Egypt: Infections on the front line

Reem Leila , Thursday 7 May 2020

The number of Covid-19 infections among medical personnel in Egyptian hospitals has been rising, with critics pointing to a lack of protective materials

Infections on the front line
Infection rates are high among doctors

Among Egypt’s 6,813 cases of Covid-19, there have been 113 doctors, eight of whom have lost their lives after being infected in the course of duty. A report by the World Health Organisation (WHO) states that around 13 per cent of those infected in Egypt are among healthcare staff.

On 4 May, the Ministry of Health ordered the closure of the Al-Raquda Hospital in Alexandria for 14 days, due to the spread of Covid-19 among its personnel.

The decision came a couple of weeks after a hospital in the Daqahliya governorate was shut down for two weeks after 21 doctors, nurses, and radiologists tested positive for the coronavirus. A few days earlier, the National Cancer Institute saw the infection of several healthcare workers with the coronavirus, leading to concerns among patients and staff members.

Some doctors said they were risking their personal safety due to poor working conditions, mismanagement, and shortages of protective materials, adding that they felt their worries were not being taken sufficiently seriously.

The Doctors Syndicate filed a complaint with the prosecutor-general on 3 May against the head of the Agami Hospital in Alexandria for ignoring a doctor’s request to be tested for the coronavirus after being in contact with coronavirus cases.

The doctor, who tested positive for the virus, asked to undergo the test for two days. He tested positive on a third test but was forced to return to work after the first two tests were negative for the virus.

Secretary-General of the Doctors Syndicate Ihab Al-Taher told Al-Ahram Weekly that the syndicate’s board had issued a statement expressing its concern over the high rates of infection among healthcare staff.

“The syndicate expects further health professionals, including pharmacists, dentists, nurses and other medical specialists, to have also contacted the disease,” Al-Taher said.

He said the syndicate had not received complaints of a shortage of protective supplies in hospitals, but the ministry was depending on serological testing, which has not always been proven effective in detecting the disease, thus risking the lives of healthcare workers.

“Medical protective supplies required for protecting doctors and staff members are available only at quarantine hospitals and fever hospitals designated for quarantine,” Al-Taher said, adding that according to WHO guidelines rapid serological tests cannot be relied on for diagnosis of the coronavirus and that the only approved test for the moment was the PCR (polymerase chain reaction) test.

According to Maher Al-Garhi, manager of the Imbaba Fever Hospital, the Ministry of Health is generally providing enough protective supplies to medical teams. “My staff wears gloves and face masks, but the ministry has not provided us with the protective medical vests that doctors and nurses dealing with Covid-19 patients should be wearing. These vests are available only for staff members working at quarantine hospitals,” Al-Garhi said.

Khairia Ebeid, a staff member at the Menouf Chest Hospital, said the high rate of infection among health workers was due to a lack of protective supplies. “Neither the disposable face masks that surgeons use during surgical operations nor masks made of cloth protect doctors against contracting the virus from infected patients. Only N95 face masks protect against contracting the virus, though by 95 per cent and not 100 per cent,” Ebeid said, adding that the ministry does not provide these masks to general hospitals on a regular basis.

According to Ebeid, N95 face masks are reusable if used by the same person and if properly sterilised. They are expensive, with one mask costing more than LE200. “Not many doctors or nurses can afford to buy masks every day at this price,” Ebeid said, adding that they were standard issue at quarantine hospitals along with special vests.

Osama Mahmoud, a doctor at the Menoufiya Public Hospital, said that though the ministry provides hospitals with the necessary preventive supplies, some doctors either do not use them or misuse them. “Some doctors put on and take off the face masks in the wrong way, thus increasing the possibility of being infected, especially when dealing with patients positive for the coronavirus,” he said.

Ahmed Leila, a doctor at the Um Al-Masryeen Public Hospital, said that the high infection rates among doctors and nurses was to be expected as they were dealing closely with the virus. Doctors working in quarantine hospitals would be dealing with infected patients, he said.

“Doctors dealing with Covid-19 patients who are being placed on ventilators have to insert the ventilator’s tube into the patient’s throat. They have to be very close to the patient to see the tube. The body, even if under anesthesia or in a coma, makes a gag reflex reaction against the tube. So, the patient unconsciously coughs, thus spreading respiratory droplets,” Leila said.

*A version of this article appears in print in the  7 May, 2020 edition of Al-Ahram Weekly


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