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Elsayed Mohammed Mohsenawi, a nurse at El-Nujaila Hospital in Marsa Matrouh (west of Egypt), would go to work with an N95 mask fitted tightly to his face, thinking he was immune to the deadly virus. Little did he know, his main source of protection was in fact a counterfeit. It didn’t take long for him to contract the virus, shortly after which he sadly passed away.
After news of his death, the words “Rest in Peace” flooded his pictures online, as people mourned the nurse who had fallen victim to the virus as announced by Mohamed Allam, Vice President of the First Hospital allocated for COVID-19 isolation in Egypt on April 27, 2020.
But Al-Mohsenawi was not the first El-Nujaila hospital staff member to succumb to the deadly virus. In fact, he was one of many. Preceding his tragic death, was that of the hospital’s warehouse keeper, Naji Saleh al-Jarari, who passed away shortly before the hospital announced that three of its staff physicians were infected.
Dr. Mohamed Allam, another infected physician, attributes his injuries to direct contact between patients and health sector workers. He also affirmed that the hospital supplied them with all the preventive tools stipulated in the infection control protocol, including the US-made mask model “N95”.
Dr. Musab Al Badrawy had a similar experience after he was infected while working in the emergency department of Cairo’s Dar Al-Shifa Hospital and seemingly despite all odds, considering that he was fully protected with the gear provided to him before he tended to possible COVID-19 victims.
A common factor between these four COVID-afflicted hospital staff is that they all relied on the same kind of face mask – the “N95 NIOSH” type “TY 0424” – as a protective measure against the virus.
The N95 mask tops the list of the seven protective measures advised by the Egyptian Protocol for Infection Control. The World Health Organisation (WHO) also recommends using it when dealing with an infected person. The implication is that not using the mask, or any malfunctions in its performance, significantly increases the risk of infection.
This investigation documents how the TY 0424 masks used in Egyptian hospitals are not on the list of approved masks issued since the outbreak of the COVID-19 by the specialised US institute NIOSH. Instead, scattered across Egyptian hospitals are the product of an unauthorised Chinese factory: counterfeit N95 face masks.
Elsayed Mohammed Mohsenawi wearing the mask
Dr. Musab Al Badrawy wearing the mask
The use of these masks within Egyptian health care institutions is in violation of the Egyptian protocol for COVID-19 prevention at hospitals which specifically obliges medical staff to wear N95 masks or a mask that matches its efficiency when directly handling patients suspected or infected with COVID-19, and to prevent infection through saliva and mucous droplets.
Furthermore, their use contradicts recommendations by the WHO to supply healthcare workers with N95 masks, especially those who are in direct contact with patients suspected to be infected with the virus.
Tracking the masks’ production and shipping routes reveals that their arrival in Egypt dates back to 2007 — almost 13 years before the pandemic. Further investigation revealed an intermediary company, HIGH TECH FOR PROJECTS AND TRADING S.A.E., that won a call for a bid to supply masks to the Egyptian Ministry of Health within the framework of a project funded by the World Bank to prevent seasonal and avian flu (H5N1); a project that ceased all operations in 2011.
Thus, the so-called N95 masks that have appeared at Egyptian hospitals during the pandemic have in fact been stored in warehouses for 13 years.
Inside 10 Egyptian medical edifices we took samples for our research. We reported the masks’ distinctive-shape with a rectangular label embossed with its type and production number, and at the bottom an indication that the TY 0424 muzzle belongs to the US brand N95 approved by the National Institute for Occupational Safety and Health.
Al-Nakhilah Central Hospital in Matrouh
Abu Khalifa in Ismailia (eastern Egypt)
Qiha in Qalyoubia Governorate (northern Egypt),
the Agami isolation hospital in Alexandria (Northern Egypt)
the Isolation Hospital in Aswan (the far south of Egypt)
Luxor International Hospital
the isolation department at Assiut University
the Health affairs laboratories in Assiut (southern Egypt) which are specialised in analysing PCR samples
Dar Al-Shefa Hospital in Cairo.
We took it upon ourselves to search the NIOSH institute and the US Food and Drug Administration’s website for lists of the approved medical N95 face masks, but the TY 0424 was nowhere to be seen.
A search for the source of the counterfeit mask revealed that it is a product of “TE Yin” located in Jiangsu, China. On its website it lists masks that claim to carry the NIOSH N95 trademark. The company has a factory that specialises in the production of protective clothing and accessories. However, a cross-reference with the US NIOSH Institute website, revealed that the factory itself was not among the list of approved suppliers.
Upon comparing the Chinese mask with the masks approved by NIOSH as listed on their website in order to distinguish between original and counterfeit products, we found, firstly, that information placed on the mask is ordered differently, and secondly, that the Chinese version lacks a TC code of product approval. The NIOSH institute warned that any product without the approved TC number indicates counterfeits.
The media department at NIOSH, via e-mail correspondence, asserted that if the TC code number and the Lot number are not printed onto the front of the TY mask, then “we cannot say it is NIOSH-approved.”