Egypt’s health ministry has said that a fourth wave of coronavirus is coming in autumn, as the population grows complacent amid declining cases.
“We are all expecting it. It is a given that the cases will start increasing,” Dr Noha Assem, adviser to the health minister, told local television channel Al Hayah on Monday night.
After the third wave hit its peak at around 1,200 cases and 60 deaths in mid-May, the daily count has been steadily declining.
Daily cases decreased to 31 and deaths to four on July 28 — the lowest level since March 2020.
The US Centres for Disease Control and Prevention, in its latest update on Monday, moved Egypt from Level 3 — high risk — to Level 2 — moderate risk.
Egypt has reported an official total of more than 284,000 cases and more than 16,500 deaths, but the real number is estimated to be 10 times that due to limited testing and the exclusion of private lab results.
“The figures don’t reflect the reality — nothing has changed in that regard. But they provide an indicator of the curve,” said health researcher Ayman Sabae.
While vaccination rates remain low, health experts say Egypt has so far avoided a spike in cases partly because the highly infectious Delta variant has not yet been detected in the country.
But Dr Assem said the key word is “yet” and it could be a matter of time before the Delta variant, which has been wreaking havoc globally, reaches Egypt.
The variant has already been detected in 15 countries in the World Health Organisation’s Eastern Mediterranean region.
Meanwhile, Covid-19 cases and deaths in Egypt have started slowly creeping up again in recent days.
The country may enter a fourth wave as soon as September, Dr Assem said, after Egyptians return from travel and lax precautionary measures during summer holiday jaunts on the North Coast bear consequences.
“People in [the North Coast] aren’t taking any precautions and yet the rate decreased,” said Dr Assem El Essawy, professor of chest diseases at El Fayoum University. “We’ll see in September that the curve will go up again.”
Besides the absence of the Delta variant, he said it is unclear why cases have decreased recently.
“There are countries that are hotter than us and they’re in a peak, so it’s not the weather,” Dr El Essawy said. “It’s not related to the vaccine because the people that are vaccinated are not a lot.”
Only about 2.7 per cent of the country’s 100 million people are fully inoculated against Covid-19.
Egypt has secured enough doses to vaccinate its entire population through bilateral deals, the Covax initiative and other sources, the IMF-WHO Covid-19 vaccine supply tracker showed.
But production bottlenecks and high global demand could delay actual receipt into 2022.
Health Minister Hala Zayed said last month that only about 10 million doses are available so far.
Egypt’s Vacsera has locally produced around 650,000 doses of China’s Sinovac vaccine, which are due to be administered to Egyptian citizens this month.
In the meantime, the ministry is delaying second shots of the AstraZeneca vaccine by two weeks to deal with the supply shortage.
“The capacity of the vaccination centres has been reaching the maximum easily and the waiting was long,” said Mr Sabae, chief executive of Shamseya, a healthcare solutions provider. “Now the purpose of the government is to match between the numbers registering and the availability.”
The supply bottleneck is one explanation for the lack of a national campaign to combat vaccine hesitancy and misinformation, Mr Sabae said.
The WHO has released videos entitled The Truth about Covid-19 Vaccines with Dr Yvan Hutin, director of communicable diseases in its office for the Eastern Mediterranean Region, but rampant rumours persist.
Omar Sereeh, a 27-year-old schoolteacher in El Dabaa on Egypt’s North Coast, said he has not registered for the vaccine.
“I thought it was only open for older people and those with health conditions,” he said. “Anyway, I heard that a lot of people are scared to take the Chinese vaccine. I’m a little worried to take it.”
Online vaccine registration opened for health workers, older people and people with pre-existing health conditions on February 28, and to the general public on March 6.
Khaled Ali, a 48-year-old family driver working in New Cairo, said he only registered two months ago because before, “it wasn’t on my mind”.
He has not secured an appointment, but seemed to be in no hurry.
“Now the cases are less than before,” he said.
Dr Mohammed Ali, an infectious diseases specialist who works at various private and public hospitals in Cairo, said he is starting to see an increase in cases again and nearly all are among the unvaccinated.
“People still ask us whether they should take the vaccine or not,” he said in disbelief.