level of enthusiasm across the globe,” which had made this “one of the largest virtual events ever witnessed.” 

The result of the summit was the Riyadh Declaration, a manifesto for “The Role of Digital Health in Fighting Current and Future Pandemics,” forged over a series of meetings of a panel of experts from Saudi Arabia, the UK, the US, France, Australia and South Korea.

The summit also reflected the reality that, even as the battle against COVID-19 continues, scientists and governments are turning their attention to the next pandemic that many believe is inevitably heading our way.

In April, scientists working with the Smithsonian's Global Health Program discovered six new coronaviruses in bats in Myanmar. Although “none of the viruses appeared to be closely related to SARS-CoV, MERS-CoV, or SARS-CoV-2,” they reported in the journal PLOS One, it is not yet clear if the new viruses would be harmful to humans.

Even if they are not, the odds are high that a new coronavirus will emerge that is; bats alone are thought to harbor more than 3,000 as yet undiscovered coronaviruses.

Although the human and economic costs of the COVID-19 pandemic will be enormous, “the current crisis will eventually end,” wrote Professor Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, in Foreign Affairs in July.

But, he warned, “the public health community has for years known with certainty that another major pandemic was on the way, and then another one after that (and) some future microbial outbreak will be bigger and deadlier still.” 

The COVID-19 pandemic, added Prof. Osterholm, “is probably not ‘the Big One,’ the prospect of which haunts the nightmares of epidemiologists and public health officials everywhere.”

Under the banner of its G20 presidency, Saudi Arabia has unified the world in recognition that global collaboration is the only way forward if the world is to be better placed to fight off its next, inevitable microbial enemy. 

This message was reinforced on Aug. 13 in a speech by the WHO’s director-general, marking the sixth-month anniversary of the designation of the COVID-19 outbreak as a Public Health Emergency of International Concern. 

Back in January, he recalled, there had been just 100 cases outside of China and no deaths. Since then, he said, “there has been an exponential rise in cases, and every country in the world has been impacted.”

By Aug. 13, the day he spoke, there had been a total of 21 million cases and over 756,000 deaths around the world.

“Everyone,” said Dr. Ghebreyesus, “is asking, ‘So how do we go back to ‘normal?’ And today, I want to talk about not how we’re going to go back, but how we’re going to go forward — and that to move forward, the best bet is to do it together.”

In the achievement of that ambition, in an extraordinary year during which Saudi Arabia’s standing on the global stage has grown immeasurably, the Kingdom is leading the way.

At the virtual G20 summit in March, hosted by King Salman, world leaders committed to spending $5 trillion on measures to combat the pandemic. (SPA)

At the virtual G20 summit in March, hosted by King Salman, world leaders committed to spending $5 trillion on measures to combat the pandemic. (SPA)

A nurse inoculates a volunteer in Moscow with Russia’s new COVID-19 vaccine. (AFP)

A nurse inoculates a volunteer in Moscow with Russia’s new COVID-19 vaccine. (AFP)

Russian Direct Investment Fund (RDIF) CEO Kirill Dmitriev. Saudi Arabia is a partner in the clinical trials of a COVID-19 vaccine being developed in Russia. (AFP)

Russian Direct Investment Fund (RDIF) CEO Kirill Dmitriev. Saudi Arabia is a partner in the clinical trials of a COVID-19 vaccine being developed in Russia. (AFP)

Hear everyday Saudis talk about their lives during the COVID-19 pandemic and how they've managed to find a bright side.

Credits

Editor: Mo Gannon 
Creative director: 
Simon Khalil
Designer: 
Omar Nashashibi
Graphics: Douglas Okasaki, Farwa Rizwan
Video producer
: Eugene Harnan
Video editor:
 Hassenin Fadhel
Video interviewer: Hussam Al-Mayman
Videographers: Mohammed Al-Baigan, Nuaf Al-Mutery, Abdullah Almdefer
Photo research: 
Sheila Mayo 
Copy editor: 
Sarah Mills
Social media: 
Mohammed Qenan
Producer:
 Arkan Aladnani
Editor-in-Chief: 
Faisal J. Abbas

A Saudi man walks past a mural of King Salman in Riyadh on March 15. (AFP)

A Saudi man walks past a mural of King Salman in Riyadh on March 15. (AFP)