The Impact of Implementing the Egypt Pandemic Preparedness Plan for Acute Respiratory Infections in Combating the Early Stage of the COVID-19 Pandemic, February-July 2020: Viewpoint

Abstract

This article briefly describes Egypt’s acute respiratory infection (ARI) epidemic preparedness and containment plan and illustrates the impact of implementation of the plan on combating the early stage of the COVID-19 epidemic in Egypt. Pillars of the plan include crisis management, enhancing surveillance systems and contact tracing, case and hospital management, raising community awareness, and quarantine and entry points. To identify the impact of the implementation of the plan on epidemic mitigation, a literature review was performed of studies published from Egypt in the early stage of the pandemic. In addition, data for patients with COVID-19 from February to July 2020 were obtained from the National Egyptian Surveillance system and studied to describe the situation in the early stage of the epidemic in Egypt. The lessons learned indicated that the single most important key to success in early-stage epidemic containment is the commitment of all partners to a predeveloped and agreed-upon preparedness plan. This information could be useful for other countries in the region and worldwide in mitigating future anticipated ARI epidemics and pandemics. Postepidemic evaluation is needed to better assess Egypt’s national response to the COVID-19 epidemic.

A pre-vaccine exploratory survey of SARS-CoV-2 humoral immunity among Egyptian general population

“…This finding might be due to the more population-dense nature of urban cities, with higher crowding and thus more infection rates. These findings are in accordance with those of another Egyptian study during the same period, where incidence rates were higher in urban compared to rural governorates (60.3 and 145.8/1,000,000 population, respectively) [14].…”

“…Due to the high expense of PCR testing, especially in low- and middle-income countries, the actual magnitude of COVID-19 prevalence in the community is largely indeterminate due to the limited numbers of tested samples [ 12 ]. COVID-19 surveillance in Egypt mainly depends on PCR tests, which are usually carried out in symptomatic cases presented at governmental hospitals [ 13 , 14 ]. Results from private laboratories are not included in the official records of new cases and mortalities.…”

“…On further analysis of these rates, when considering our PCR-confirmed cases to reflect the actual number of infections (regardless of the type of laboratory issuing the PCR result), the attributable mortality rate for COVID-19 might thus be lower than official rates (16,242/1,470,000 = 1.1%). According to an Egyptian study during the first two COVID-19 waves, the case fatality rate (CFR) declined from 9.22% in week 1 of the pandemic to 2.57% in weeks 9–10 [ 14 ]. In India, another study performed during the first two waves reported a CFR among PCR-confirmed cases of 2·4% [ 17 ].…”

Low incidence of COVID-19 case severity and mortality in Africa; Could malaria co-infection provide the missing link?

“…Several countries in Africa have switched focus towards COVID-19 care which results in ambiguous surveillance data for other infectious diseases. Some countries like Egypt has adopted measures to improve their surveillance system to track COVID-19 disease, improved their healthcare system and most importantly, established a national Egyptian Public Health system to enable health authorities to monitor the extent of the pandemic in Egypt [ 46 ] whilst countries like Burundi and Congo lack sufficient interventions with regards to COVID-19 surveillance as a result of inadequate logistics and failure to learn from previous Ebola outbreak [ 47 ].…”

Adapting an integrated acute respiratory infections sentinel surveillance to the COVID-19 pandemic requirements, Egypt, 2020–2022

“…The preventive sector of MoHP was given access to surveillance data for follow-up of patients and contacts through phone calls or visits. Symptomatic contacts were further investigated for early case detection [ 11 ]. Contact tracing and management procedures were developed and distributed at all levels of the healthcare system and an online application was developed within the national reporting system for contact tracing.…”