Three weeks — make or break

Dina Ezzat , Sunday 29 Mar 2020

Hoping for the best and bracing for the worst, Egyptian authorities are focused on flattening out the curve of COVID-19 infections

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THE GREAT Pyramid of Khufu on the Giza Plateau, the only surviving Wonder of the Ancient World, was illuminated on Monday night with a message encouraging people worldwide to stay at home and to stay safe as Egypt ramped up its efforts to slow the spread of the Covid-19 outbreak. The message also encouraged people everywhere to show their appreciation for the medical personnel tirelessly battling the pandemic along with members of the emergency services and police. (photo: Reuters)

On Tuesday the Ministry of Health acted to quarantine on areas where potential clusters of COVID-19 have been recorded. Al-Haytem village in the governorate of Gharbiya was fully quarantined. In Port Said two apartment buildings were also isolated.

The measures came against a backdrop of a relatively stable increase in the curve of recorded cases of the new coronavirus. As Al-Ahram Weekly was going to press around 660 cases had been reported since 14 February when the authorities in Egypt announced the first case.

In a press conference this week, Minister of Health Hala Zayed said that of the reported cases 182 had recovered and 132 had since tested positive and are being followed up pending their recovery. Egypt has recorded 41 deaths, including both Egyptians and foreigners.

In statements this week Zayed said that the Ministry of Health is acting to make sure all cases recorded are promptly isolated and that contacts of confirmed cases are being traced.

Zayed said contact tracing was essential to contain the fast circulating virus and flatten the infection rate curve to ensure health facilities are not suddenly swamped with positive cases.

If Egypt manages to get through the next three weeks without the curve steepening then, according to Zayed, Egypt could well move into a period of reduced infection rates.

Meanwhile, informed medical sources say the authorities are preparing for the possibility the situation could get worse.

According to the sources, measures being taken include preparations for setting up temporary emergency hospitals in many governorates. These plans are being conducted in coordination with the Armed Forces.

The Ministry of Health and the Ministry of Higher Education have also ordered the suspension of all non-urgent surgical operations in public and university hospitals for three weeks to free up medical and ICU capacity.

According to the same sources, the two ministries aim to keep occupancy of ICUs at 50 per cent.

The Ministry of Health has put in place measures to re-contract retired doctors to beef up capacity in public hospitals. It has also appealed for possible medical volunteers. Within three hours the appeal generated 10,000 responses.

The Ministry of Health is working with several government bodies to stockpile supplies needed by hospitals.

Medical sources at several leading hospitals said this week they have sent lists of supplies to the ministry so it can identify stocks that need to be supplemented.

In a tweet on Monday evening, the official spokesmen of the Armed Forces said that “as part of the combat against the new coronavirus, the Armed Forces are working on providing all necessary medical equipment and supplies in cooperation with the Ministry of Health and the Unified Authority for Medical Purchases and Supplies.”

An informed medical source told the Weekly that the plan that Egypt is currently working on includes the purchase of 1,000 ventilators to treat the persistent pneumonia and possible damage to lung tissue that are symptomatic of acute cases of COVID-19.

Minister of Industry and Trade Nevine Gamea said directives had been issued to companies that produce medical supplies to concentrate production on products required by the Unified Authority for Medical Purchases and Supplies for the next three months. These include protective clothing, gloves and masks needed by medical workers and medication required for the treatment of patients with COVID-19.

The measures that the authorities are taking are in line with World Health Organisation (WHO) recommendations.

At a conference in Cairo on Monday, John Jabbour, the representative of WHO in Egypt, praised Egyptian doctors and medical staff on the front line in the battle with the novel coronavirus.

“I would like to extend my sincere thanks to the doctors, nursing staff and other health workers on the front lines of combating this pandemic, as they make every effort to save lives and prevent the spread of the virus inside the country despite the challenges,” Jabbour said.

Yvan Hutin, director for communicable diseases at the WHO Regional Office for the Eastern Mediterranean, said “Egypt has a real opportunity to stop the transmission.”

Though Hutin cautioned that there was a possibility transmissions could expand leading to a large number of cases in the country, he said the number of new cases detected in Egypt since the first case was confirmed on 14 February suggested that “transmission is limited to chains of infection.”

Avoiding the worse is not only a medical job, said Zayed. The public must observe social distancing guidelines and the partial curfew.

This week the Ministry of Interior upgraded its surveillance of the curfew. Government sources have said since the beginning of this month that if infection rates were to increase, more restrictive measures to stop the spread of this virus would need to be imposed.

While the government and public sectors have opted to reduce the workforce to decrease chances of  infection private sector workers are not exempted from full attendance, leading to crowds during rush hours, particularly on public transport.

This week pictures of crowded metro stations appeared prompting fears over possible increases in infection rates. Minister of Transport Kamel Al-Wazir said that more buses and underground trains would enter service to reduce crowding during the busiest times.

Many leading members of the business community have strenuously resisted suggestions working hours be reduced.

Activist groups have criticised what they qualify as the indifferent attitude of private business leaders and demanded government intervention to reduce the possibility of crowds.

Three weeks ago the government suspended academic activities at schools and universities, and the suspension was subsequently extended this week. Minister of Education Tarek Shawki has announced that final exams for primary and preparatory schools have been cancelled in the face of the COVID-19 outbreak and student assessment will instead be based on research assignments.

Reda Hegazi, deputy to the minister of education, said that for the benefit of those high school students who will still take exams online the Ministry of Telecommunications will be distributing SIM cards. The distribution started on Monday, with schools being roped in to help to avoid crowds gathering at telephone offices.

Minister of Higher Education Khaled Abdel-Ghaffar said on Monday that while final exams have been “tentatively” timetabled to start at the end of May rather than the end of April, the date could be further delayed to the end of August or maybe beyond.

University professors who spoke to the Weekly this week said that they have yet to be informed of possible scenarios for final exams.

Meanwhile, the government has been hard-pressed to deliver solutions for the estimated five million daily workers who are struggling to make ends meet at a time when all economic activity has been hit by the impact of the pandemic.

The Ministry of Labour has announced that casual workers will receive a one-off payment of LE500. Already, 1.2 million workers have applied. The Ministry of Social Solidarity has also said that it will expand the membership of its support programmes Takaful and Karama (Solidarity and Dignity).

With no clear timeframe in sight for an end to the crisis caused by the battle against COVID-19, MP Ahmed Tantawi has been arguing for more concrete support to be offered for those on limited incomes. The package Tantawi has proposed includes social and financial support, the scrapping of electricity and water bills and an increased supply of discounted rations.

With the holy month of Ramadan just three weeks away there is concern in some quarters about the availability of staple food items. This week President Abdel-Fattah Al-Sisi met with Prime Minister Mustafa Madbouli and the Minister of Supply Ali Moselhi to review the situation. Speaking after the meeting, Moselhi said national stocks of food supplies remained adequate. The government has already ordered the suspension of exports of some food products pending the end of the crisis.

Independent medical sources agree with the minister of health that there are no accurate predictions about when the crisis will end. They say, however, that if the situation remains under control for the next three weeks then Egyptians could start getting back to normal in late May or June.

*A version of this article appears in print in the  2 April, 2020 edition of Al-Ahram Weekly

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