The death of a Tora Prison complex employee on Friday who tested positive for COVID-19 is raising concerns that the pandemic might spread to Egypt’s overcrowded prisons, where there has been a documented lack of healthcare provision.
Sayed Ahmed Hegazy died on Friday, just under two weeks since he first began exhibiting symptoms of COVID-19 on May 18. According to two of his family members who spoke to Mada Masr on condition of anonymity, the Hegazy family struggled to find him a hospital bed after being denied help from the Interior Ministry and his employer, and being turned away at several private hospitals on account of not having a copy of his PCR test results that confirmed he had tested positive. Hegazy died in the family’s car as they were driving to a private hospital in an attempt to have him admitted for care.
As news of the Tora Prison employee’s death made its way online on Saturday, lawyers have moved to pressure the public prosecution to be transparent about the incident and take the necessary steps, including testing all prisoners, if Hegazy is acknowledged to have died of COVID-19.
The Interior Ministry released a statement on Sunday addressing Hegazy’s death. According to the ministry, Hegazy had been on leave since May 17 for treatment of a chronic health condition. During this time, the ministry claimed, Hegazy was administered a PCR at the Imamba Fever Hospital, but he died before the positive results came back. The ministry has since taken “necessary precautions were immediately taken to sterilize his work site, and those he was in contact with have been monitored to ensure their safety.”
Underlining the contentious atmosphere around health conditions in prisons, the Interior Ministry’s statement warned that legal measures would be taken against those who promote inaccurate news that would cause confusion among citizens, while asserting that all facilities in the prison sector are sterilized on a daily basis and that prisoners receive periodic medical examinations to ensure their safety in line with the Health Ministry and World Health Organization’s protocols.
However, the family’s account offers more details and differs from some of the details offered in the Interior Ministry’s statement.
According to the family members who spoke to Mada Masr, Hegazy had felt “tired and exhausted” since mid-May, but he dealt with these symptoms as “normal symptoms of the common cold or the usual complications from his diabetes.” He continued to go to work until May 18, but when his temperature and blood sugar levels spiked and his two daughters and wife began to exhibit symptoms, the entire family sought out antibody tests. The results showed a decrease in the number of white blood cells for Hegazy and one of his daughters, a possible indication that they had contracted the virus.
On May 19, Hegazy, along with his wife and daughters, went to the Imbaba Fever Hospital near their house, where they waited until the evening and ultimately failed to secure PCR tests. On the following day, the family went to the Abbasiya Fever Hospital instead. There, the doctor who examined the family agreed to carry out a PCR swab for Hegazy, asking the rest of the family to quarantine themselves inside the family house until Hegazy’s results came back three days later.
A family member tells Mada Masr that when Hegazy’s daughter went to the hospital to receive the test results, she was told that her father had tested positive but that the actual tests results had not yet come back from the lab.
A medical source in the Abbasiya Fever Hospital tells Mada Masr that Hegazy’s PCR test came back positive. After reading several posts on social media demanding that the Tora employee’s test results be disclosed, he checked the hospital records for positive cases and confirmed that Hegazy was one of them. The source also points out that the usual procedure is to hand over the patient test results to the family after notarizing it, provided that the family shows the patient’s ID card. However, three members of Hegazy’s family tell Mada Masr that the hospital administration refused to hand them Hegazy’s test results on Saturday, without providing any reason for the refusal.
Another family member, who spoke to Mada Masr on condition of anonymity, adds that Hegazy’s condition deteriorated after he took the PCR test on May 20, which prompted the family to call a doctor for a home visit. The doctor told the family that he suspected Hegazy had contracted COVID-19 based on his symptoms and upon looking at his antibody test results. The doctor prescribed several medications and an oxygen tank. However, these measures did not alleviate Hegazy’s symptoms. According to the family member, Hegazy went into a diabetic coma and the doctor told them that he needed to be transferred to an ICU.
Despite Hegazy’s status as an employee, the Interior Ministry did not provide a place for him in any of its hospitals. “The Interior Ministry asked us to call the Health Ministry hotline to find a place for him,” the family member says, pointing out that the family took Hegazy to a number of private hospitals that all refused to admit him because he did not have his PCR test results in hand.
The family member adds that, on Friday morning, two public hospitals designated to receive confirmed cases and those suspected of having COVID-19 — Azhar Specialized Hospital and the Health Insurance Hospital in Nasr City — refused to admit Hegazy on the pretext that they only admit patients brought to the hospital via ambulance.
“We took him to the Azhar Specialized Hospital, but they also refused to admit him,” another family member tells Mada Masr. “On our way to Qasr al-Ainy Hospital, he died, so we returned him to the house.”
Each time the family called the Health Ministry-designated hotline while their father was alive, they received the same response: wait for two hours for an ambulance to arrive.
After Hegazy died on Friday, the family called the hotline again and received the same response: wait until an ambulance comes to pick up Hegazy’s body in order to transfer him to a cemetery, a measure outlined in the ministry’s preventative medicine procedures. The ambulance never came, however. So the family arranged to have people wearing personal protective gear carry out the washing and shrouding burial procedure. Then, they transported the body to the cemetery.
According to Hegazy’s family, his wife and two daughters are suspected of having contracted the virus given that they are also exhibiting symptoms, but, due to the lack of evidence to prove the death of their father due to COVID-19, private hospitals have refused to carry out PCR tests for the family or admit Hegazy’s wife to a quarantine hospital.
The medical source in Abbasiya Fever Hospital says that the hospital cannot receive Hegazy’s widow and his two daughters nor administer PCR tests for them because the new treatment protocol, which was implemented last Thursday, stipulates the need to adhere to a geographical scope when admitting people suspected of having COVID-19. He also explained that Abbassiya Fever Hospital is now restricted to receiving only those patients who reside in the Abbasiya, Heliopolis and Nasr City areas.
Alongside the family’s plight, there are also concerns about what Hegazy’s death means for his workplace.
Information about what is happening inside Egypt’s prisons has been sparse since the global pandemic made its way to Egypt. The Supreme Judicial Council, the Public Prosecution and other judicial authorities decided to postpone all pending cases, including remand detention renewal hearings in Egypt’s court system, for two weeks, a decision that has remained in effect. On March 9, the Interior Ministry suspended all prison visits for 10 days, a move that has also been extended indefinitely.
Alaa Ghanam, the health officer at the Egyptian Initiative for Personal Rights (EIPR), previously told Mada Masr that if COVID-19 made it into the prison system, it would be catastrophic. Prisons need additional preventive measures, he says.
“There is a danger in any crowded place, like schools,” Ghanam added. “They should be doing the same kind of sanitization and testing of prisoners [as outside], but the only decision taken has been to ban visits, as if prisoners are immune somehow.”
Magda Adli, a doctor with the Nadeem Center for Rehabilitation of Victims of Violence and an activist for prison health conditions, also previously Mada Masr: “There is extreme overcrowding and very poor ventilation. People sleep propped on their sides and sometimes sleep in shifts because of the crowding. The food is bad too, especially when visits are banned. This is on top of the risk to elderly and sick prisoners and the lack of healthcare and testing capabilities inside prisons.”
To try to push for greater transparency surrounding Hegazy’s death and his potential contact with others in Tora Prison, lawyers Khaled Ali and Nabih al-Ganady submitted a request to the public prosecutor on Saturday, urging the the investigative body to take the necessary legal measures to ensure the accuracy of what had been published about Hegazy. Pending the results of a prosecution investigation, the lawyers called for a prompt administration of PCR tests to those who were in contact with Hegazy to prevent the spread of the virus.
The two lawyers also filed a complaint on behalf of four detainees held in remand detention in the Tora Prison complex, urging the prosecution to grant those held in remand detention conditional release to their homes for their safety.