For three months, Egypt seemed to escape the huge case numbers seen in many other nations, including those with far lower populations. But the number of reported cases in the country has steadily risen in recent weeks, with more than 1,500 infections per day since Friday, escalating pressure on a health-care system that was strained long before the pandemic.
On Monday, Egypt reported 97 deaths, the most in a single day since the outbreak began. Some Egyptian officials and health experts say the number of cases is probably much higher than officially reported.
Egyptians are now posting dire messages on social media seeking scarce hospital beds and money to pay for treatment. Doctors are accusing the government of negligence, blaming it for shortages of personal protective equipment and a lack of adequate safety measures. Several hundred doctors and nurses have tested positive for covid-19, the disease caused by the coronavirus, and scores have died. The medical union has warned that Egypt’s health system could “collapse.”
“The patients are increasing in very rapid numbers,” said a 32-year-old doctor at a quarantine hospital in the southern city of Esna, where every bed was filled with coronavirus patients. “But you don’t have the capacity of beds, hospitals and staff numbers. It’s really exhausting for the staff.”
Like other doctors interviewed, he spoke on the condition of anonymity because President Abdel Fatah al-Sissi’s government has sought to muzzle criticism of its response to the pandemic.
Doctors and journalists have been arrested, according to the medical union and human rights activists. Managers at government-run hospitals have threatened to fire outspoken staff members or report them to security officials, doctors said in interviews and social media posts.
The United Nations’ human rights office said that 15 people were arrested in April on charges of spreading “false news” about the virus and that a doctor and a pharmaceutical worker were arrested for Facebook video posts complaining about a dearth of face masks. At least two journalists have been arrested for what the government described as publishing false news about the pandemic, said Gamal Eid, a human rights lawyer.
Sissi has weighed in with tweets saying that the state was trying to counter the pandemic while seeking to keep the economy stable. He warned that “enemies of the state are trying to question the state’s efforts and achievements.”
Still, more and more Egyptians are speaking out every day on social media.
“There is a shortage of ICU units, a shortage of ventilators, a shortage of doctors and a shortage of nurses,” a doctor in her 20s who works at one of Cairo’s premier educational hospitals said in an interview. “Even the smallest pressure can make the Egyptian health system collapse.”
To protest poor safety measures to prevent the spread of the virus, she said, she and others had planned to strike. But the hospital’s managers accused them of being members of the banned Muslim Brotherhood and traitors to the country. Out of fear, they abandoned the protest.
In an online discussion last week, Ayman Sabae, a researcher on health rights at the Egyptian Initiative for Personal Rights, said he thinks Egypt’s health-care system has the infrastructure and capability needed to stem the pandemic. The problem, he said, is poor management.
Egypt’s head of the State Information Service and a spokesman for the Health Ministry did not respond to four separate requests last Thursday for comment.
Across Egypt, millions live in overcrowded neighborhoods, where the virus can quickly spread, and pack into small apartments, where self-isolation is difficult.
Although schools and cafes are shut and a curfew is in place, a full lockdown has not been implemented despite calls to do so by the medical union and prominent health experts. And, as in other nations, authorities have not fully enforced social distancing requirements or the wearing of masks.
Yet the number of infections remains relatively low. As of Tuesday, there were nearly 48,000 confirmed cases and 1,766 deaths in a country of 100 million people. One reason for the modest number is that coronavirus testing has been limited, said health experts and Western diplomats. At the same time, many Egyptians have difficulty accessing medical care and some may not report their illness for fear of being stigmatized, health experts said.
Two weeks ago, Khaled Abdel Ghaffar, the minister of higher education and scientific research, said Egypt could already have had more than 100,000 cases. “We present a more pessimistic outlook [than the official tally], as it is likely that we are five or 10 times higher,” he said in a televised statement on June 1.
In early April, doctors at the National Cancer Institute began posting on social media that many colleagues had been infected but that the hospital’s management had not taken appropriate measures to quarantine patients or staff members.
“The Institute has turned us into a tool to spread the virus between us, patients as well as our families,” Maggie Mousa, an anesthesiologist, tweeted at the time. “This is absolute arrogance, negligence.”
Another doctor, Armia Mohsen Shafik, posted on Facebook that the hospital’s management threatened to fire him for speaking out about shortages of personal protective gear and demanding that the hospital be shut down and sanitized.
Cairo University, which manages the hospital, announced that at least 17 doctors and nurses had tested positive for the virus. The university said it would open an investigation of possible negligence by the hospital.
Since then, scores of medical workers have been infected in hospitals nationwide. Last month, the World Health Organization said 11 percent of those infected in Egypt were medical workers, including 124 doctors.
Nagila Hospital, located outside the northern city of Marsa Matrouh, was forced to stop receiving new patients after nearly half of its 79 staff members tested positive, according to the Mada Masr newspaper.
By early May, a health ministry official had informed lawmakers that 17 hospitals designated to quarantine patients were full.
Manshiyet al-Bakry hospital in Cairo was designated a quarantine hospital to accept the overflow of coronavirus patients, but 29 of its staff members already had tested positive for the virus. Its doctors went on strike demanding testing for employees and other safety measures. But in a statement, the doctors alleged that the hospital’s management threatened to report them to the country main domestic security agency, unless they return to work. The strike ended.
Amani Atef, the hospital’s director, did not respond to a request for comment.
The Egyptian Medical Syndicate, a union for doctors and other health-care workers that is partly state controlled, has not remained silent.
After a doctor died last month, the group publicly blamed the health ministry for fatalities among doctors and nurses, saying it was “falling short” of protecting them.
“The health system could completely collapse, leading to a catastrophe affecting the entire country if the health ministry’s negligence and lack of action toward medical staff is not rectified,” the union warned.
In response, the health ministry said that it had allocated enough beds for infected staff members and that adequate protective measures were in place.
Today, the union’s Facebook page reads like a newspaper’s obituaries section. As of Sunday, at least 65 doctors and nurses have died of the virus, the union said.
One of the most recent to die was Sayed Nady Kamel. Concerned about his pregnant colleague, he had volunteered to treat her patient, a 72-year-old with covid-19 symptoms, her husband wrote on her Facebook page. Kamel contracted the virus and died Sunday.
“May God have mercy on you Dr. Sayed, who died almost an hour ago,” Sameh Atef Ahmed wrote. “I owe you the life of my wife and my daughter.”