The “Arab Spring” is remembered as the most disruptive political event to shake the Middle East since the fall of the Ottoman Empire at the end of World War I. Purported presidents-for-life were pushed from office, three countries descended into civil war, and the accepted balance between the governed and their governments was turned on its head, if only for a time.

The Middle East is now on the verge of an even greater set of disruptions — ones that are likely to shake the region to its core. Irrespective of a debate in the United States of how much attention it should devote to the Middle East, these changes will rock a wide range of U.S. security interests in the region itself and around the globe.

The region is facing a set of cascading challenges that will shake friendly and hostile governments alike, wreck economies, and devastate populations. The region that emerges will have vastly different contours than what we have grown accustomed to for the last half-century or more.

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Even before COVID-19 spread to the Middle East, the region was in political turmoil. Yemen, Libya and Syria descended into civil wars with the Arab Spring, and those wars continue to blaze. Algerians took to the streets in February 2019 to push President Abdelaziz Bouteflika from power; he left last April, but large-scale demonstrations endure. Mass protests started in Lebanon and Iraq in October and have largely continued. Egypt and Iran used a heavy security presence to snuff out protests in September and November, respectively, but politics in both countries remain unsteady.

On this weak foundation, the region finds itself at the front end of a massive public health crisis. Iran is facing a full-blown disaster which continues to escalate. Travel between Iran and Iraq, Lebanon and Syria is common, surely spreading the disease in those places. Despite more than a dozen tourists and crew catching the virus on a Nile cruise ship, Egypt has defiantly stated that it has fewer than 200 cases and revoked the press credentials of a journalist who reported a Canadian’s estimate of 19,000.

Whatever number is correct now, Egypt is a country of 100 million with a poor public health record. Approximately 10 percent of Egypt’s population carries hepatitis C because of bad hygiene in a decades-long injection campaign to protect Egyptians from bilharzia.

It goes without saying that the millions of refugees and the internally displaced in the region — spanning from Libya through Syria to Yemen — are hungry, cold, and especially vulnerable.

On top of the looming public health crisis is a massive fiscal crisis. Because COVID-19 cut global demand for oil, two of the world’s largest producers — Russia and Saudi Arabia — were at the lead of an international effort to cut supply so prices would not crash. Unable to reach agreement, the two sides instead got into a spitting match. Saudi Arabia insisted that it would increase production and flood the market, and Russia insisted that it would increase production, too. The resultant price war has driven oil prices to their lowest levels since 2003. Even with increased volumes, Russia and Saudi Arabia are facing starkly lower oil receipts. Other producers such as Iran, Iraq, the United Arab Emirates (UAE) and Kuwait are watching their government revenues plunge. Persistently weak demand and high quantities of oil in storage will mean prices will climb back slowly when they do.

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And it is not only oil exporters who are hit. Many of the poorer countries in the Middle East are labor exporters. In Egypt, Jordan and Lebanon, the wages that citizens working overseas send back represents about 10 percent of those economies. With much lower oil prices, those remittances will crash and skilled workers will return, unemployed, to markets that can’t provide for them.

On top of all of this, regional tourism will crumble in the wake of a global crisis. That tourism has several components. First is the leisure tourism that has helped buoy the economies of Egypt, Tunisia, Morocco and Lebanon — beach vacations and boat trips will evaporate. Second is religious tourism: Pilgrims have flooded into shrines in Saudi Arabia, Iran and Iraq for centuries; that travel will end for months or years. Finally, the UAE and Qatar have developed an elaborate infrastructure as they became hubs for international air travel that spanned the globe. The global economic downturn will squash much of that travel, and some of the rest will dry up as COVID-19 rages in some of the more remote areas that the Gulf airlines only recently integrated into the international economy.

When the Arab Spring struck in 2011, many governments responded by opening up their pocketbooks. Gulf governments in particular believed that larger public expenditures, in their own countries and in the more populous countries in the region, would buy social peace. To a degree, they were right. But this time, as public discontent rises and oil prices swoon, money is not available.

There is not a country in the region that will not feel dire effects, and many of the ones that will feel the most severe ones are important to U.S. security. The combined health and economic crisis hits Iran as it is already suffering under a U.S.-led “maximum pressure” campaign. What comes out the other end — a more pliable government, a more radical one, or merely ongoing internal chaos — is impossible to judge.

The health and financial crises are unlikely to topple the Saudi government, but they surely endanger the expensive, ambitious modernization program that Crown Prince Mohammed bin Salman has made his calling card, and which he argues is vital to the kingdom’s future.

While Israel has significant financial and public health resources, all of its neighbors are imperiled. Even before COVID-19, Lebanon had an ongoing political crisis, a Syrian refugee population that accounts for almost one-in-five people in the country, and a debt crisis that forced the default on a large chunk of its international debt. Jordan, whose security is seen as vital to Israel, the Gulf States and the United States, is in danger. Egypt may be on the verge of a catastrophe, as Egyptians continue to congregate in coffee shops and mosques and argue that God will protect them.

While the Arab Spring had many drivers, much of the discontent boiled down to complaints about governance. Men and women, young and old, complained that governments only looked after themselves and did little to help people’s livelihood. Now, with economies spiraling downward and health systems under unprecedented strain, governments are likely to find that they cannot protect their citizens’ livelihoods — and that they also cannot protect their citizens’ lives. In that environment, all bets will be off.

Jon B. Alterman is senior vice president, Brzezinski Chair in Global Security and Geostrategy, and director of the Middle East Program at the Center for Strategic and International Studies, a Washington-based think tank focusing on defense, national security and international relations issues.