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A doctor arrested after writing an article about Egypt’s fragile health system. A pharmacist picked up from work after posting online about a shortage of protective gear. An editor taken from his home after questioning official coronavirus figures. A pregnant doctor arrested after a colleague used her phone to report a suspected coronavirus case. 

As Egyptian authorities fight the swelling coronavirus outbreak, security agencies have tried to stifle criticism about the handling of the health crisis by the government of President Abdel Fattah el-Sissi. 

At least 10 doctors and six journalists have been arrested since the virus first hit Egypt in February, according to rights groups. Other health workers say they have been warned by administrators to keep quiet or face punishment. One foreign correspondent has fled the country, fearing arrest, and another two have been summoned for reprimand over “professional violations.” 

Coronavirus infections are surging in the country of 100 million, threatening to overwhelm hospitals. As of Monday, the Health Ministry had recorded 76,253 infections, including 3,343 deaths — the highest death toll in the Arab world.   

“Every day I go to work, I sacrifice myself and my whole family,” said a front-line doctor in greater Cairo, who spoke on condition of anonymity for fear of reprisals, like all doctors interviewed for this story. “Then they arrest my colleagues to send us a message. I see no light on the horizon.” 

In 2013, el-Sissi, as defense minister, led the military’s removal of Egypt’s first democratically elected president, Mohamed Morsi, after his brief rule sparked nationwide protests. In years since, el-Sissi has stamped out dissent, jailing Islamist political opponents, secular activists, journalists, even belly dancers. 

Now the clampdown has extended to doctors who speak publicly about missing protective gear or question the official infection count. 

A government press officer did not respond to requests for comment on the arrests of doctors and journalists but did send The Associated Press a document entitled “Realities defeating evil falsehoods,” which details what it says are el-Sissi’s successes in improving the economy and fighting terrorism. 

El-Sissi has said the virus’s trajectory was “reassuring” and described critics as “enemies of the state.” 

In recent weeks, authorities have marshaled medical supplies to prepare for more patients. The military has set up field hospitals and isolation centers with 4,000 beds and delivered masks to citizens, free of charge, at metro stops, squares and other public places. 

The government has scaled up testing within all general hospitals and ordered private companies to churn out face masks and gear for front-line health workers. El-Sissi has ordered bonuses for medical workers equivalent to $44-$76 a month. 

But health personnel are sounding alarm on social media. Doctors say shortages have forced them to purchase surgical masks with their meager salaries. Families plead for intensive care beds. Dentists and pharmacists complain of being forced to handle suspected virus patients with little training. 

The pandemic has pushed the Egyptian Medical Syndicate, a non-political group of professionals, into a striking new role as the country’s sole advocate for doctors’ rights. 

Last month, the union released a letter to the public prosecutor demanding the release of five doctors detained for expressing their views about the government virus response. More syndicate members have been arrested than reported, said one board member, but families have kept quiet.   

Doctors’ low morale sank further last week, following the arrest of board member and treasurer Mohamed el-Fawal, who demanded on Facebook that the prime minister apologize for comments that appeared to blame health workers for a spike in coronavirus deaths.   

In a televised briefing, Prime Minister Mustafa Madbouly criticized doctors’ “negligence and mismanagement” for endangering citizens’ health. 

Incensed doctors hit back, saying they’re untrained, underpaid and under-resourced, struggling to save patients at crowded clinics. So far at least 117 doctors, 39 nurses and 32 pharmacists have died from COVID-19, according to syndicate members’ counts, and thousands have fallen ill. 

After Madbouly’s comments, the union scheduled a press conference in late June to raise awareness about doctors’ sacrifices and discuss staff and supply shortages. But before anyone could speak out, security forces surrounded the syndicate and sent members home, according to former leader Mona Mina. A communications officer who promoted the event was detained and interrogated by security agents for hours, said a board member, before being released.   

In its latest statement, the syndicate said the accelerating detentions have caused “widespread anxiety” among health workers. 

“These doctors have no history of activism, they were arrested because they offered criticism of their very specific professional circumstances,” said Amr Magdi of Human Rights Watch, which has confirmed the arrests of eight doctors and two pharmacists. Two have been released, he said, while the rest remain in pretrial detention. 

Last week, Dr. Ahmed Safwat, an intensive care doctor in the Cairo suburb of Nasr City and syndicate board member, disappeared, according to social media posts from fellow doctors. Because he had experienced virus symptoms, many assumed he was self-isolating at home until his family filed a complaint to the syndicate, saying they hadn’t heard from him in days. A lawyer representing several detained doctors confirmed that he had been taken by state security and accused of terrorism activities. His last Facebook post also criticized the prime minister’s comments, adding, “The government says that everything is fine and under control, but you enter hospitals and find the opposite.”   

In another case, security agents burst into the home of Hany Bakr, an ophthalmologist north of Cairo, according to his lawyer and Amnesty International, over his Facebook post that criticized the government for sending coronavirus aid to Italy and China while its own doctors were desperately short of protective equipment. He remains in detention on terrorism charges, his lawyer added. 

In March, public prosecutors accused 26-year-old Alaa Shaaban Hamida of “joining a terrorist group” and “misusing social media” after she allowed a colleague to call the Health Ministry’s coronavirus hotline from her phone instead of first reporting the case to her managers, according to Amnesty International. Three months pregnant, she remains in pretrial detention.   

Doctors in three different provinces say their administrators have threatened to report them to the National Security Agency if they expressed frustration over working conditions, walked off the job or called in sick. 

In one of several voice recordings obtained by The Associated Press, a health deputy in the Nile Delta province of Beheira can be heard telling workers, “Even if a doctor is dying, he must keep working … or be subjected to the most severe punishment.” 

In another message sent to staff, a hospital director in the same province describes those who fail to show up to work as “traitors,” adding, “this will be treated as a national security matter ... and you know how that goes in Egypt.” 

A doctor in Cairo shared WhatsApp messages with the AP from his manager, alerting staff that their attendance sheets were monitored by state security. He said two of his colleagues received a pay cut when administrators discovered their complaints on social media. In two other hospitals in the capital, workers retracted letters of collective resignation over working conditions for fear of reprisals.

The suppression of criticism in Egypt is hardly unusual, analysts say, but the government has become even more jittery as the pandemic tests its capabilities and slows the economy. 

Although el-Sissi resisted a total lockdown because of the economic impact, schools, mosques, restaurants, malls and clubs were closed early in the outbreak and a nightly curfew imposed. 

With borders shut and cruise ships docked, Egypt’s critical tourism revenue has disappeared, among other sources of income. The country secured a badly needed $5.2 billion loan from the International Monetary Fund in June, on top of a previous $2.8 billion arrangement. 

Last week, fearing further economic fallout, the government reopened much of society and welcomed hundreds of international tourists back to resorts, even as daily reported deaths exceeded 80. Restaurants and cafes are reopening with some continued restrictions, and masks have been mandated in public. 

“Because of Egypt’s constant attention to its image as a place open for tourism, open for business, open for investment, authorities appear particularly sensitive to divergent perspectives during the pandemic,” said Amy Hawthorne, an Egypt expert at the Project on Middle East Democracy. “They want to project an image that everything is fine, they’re in control.” 

Those who spread “false news” online about the coronavirus could face up to five years imprisonment and steep fines, Egypt’s top prosecutor warned this spring. 

The U.N. High Commissioner for Human Rights voiced concern in late March that 15 individuals had been arrested for broadcasting alleged false news about the pandemic. 

Four Egyptian journalists who reported on the outbreak remain in prison, according to the Committee to Protect Journalists, which has labeled Egypt one of the world’s worst jailers of journalists, along with Turkey and China. 

Security forces have also taken aggressive action against foreign reporters. In March, Egypt expelled a reporter for The Guardian who cited a scientific report disputing the official virus count. Egypt’s state information body has summoned The Washington Post and New York Times correspondents over their critical coverage during the pandemic. 

Despite growing human rights abuses, the international community counts on Egypt as a bulwark against regional instability, said a Middle East-focused rights advocate at the U.N., speaking on condition of anonymity to discuss policy matters. 

“There is no appetite,” the advocate said, “to address what is going on in Egypt, let alone sanction them in any way for what the government is doing to their own people.”