Moreover, hospitals administrations disregard the recommendations of the WHO to conduct PCR tests for all medical teams before they leave their workplaces and return to their homes. They merely do the swabs for those who have symptoms of the disease. Nevertheless, data refers to the infection of 90 doctors. Five doctors already died. These numbers were collected by the Egyptian Doctors’ Syndicate and its branches. In early April, the first doctor to die from the coronavirus was Dr. Ahmed El-Lawah, Professor and Head of the Department of Clinical Pathology, in Abou Khaliefa Hospital in Ismailia which is one of the quarantine hospitals for coronavirus patients. Two weeks later, Sonia Abdul-Azeem - a doctor from the governorate of Daqahleya – died. She was followed by Dr. Hesham Al-Sakket, Vice-Dean of the Faculty of Medicine of Cairo University. This was followed by the death of Mohamed Abdullah Al-Mohsenawy, one of the medical team of Al-Nagila Hospital dedicated for the quarantine of coronavirus patients as a consequence of his infection with the coronavirus.
On the 25th of April 2020, sources in the Ministry of Health and Population revealed that the Ministry decided to stop receiving new cases into Al-Nagila Hospital in Marsa Matrooh because of the infection of 22 members of its medical team. This was not the first time in which confirmed cases of coronavirus are found among medical teams of Egyptian hospitals. Many cases took place in some of Egypt’s hospitals. This includes infections among the medical team of the Hospital of the Faculty of Medicine of Cairo University (Kasr Al-Aini). Likewise, 16 members of the medical team of Benha University Hospital tested positive for coronavirus. The Dean of the Faculty of Dentistry of Cairo University was infected, and the building was closed for 14 days. The medical team of the Internal Medicine Department of the Faculty of Medicine of Assiut University was replaced after discovering cases of coronavirus infections. A nurse in the reception of Ahmed Maher Hospital in Cairo contracted the virus and was transferred to the public isolation hospital. Moreover, the Internal Medicine Department of the Hospital of the Faculty of Medicine of Mansoura University was closed, and 74 members of its medical team were isolated following the discovery of nine positive cases of coronavirus. Dr. Manar Samy who is working in Al-Ahrar Educational Hospital of Zaqaziq also contracted the virus, and was isolated in Al-Bagoor hospital. Moreover, 13 nurses, five doctors and two workers in the Faculty of Medicine of Suez Canal University were isolated. Five departments of the Hospital of Mansoura University were closed following the discovery of nine coronavirus cases. A radiology technician from Luxor Hospital called Omar Mohammed contracted the virus, as well as his twin children who contracted the disease from him. Moreover, two doctors from Aswan University Hospital contracted coronavirus, and the administration of the hospital decided to suspend work in the departments of Reception, Accident and Emergency, Orthopedics, and Cardiology until identifying those who were exposed to confirmed positive cases among the medical team, workers and patients, and taking adequate measures for each case. It is expected that numbers will increase if instructions related to prevention are not applied by the Ministry of Health in all hospitals.
In this context, the representative of the WHO in Egypt pointed out that infections in the medical sector amount to 13% of infections in Egypt (Al-Shorouk, 13 April 2020), which is high compared to the overall number of infections.
Thus, doctors repeatedly called upon the Egyptian Ministry of Health via social media and the electronic platform of their Syndicate to adopt a protocol, consistently with international standards, to protect doctors and apply it in all hospitals throughout the country. The purpose of is to overcome problems of shortage of protective equipments necessary for protection from the virus, and to limit the spread of the infection among medical teams. However, the only response from the Ministry of Health was to deny doctors’ claims of shortage of equipments, or lack of necessary protective measures in public hospitals as rumors. It also took arbitrary measures against doctors and support staff that make it even more difficult for them to adequately perform their duties. After the spread of the disease in one hospital, the General Agency for Medical Care issued Periodic Book no. 1 on the current crisis of the coronavirus pandemic clarifying measures that have to be taken to confront the spread of the virus among doctors. This Book divides work among medical teams of hospitals into shifts over the month, so that each group works at the hospital for two consecutive weeks, then they go into self-isolation for the next two weeks. These measures were criticized by the Doctors’ Syndicate as they disregard doctors’ family life, and expose their families to risk because there are no suitable places for doctors to remain in the hospital during this continuous period.
The Periodic Book also included that disciplinary measures will be taken against any doctor or nurse that contracts coronavirus because this adversely affects the performance of work, and entails a violation of preventive instructions. Is it reasonable to impose a punishment on people for contracting a disease especially if they are doctors who risk their lives in order to protect public health, and are more likely to get infected?
In a similar vein, the Health Department in the governorate of Sharqeya referred a doctor for investigation after publishing a video on social media complaining from shortage in protective equipments, especially protective face masks, for dealing with suspected cases. The Doctors’ Syndicate considered this an illegal action that aims at blocking information on bad health conditions in public hospitals.
On another front, nurses working in Imbaba Fever Hospital in Giza, which is assigned for the quarantine of coronavirus cases, organized a protest against the inadequacy of protective equipments available to them when dealing with patients after the infection of one nurse. Moreover, nurses in Mansoura Medical Insurance Hospital went on strike in order to protest the refusal of the Health Department to take swabs from them after the confirmation of five positive cases of doctors in the Cardiac Care Unit of the same hospital.
Weaknesses of Egyptian hospitals and recurrent infections among medical teams that we are witnessing now are normal consequences of the reduction of budgetary allocations to the health sector in order to increase spending on other sectors. The percentage in the current fiscal year is 2.4% which is less than the constitutional obligation of article 18 of the Egyptian Constitution of 2014: “The State shall allocate a percentage of government spending to health equivalent to at least 3% of Gross National Product (GNP), which shall gradually increase to comply with international standards.”
Trying to express appreciation of the efforts of doctors and nurses, according to a statement by the Presidential Spokesman, the President of the Republic ordered to increase infection allowance for doctors to 1200 EGP, and for nurses to 700 EGP, as well as issuing an exceptional reward from Tahya Misr Fund (Long Live Egypt Fund) to workers in quarantine, chest and fever hospitals, and central laboratories in the Republic. At the same time, the Doctors’ Syndicate announced that it will pay 100,000 EGP for the family of any of its members who dies because of coronavirus and 20,000 for the member who gets infected, which is within its financial capabilities.
The crisis of the coronavirus pandemic necessitates responding to the following demands so that we can overcome the crisis:
· Developing the health sector and providing protection for medical teams.
· Enhancing the capacities of public hospitals by preparing more intensive care units and ventilators.
· Applying Law 18/2018 on Honoring the Injured and Martyrs on members of medical teams who die or get infected.
· The Ministry of Health has to perform tests every two weeks for all health care workers, and to test all patients who suffer shortness of breath for coronavirus.
· Sending delegations to hospitals in order to make sure that there are sufficient protective equipments.
· The Ministry of Health should give the priority in the performance of coronavirus PCR tests to medical teams directly dealing with coronavirus patients in hospitals, similarly to members of judicial bodies and essential and sovereign institutions, in order to make sure their health is safe.
· Increasing the percentage of government spending on health to meet the constitutional provision of 3% of government spending. This will directly reflect on services performed to citizens so that we can overcome the crisis with the least possible human losses.
Center for Trade Union and Workers Services (CTUWS)
3 May 2020