Faced with overcrowding at quarantine hospitals, the Ministry of Health announced last Thursday that it would divert suspected COVID-19 cases to two other hospitals until beds opened up. An outbreak of COVID-19 among medical staff at one of the diversion sites before that decision, however, prompted doctors to halt work on Friday morning until their demands are met.
The Health Ministry’s decision applied to two hospitals: one in Manshiyet al-Bakry in Cairo and the other in Warraq in Giza. Patients were to be administered PCR tests, and then wait in either of the two quarantine sites until their results came back. Patients whose test results come back positive and suffer from severe symptoms would then be transferred to an isolation hospital as soon as a bed became available. Meanwhile, positive cases with mild or moderate symptoms would be transferred to university dorms.
However, doctors at Manshiyet al-Bakry hospital who spoke to Mada Masr over the weekend say that a COVID-19 outbreak was underway at least a week before the Health Ministry’s decision. By Thursday morning, the same day as the ministry’s announcement, 29 hospital staff members, a number which includes administrators, had tested positive, according to Dr. Mohamed Moqbel, a gastrointestinal consulting physician at Manshiyet al-Bakry.
In a statement released on Friday, the hospital’s doctors said 16 medical staff had contracted the virus. According to the news portal Daarb, however, that number had increased to 25 as of Sunday, with more test results still to come in.
With a lack of clear messaging from the hospital administration about the ministry’s plan and the ability for doctors exposed to positive cases to be tested, doctors halted work on Friday morning and then called on hospital administrators to reject the Health Ministry’s plan to divert potential COVID-19 patients to Manshiyet al-Bakry, Moqbel told Mada Masr.
In a letter sent to the hospital administration on Saturday, a copy of which Mada Masr obtained, Manshiyet al-Bakry doctors made three demands: providing PCR tests for all medical and administrative staff, create areas within the hospital designated for suspected cases and areas that are safe for employees per infection control standards and provide dormitories for doctors and nurses that are separate from patient isolation housing.
By Saturday night, the doctors had released a second statement, noting that the head of the hospital’s preventative medicine department threatened to report the doctors to the National Security Agency in an attempt to force them back to work.
The signs of a potential outbreak at Manshiyet al-Bakry Hospital, however, came long before last weekend’s escalation.
At the start of last week, an OBGYN doctor at Manshiyet al-Bakri Hospital began showing coronavirus symptoms, according to Hamada al-Geoushi, a doctor in the hospital’s department of obstetrics and gynecology. Instead of administering a PCR test, however, the hospital’s deputy granted her a ten-day leave, Geoushi tells Mada Masr. When her medical condition worsened, friends of hers at Abbasseya Chest Hospital managed to administer a PCR test, the results of which came back positive. The same thing happened with another doctor two days later, which increased the number of positive cases among medical staff to two. Then, an employee who works in attendance showed symptoms, Geoushi adds.
By Thursday, the hospital had become an “epicenter for coronavirus,” according to Moqbel. However, that didn’t stop the Health Ministry from proceeding with their plans to divert COVID-19 patients to Manshiyet al-Bakry.
At 6 am on Thursday morning, the hospital’s administration evacuated the regular and neonatal intensive care units, according to Geoushi. It then transferred the hospital’s patients to other hospitals.
“I called the OBGYN supervisor and told her that we will be transformed into an isolation hospital and asked her if we should stop receiving patients for delivery, examination or anything else,” Geoushi says. However, Geoushi’s supervisor was adamant that she did not know about the decision or how to deal with it. She then told Geoushi that the hospital director told her that Manshiyet al-Bakry will be transformed into a quarantine site, not an isolation hospital, adding that the decision will not go into effect until Saturday.
However, by 11 pm on Thursday, the Health Ministry’s decision was going into effect. A Manshiyet al-Bakry receptionist informed doctors that patients transferred from the Abbasseya Fever Hospital had arrived in ambulances. Ambulances lined up in front of Manshiyet al-Bakry Hospital, according to Geoushi, who said that doctors, nurses and employees refused to admit the patients. They closed the hospital’s doors and prevented the Abbasseya transferred cases from entering until 2:30 am on Friday morning. At that point, the doctors, nurses and hospital administrators left the hospital grounds, leaving the doors open for the transferred cases to enter.
“We left because none of us are trained to treat coronavirus cases,” Geoushi explains.
A medical source in the Abbasseya Fever Hospital told Mada Masr that 25 suspected COVID-19 cases were transferred to Manshiyet al-Bakry. The 25 patients had been administered tests in Abbasseya’s emergency room and were transferred while they awaited their results, a move necessary to decrease the patient load at Abbasseya Fever Hospital, as there are no beds available at isolation hospitals.
To attempt to remedy the situation, the hospital administration reached out to doctors via Whatsapp, saying that doctors could be administered PCR tests at Manshiyet al-Bakry if they wanted to be tested.
However, when some of the medical staff tried to pursue this option, they were refused by a doctor from a regional office affiliated with the hospital.
According to Geoushi, the doctor told those who attempted to get tested: “Swabs are only for those who’ll work. If you’re not going to work, go home.”
“I told them that I’m most likely infected,” Geoushi says, “and that there’s risk in treating suspected cases because I’ll most likely infect the uninfected.”
Geoushi, however, did work on Friday, after the hospital’s director asked available doctors of various specialties to stabilize a patient transferred from Abbasseya. The patient was suffering from severe respiratory distress and his blood oxygen saturation level was only 15 percent. He says that he took part in stabilizing the patient and asked for a quick blood gas test, used to assess disease severity, so they could be placed on a ventilator. But he could not run the tests because none of the hospital’s lab employees were present. The patient’s condition continued to deteriorate until he died on Friday afternoon.
Mada Masr could not reach the hospital’s director for comment on the situation at Manshiyet al-Bakri or the demands of its doctors.