Photo caption: Telemedicine- Egypt Today/Mohamed Ali.
CAIRO - 8 April 2020: Nowadays, physical distancing comes as an extremely vital measure for people all over the world to flatten the curve of infection with the novel coronavirus; it is also highly recommended for people who lack immunity to avoid hospitals where COVID-19 cases are treated.
Several initiatives of telemedicine have been created by groups of Egyptian physicians. Although this phenomenon turned trendy amid the current crisis, it raised questions on how acceptable this phenomenon is among Egyptians.
Facebook was a good platform for doctors to launch their initiatives, asking people to stay at home. For instance, a Facebook public group called “Stay Home (Protect Yourself and Others)...Ask Doctors of Helwan” is one of those initiatives that post the accounts of several physicians in various specializations and give medical instructions for people to protect themselves at home.
How does this service work?
When a patient writes about his or her symptoms in the group, they are connected to the specialized doctor, who later communicates with the patient.
Egypt Today had an experience with one of the groups, asking for a medical diagnosis for a disease that infected a three-year-old child. The group connected us with a pediatrician, who immediately replied and gave the proper prescription.
Some private groups like “Egypt’s Doctors for Free Medical Consultations,” which has been joined by more than 30,000 members since its launch in September 2019, set certain rules for the members; “Only doctors have the right to respond to the patients and it is strictly forbidden for the members to comment on any consultation.”
In response to a question on Messenger, an admin of the group told Egypt Today that they have copies of the medical IDs of the doctors, saying “We all have data of the doctors [who communicate with the patients on the group].” The admin affirmed that they provide this service for free.
How do people see telemedicine?
Egyptians had different views on such initiatives.
M. Zain, a father of two boys, told Egypt Today that he is totally against such groups for several reasons. “Firstly, they are not officially monitored by the government. Secondly, I do not know the real identities of those doctors. Thirdly, such groups violate the patient’s privacy. Finally, they aim at profits no more or less.”
“I am not with them [telemedicine groups]. I prefer face-to-face medical check as it allows me to trust the doctor's judgment; the doctor has to see the tests and X-rays himself,” said Hassnaa Shawqy, a mother of three children. “It is hard to trust remotely-prescribed medications,” she added.
However, Afaf Hassan, 33, told Egypt Today that online prescription is a very good service in the current circumstances, saying “I was in a situation where I needed to contact a doctor. I can only meet him if the condition gets worse. In these circumstances, not all people can go to a hospital.”
Shaimaa Farag, who prefers remote prescription amid the coronavirus crisis, thinks that only patients with severe conditions should go to a hospital or a doctor's clinic, saying that she had to go to a hospital when her daughter broke her leg.
Pharmacist Aliah Salah, who works at Helwan Fever Hospital, approves of such initiatives, saying that people should not go to a hospital unless absolutely necessary. “When my daughter had a fever and got sick, I contacted one of the pediatricians. When I told him about her symptoms, he gave me the prescription and she recovered.”
"Such initiatives are successful with 60 percent of the cases," she said, adding that some members; however, could harm patients with their comments when they interfere in a discussion between a patient and a doctor. Salah continued that the online system would be more beneficial for the pharmacies that provide delivery services.
Fatma Essam, a 33-year-old mother, told Egypt Today that she is already a member of two groups and the doctors always advise patients to go to the nearest physician or hospital if a case is critical. “The most dangerous matter is the interference of some members in the diagnosis. Most of the unwanted comments were written by mothers,” she said.
What do Doctors say?
“Stay at home and Consult Us - Professors of Medicine in Alexandria,” is another group launched to reduce the turnout of patients at the hospitals amid the current crisis. The initiative does not aim to prescribe medication; it provides patients with instructions on what to do to feel better.
Physiotherapist Ahmed Abdel-Rasoul, member of the Egyptian Medical Association for Obesity, believes that such initiatives are helpful but not for the critical cases, noting that rules should be set in such groups to prevent members’ comments.
“Such groups should only allow doctors to reply to the patients' questions,” he said.
“These groups might provide advice on what to do if you get sick. But some cases need to go to a doctor. For example, some patients of physiotherapy should go to the clinic because if they don't see their doctor or have their sessions, their health will deteriorate,” he added.
Ahmed Abdel-Shakour, a pulmonologist at Shebin El-Kom Chest Hospital, refuses to give prescriptions online. However, he sometimes communicates online with the cases he knows. In most cases, he advises the patients to go to the nearest hospital, especially if the patient’s case is critical and needs respiratory sessions.
"As per the executive regulations of the Egyptian Medical Syndicate, the diagnosis is only valid through the face-to-face check," Syndicate Treasurer Mohamed Abdel-Hamid told Egypt Today.
“It is permissible if these groups give medical advice but not a prescription or diagnosis,” he said, adding that online follow-up has no problem as the physician is already aware of the patient’s case. Abdel-Hamid affirmed that it is hard for the syndicate to monitor or control Facebook groups.