CAIRO/ISTANBUL — At a private charity in Cairo late last month, women waited for hours for meat and oil. It was crowded, but many didn't wear masks because they said they could not afford them.
And they were not alone. One in three people in Egypt lives on less than $1.50 a day. And for many of them, the coronavirus shutdown has been more frightening than the virus itself.
Egypt is planning to start slowly lifting restrictions this month, even as cases of COVID-19, the disease caused by the virus, increase faster than ever. Medical experts warn that the nation cannot handle a larger outbreak if the economy reopens too fast.
"There are very few hospital beds compared to the population of Egypt," said Dr. Naira Ahmad Bayomi, the infection control chief in Cairo's Zaid Hospital. "And we don't have enough doctors."
Many countries are facing a similar dilemma right now. Lockdowns protect public health, but failing economies can only be restarted by opening up. In countries like Egypt, where widespread extreme poverty also endangers lives, there are no easy answers.
"I live with my husband, three daughters and three grandchildren," said Mahrousa Mostafa, at another food distribution center. She supported her family as a school cleaner before the shutdown but now they have no income. "My husband is very sick. Now I would take any job."
As of May 6, Egypt had more than 7,580 confirmed cases of COVID-19 and 469 deaths.
Two weeks ago, Egypt had 3,700 cases since the virus was first discovered there in mid-February. In March, Egypt shut down schools, airports and most businesses. A 12-hour, nighttime curfew was imposed and public religious services were canceled.
The government attributed the recent rise in cases to the beginning of the religious observance of Ramadan, as people frequented the markets in preparation for holiday meals.
There are other reasons Egypt's measures to contain the virus haven't been entirely successful, added Dr. Baheyeddin Moursy, an Egyptian surgeon and former consultant to the Ministry of Health. Misinformation from the media and religious leaders has led to people ignoring guidelines, he said.
"No one can guarantee whether a [greater] outbreak could happen," he wrote in an email on Wednesday. "But, if it happened, no risk management formula is ready to apply within the public mind."
The Egyptian health care system has gotten a huge financial boost in the past year, he said, but mismanagement and low pay for doctors have also stymied the fight against the virus. Doctors' salaries are sometimes less than $100 a month and two-thirds of Egypt's physicians work abroad.
"Government hospitals are known to be rife with negligence and generally provide minimal care," Moursy explained.
Despite the rising number of cases, Egypt is preparing to partially reopen hotels and some other businesses, reintroduce domestic flights and shorten nighttime curfews in coming weeks.
"During the coming period the world will be gradually restoring normalcy while applying precautionary measures," said Egypt's minister of health, Hala Zayed, in Al-Ahram, an Egyptian newspaper. "What will matter is people's behavior."
Tourism, one of Egypt's most important industries, has collapsed. And Egypt's informal sector, which normally employs more than half of Egyptian workers, has dwindled to nearly nothing, sending millions more people to search for emergency aid.
The Egyptian food bank now feeds 3 million people, but that's only 10 percent of the population below the poverty line.
Allowing some economic activity may be dangerous, but Moursy, the surgeon, said reopening some tourist sites may help break "the cycle of economic collapse" and "restore part of the confidence to restore life."
And at the Giza Zoo, workers said the changes cannot come soon enough.
"This is a public place," said Nady Abdulhalim Mahmoud, a zookeeper, while a nearby giraffe munched on leaves. "If people don't come out, we can't make any money."
Yet even for workers like Mahmoud, who are desperate to see people out in public again, fear of the virus lingers, as they watch other countries struggle with massive death tolls.
"Every day when I leave my house, I pray: 'Please God, protect us,'" he said.