Egypt is bracing for what is hoped will be a mild seventh wave of Covid-19

It is not a busy day at this Heliopolis health centre in Cairo on the last working day of the first week of November. However, there are a few people who are showing up to get their Covid-19 vaccinations. Dina Ezzat saw many are waiting for the second shot, which makes them effectively fully vaccinated. Others are waiting for their third or even fourth.

Nahla, an art teacher at a primary school in Cairo, was waiting for her fourth shot. At the age of 44 and with a work routine that requires a great deal of close physical contact with children who could carry the virus and show few if any symptoms, Nahla decided it was “wise to get the fourth shot now that winter is coming.”

“I was planning to get it ahead of the academic year, but I thought I would wait to get it in November to make sure that my immunity was at its best when we are in the months of December, January, and February when the virus is most active,” Nahla said.

Last February, despite being vaccinated with two shots and despite the close observation of precautionary measures at the international school where she works, Nahla contracted “a not so mild” case of Covid-19.

Luckily, she said, she felt the symptoms at an early stage and managed to isolate herself and spare her family, who all tested negative. Nahla is convinced that had it not been for the two shots of vaccination, “things could have taken another path.”

“Better safe than sorry, and already there are many more people who say they have symptoms of something that could be either the coronavirus or flu.”

“We don’t get as many people coming in now to buy the rapid test for the new coronavirus. We are getting more demand for the medicines that are usually prescribed to treat it, however,” said Hassan, a pharmacist who works in Dokki.

“I guess people are now more inclined to opt for home treatment, at least for a few days, and then to consult their pharmacist rather than go to a hospital or consult a physician,” he added.

Hassan said that most of his regular clients recover well within five days or so with home treatment. “It is obvious that in Egypt like in the rest of the world, the coronavirus has weakened, so while we seem to be having a sort of increase in the number of people needing medication with the advent of winter, we are not seeing the kind of severe cases that were there with the first and second wave,” he said.

“So, we are hopeful that the worst is over, even if we are not over with the pandemic yet.”

In press statements made last week, Khaled Abdel-Ghaffar, the minister of health, said that the newer variants of Covid-19 have weakened the virus and made the symptoms much milder. This, he said, was the reason why Egypt, like the rest of the world, was not feeling alarmed about a possible seventh wave with the advent of winter.

Awad Tageddin, presidential consultant on health affairs, said that for Egypt the sixth wave of the virus had been “generally extremely weak”. He credited the campaign that made the vaccine readily available across the country for the successful control of the spread of the virus, reducing the number of severe cases that required hospitalisation or increased the risk of mortality or co-morbidity.

According to figures from the Ministry of Health shared by the World Health Organisation (WHO), from January 2020 until 12 November this year Egypt had 515,412 confirmed cases of Covid-19, with recorded deaths in 24,798 cases. Since the beginning of the pandemic, Health Ministry officials, WHO sources, and physicians have said that the numbers are probably higher, however.

Today these sources agree that with “a successful, even if initially rather slow, vaccination campaign”, Egypt is one of the top countries in Africa to have implemented efficient control of the coronavirus.

According to figures from the Ministry of Health, over 51 per cent of the population has received at least one shot of the vaccine, while close to 39 per cent are fully vaccinated, some with two shots and some with more.

With the advent of winter, the Ministry of Health has reactivated its vaccination campaign to encourage people to observe precautionary measures. Its website and Facebook page are again advising people to observe the wearing of masks, especially when in crowded places and indoors, and to opt for a booster Covid-19 shot and a flu shot.

In TV appearances, government officials, including Abdel-Ghaffar and Tageddin, have been pressing people with chronic diseases and those in an older age group to opt for a third or fourth shot of the vaccine. They also said that Egypt has over 50 million shots of different vaccines available.

 

BOOSTERS: Sami, an 82-year-old retired civil servant, said he was hesitant to get the fourth booster shot.

“I have been reading that it is not particularly efficient with the Omicron variant, and I was not sure if it really was going to be helpful and if it was better to wait for a new vaccine that is designed to work on the new variants,” he said. However, upon the advice of his physician, Sami went to get his fourth shot.

Hossam Hosni, head of Egypt’s national scientific committee on the new coronavirus, warned that high-risk groups should not hesitate to opt for a booster shot. He also advised these groups to opt for a flu shot. Hosni’s warnings are in line with WHO guidelines for the autumn and winter seasons. With an already clear increase in the number of cases, mostly mild as they are, in Europe, the WHO has advised a booster shot for the coronavirus and a flu shot along with precautionary measures.

Doctors working in public and private hospitals in Egypt say that they always keep an eye on developments in Europe because Egypt usually gets its new wave of the coronavirus five to seven weeks after the spike starts in Europe.

Ahmed Mahmoud, an emergency room doctor in a public hospital in Cairo, said that “we are preparing for a new wave, but we are hoping that like with the previous two waves things will not be so bad, especially the demand for intensive-care beds.”

According to official figures, less than one per cent of recorded confirmed cases have required admission to intensive care, and in most cases those admitted have been released early. Mahmoud agreed that most Covid-19 mortalities are in fact cases of co-morbidities. “This is why the current vaccination campaign is particularly targeting older people and people with chronic diseases,” he explained.

He added that “I still see patients who are admitted to the emergency department for one reason or the other who have not even had a single vaccine shot. Of course, now the risk of severe illness is much less, but we don’t know exactly how the virus works on a totally unvaccinated body even in its new, and so far, weaker variants.”

Late last month, Ashraf Hatem, head of parliament’s Health Committee and a member of the Supreme Council for Respiratory Diseases, said that XXB, the most recent variant of Covid-19, has not been detected in Egypt “so far”.

However, according to Mahmoud, with the end of mandatory PCR testing for travellers coming to Egypt and with fewer people needing to go to hospital for medication in view of the mild nature of the symptoms in most cases, it might require time to detect cases of the newer variants.

“In any case, we are hoping that any new variant will still be a weak one, but we have seen some variants resisting the vaccines. So, in addition to the call for vaccination, we need to see a call for precautionary measures even at a more relaxed level than those in the first to third waves, just to avoid having any pressure on health services again,” he said.

Officially, Egypt, in line with the dominant trend, earlier this year dropped mandatory masks in closed places, public transport, and public facilities. It has also dropped mandatory vaccination for admission to public facilities or participation in large gatherings.

Last month, Tazkarti, the official booking operator for football games, announced that fans wishing to attend league games were no longer required to wear a mask or to register their QR vaccination code. This was not even after its advisor and Ahly player Moemen Zakaria announced he had tested positive for the coronavirus.

An official from Tazkarti said that the regulations were adopted after consultation with the Ministry of Health and were in line with world trends on the management of the coronavirus. “Luckily, we are past the worst phase. We are moving on, and should there be any emergency we will revisit our regulations. But we are hopeful that this will not happen and that we are now moving to a time when the coronavirus is being treated like a bad flu,” he said.

This is not necessarily the case, however, said Mervat, a 66-year-old who contracted Covid-19 in the second wave and was told by her doctors that she was fully cured. “I have not been the same as I was prior to my infection. I still have a certain level of brain fogginess, and I have stopped driving altogether because I am too scared to drive now with my fluctuating levels of concentration,” she said.

Already retired and with few tasks to worry about beyond some basic housework and family commitments, Mervat is still finding it hard to focus on reading or spending long hours with her needlework as she used to do.

“My X-rays are all good, but I consulted a neurologist and he said that there have been cases of post-Covid declines in concentration, even with people who had mild symptoms. The doctor said I will probably get better, but he was not sure when,” she said.

According to Mahmoud, with the “incredible pressure” on the health system in Egypt and other developing countries there has not been enough attention paid to “long Covid”.

 “We don’t know enough about the coronavirus, and we know even less about long Covid, which sometimes influences cognitive skills and sometimes influences digestive functions. The world is still learning,” he said.

“This is precisely why I always tell patients who admit to not having been vaccinated that the risk they are taking might go beyond some light flu symptoms. I tell them that nobody can promise them that a Covid-19 infection will leave them with no long-term ailments that might not be immediately diagnosed.”

*A version of this article appears in print in the 17 November, 2022 edition of Al-Ahram Weekly.