ORDER BY can read one key first, then a second key inside ties.
first key, second key
Region then quantity
The compiler uses 2 columns and leaves 1 tied group.
order columns=2
Multi-column sorting examples are tiny finite table transforms; SQL dialect completeness, collation rules, optimizer behavior, indexing, product behavior, and performance claims are out of scope.
Direction belongs to each key
Region is ascending while quantity is descending inside each region.