By Mena Doce, Antioch High School, Antioch, Tennessee, USA
In recent months, the Egyptian government’s public health response to COVID-19 has been referenced by several foreign parties in an effort to paint one of two pictures. Foreign advocates of stricter public health guidelines have cited Egypt’s requirements to wear face masks in public areas, as well as Egypt’s ban on public gatherings, as the reason for the lower rates of infection (Sadek, 2020). On the other hand, foreign parties against strict public health guidelines have referenced the Egyptian cabinet’s lack of shutting down restaurants, cinemas, gyms, and other small businesses along with abolishing curfews and travel restrictions (Sadek, 2020).
According to data provided by Egyptian public health officials, Egypt’s incidence rate of COVID-19 is significantly lower compared to other countries. In fact, the Johns Hopkins Coronavirus Resource Center shows that Egypt has a recorded total of just over 140,000 confirmed cases as of January 2021. This is equivalent to only 0.14% of the country’s population contracting the virus according to population data from The World Bank. Comparing this to Turkey, a country whose population size and density are similar to that of Egypt, 2.75% of the Turkish population has contracted COVID-19 according to data from Johns Hopkins and the World Bank. For sheer comparison, the United States is reported to have over 20,470,000 confirmed cases as of January 2021. Similar calculations yield that 6.2% of the country’s population has contracted the virus. This leads many to ask how Egypt’s numbers are drastically lower. Is Egypt taking better precautions that others should follow, or are there alternate explanations?
A simple answer may be that this is due to a lack of publicly available testing. Unfortunately, many Egyptians may have contracted the virus but did not have sufficient access to testing, which led to a deficit in recorded cases. Egypt probably has a large burden of COVID-19 cases that are unreported and an increased clinical capacity for public health might help identify and manage cases (Tuite et al., 2020). But perhaps there is more to the story.
The lack of publicly available testing as well as the lower reported incidence rate may be intentional. Recent research claims that Egyptian officials have suppressed case data, manipulated death reports, and expanded emergency law to allow arrests of anyone contradicting state COVID-19 news (Salem, 2020). Unlike what the low reported numbers may suggest, this would mean that the Egyptian government does not have COVID-19 under control. In fact, Egypt would be financially motivated to provide the illusion of having COVID-19 under control as travel and tourism are among the country’s leading economic sectors. According to an article by Puri-Mirza (2020), travel and tourism generated about 389 billion EGP for the country’s GDP in 2018.
Putting the unconfirmed intentions of the Egyptian government aside, some have speculated that there may be other reasons for the lower numbers. Recent studies suggest that there may be environmental explanations for the lower numbers. In their analysis of this topic, Medhat et al. (2020) cite a Korean study that found that low daily temperature and low relative humidity were associated with a significant increase in the incidence of influenza, a similar, contagious respiratory illness. The analysis goes on to state that Egypt’s climate is quite different with extremely high temperatures and a hot desert climate, which may lead to the reported decrease in cases (Medhat, 2020). In support of this theory is the observation of the lower rate of COVID-19 infection in Upper Egypt, where the temperatures are even higher than in Lower Egypt (Medhat, 2020).
A final working theory behind the relative lower number of cases in Egypt suggests that the Bacille Calmette-Guérin (BCG) Vaccine may have helped lead to the decrease in cases. Egypt mandated the administration of the BCG Vaccine in 1974 to limit the spread of Mycobacterium bovis. The vaccine is believed to have non-specific immune responses, one of which may lead to an enhanced response against COVID-19 (Medhat, 2020). With the compulsory administration of this vaccine in 1974, this would impact older generations of Egyptians. Since the older generation is the most vulnerable and likely to show aggressive symptoms of COVID-19, this may be the reason for the observed trends.
As there are several proposed reasons for the relatively lower number of COVID-19 cases in Egypt, foreign parties should not use Egypt’s public health regulations as the standard for achieving lower rates of spread. As demonstrated, there are many factors that come into play, most of which have not been extensively studied or investigated. Each country should decide what is best for its citizens depending on their progress in combatting the virus.
References
Abd El Ghany, M. (2020, July 1). A man wearing a face mask is seen in front of the Great Pyramids of Giza after reopening for tourist visits, following the outbreak of the coronavirus disease (COVID-19) [Photograph]. https://www.reuters.com/article/us-health-coronavirus-egypt/egypt-reopens-airports-and-welcomes-tourists-to-pyramids-after-covid-closure-idUSKBN2426VX
COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). (2020, January). Retrieved January 02, 2021, from https://coronavirus.jhu.edu/map.html
Medhat, M. A., & Kassas, M. E. (2020). COVID-19 in Egypt: Uncovered figures or a different situation? Journal of Global Health, 10(1). doi:10.7189/jogh.10.010368
Puri-Mirza, A. (2020, December 17). Tourism industry in Egypt - statistics & facts. Retrieved from https://www.statista.com/topics/5767/tourism-industry-of-the-egypt/
Sadek, G. (2020, July 7). Egypt: Cabinet Eases COVID-19 Restrictions. Retrieved from https://www.loc.gov/law/foreign-news/article/egypt-cabinet-eases-covid-19-restrictions/
Salem, O. (2020, July 07). Egypt's Social Media Discovered Its Coronavirus Crisis. Retrieved from https://foreignpolicy.com/2020/07/07/egypts-social-media-discovered-its-coronavirus-crisis/
The World Bank. (n.d.). Retrieved January 02, 2021, from https://datatopics.worldbank.org/world-development-indicators/
Tuite, A. R., Ng, V., Rees, E., Fisman, D., Wilder-Smith, A., Khan, K., & Bogoch, I. I. (2020). Estimation of the COVID-19 burden in Egypt through exported case detection. The Lancet Infectious Diseases, 20(8), 894. doi:10.1016/s1473-3099(20)30233-4