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A tentative easing

As Egypt debates its next step in the battle against Covid-19 there is yet to be a clear exit plan from the crisis, writes Dina Ezzat

Dina Ezzat , Tuesday 19 May 2020
Madbouli
Madbouli
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Under the plan that Prime Minister Mostafa Madbouli announced earlier this week, public transport will be suspended and all public parks and beaches will be closed for the duration of the Eid holiday — 24-29 May. The curfew will begin at 5pm instead of 9pm, which has been observed throughout Ramadan, and following the end of the holiday will move to its pre-Ramadan time of 8pm to 6am. Public transport will resume but parks and beaches will remain closed.

Hotels, which have been closed since 19 March, will be allowed to resume business during the Eid holiday but only at 25 per cent of their capacity, a condition that will be reviewed in mid-June.

According to Madbouli, the middle of next month is when many of the businesses and services that have been put on hold during the past two months are likely to be given the go-ahead to resume their activities.

The Ministry of Health has dropped appeals to citizens to stay at home, and in the last two weeks has replaced its message with “stay safe”. When staying at home was the central component of the information campaign, the wearing of face masks was deemed essential for individuals infected with Covid-19 and those with whom they shared houses. The new advice is that, from 30 May, face masks will be compulsory for anyone stepping into a public space.

The public has been complaining about the availability and increasing costs of masks since March. But it is not just the public that is disgruntled. Doctors, including those on the frontline of the battle against Covid-19, have long been unhappy about the provision of Personal Protective Equipment (PPE).

“We have been asking for supplies and though we have received some from the Ministry of Health we need much more to cover our needs,” said the manager of a leading public hospital in Cairo.   

Last week, the price of a single-use mask varied between LE5 to LE50, depending on the brand and the location of the pharmacy.

“I cannot imagine how the market for masks will be managed when they are mandatory,” says Anwar, a pharmacist. “They are already eating into the budgets of those on limited incomes.”  

In his press conference on Sunday, Madbouli said that the government plans to produce washable masks that will be reusable and available at a reasonable price. He provided no further details, either on the price or availability of the government produced masks, or indeed on the government’s plans to gradually restore life to normality, beginning June.

“The one thing I was sure about after reading the details of the prime minister’s press conference is that the government will not be implementing the two-week total lockdown that the chair of the Doctors’ Syndicate and other leading medical figures have been calling for,” says Ibrahim, a doctor working in the ICU of a leading Cairo government hospital.

Ibrahim spoke on Monday, when Egypt recorded more than 500 new cases of Covid-19 and 15 deaths.

According to medical sources who spoke on condition of anonymity, hospitals accommodating Covid-19 patients are already overburdened, and should the numbers of new infections continue to rise the 35 hospitals designated to treat coronavirus patients will be unable to cope.

The capacity of hospitals is not just about beds and medical supplies but also the morale of the staff. The past three weeks have seen what medical sources qualify as a steady “depletion” of the latter. Covid-19 infections among doctors, nurses and other hospital workers have taken a heavy toll, one reason the Doctors’ Syndicate has appealed for a total lockdown.

So what will happen with the easing of restrictions that medical sources already qualify as relaxed?

Late last week the Ministry of Health published a three-phase plan on its website that it said would come into effect once it secured cabinet approval. Phase one of the plan includes measures such as the mandatory use of face masks in public places. Phases two and three allow for the gradual loosening of restrictive measures.

One of the plan’s more confusing aspects, say medical sources, is the ambiguity surrounding the commitment of health authorities to quarantine and provide medical services to patients who test positive for the coronavirus but display only mild symptoms. Will they be obliged to self-isolate at home? And what does this mean for the millions of poorer citizens whose domestic situation is marked by overcrowding?

Adel Khattab, a professor of chest diseases and member of an advisory committee on the containment of the pandemic, says that while the economy cannot be put on hold indefinitely any easing of restrictions should happen only when enough isolation places are available, and there are enough kits to ensure every suspected case can be tested.

Fears over the easing of restrictions are not confined to medical circles. Teachers and university professors worry that too hasty a loosening of the measures in place could see a spike in Covid-19 infections among students sitting for final exams in secondary schools and graduating classes at universities.

“Even if I am in a classroom with no more than 15 to 20 students over three hours I could easily infect any one of them if I had the virus. We all know that face masks do not provide total protection,” said Fatima, a high school teacher in the Gharbiya.

The worries of the teachers is not just about individual transmission but the potential consequences of a sudden outbreak of cases in schools designated as examination centres.  The Ministry of Education has already decided to allow students who wish to drop out of their final secondary year, and who are scheduled to begin sitting exams on 21 June, to postpone their exams until next year.

Meanwhile, classes for university students have been tentatively set to begin in the second week of July.

A government source said that while the government is “determined” to get things “back to normal as much and as soon as possible” it wants to avoid a surge in the number of cases.

The source, who spoke on condition of anonymity, said the original plan, partially applied in late March and April, was to adopt progressive restrictive measures and only to start to reduce them when the numbers began to decline. However, the economic fallout of the last six weeks, not just on the state coffers but also on the livelihood of millions of citizens, convinced the government that businesses must be allowed to reopen, though with strict safety measures in place.

According to the same source, two weeks ago the government had not envisaged toughening restrictions for the Eid holiday. It was the increase in the numbers of infections, among the public and medical staff, that forced the volte-face.

The plan now, says the source, is to test the gradual easing of restrictive measures over four weeks, starting mid-June. If the situation remains under control, then further steps will be considered.

The source cautioned, however, that in the best case scenario limited international flights are unlikely to resume before the last week of June, and cafés and restaurants are expected to remain shuttered until at least the end of July.

*A version of this article appears in print in the 21 May, 2020 edition of Al-Ahram Weekly

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