Egypt ranks fifth worldwide in underreporting coronavirus and first in the Middle East, according to a report published by the World Bank.
According to the report, Egypt's ratio of reported deaths to excess mortality was 13.1 in the first year of the pandemic.
Analysts and doctors in Egypt have, since the start of the pandemic, accused Egypt of undercounting the real figures of deaths and infection rate, but in response have faced punitive action including jail sentences.
Doctors have also asked for adequate PPE and called out the government on why the healthcare system is so badly underfunded.
One journalist was expelled from the country after she wrote a report casting doubt over the government's official statistics.
One of the reasons for this is the hit Egypt has taken to its tourism industry. In the middle of August the World Travel and Tourism Council announced that the Egyptian economy was losing an estimated $2 million a day when it was included on the UK travel red list.
As well as controlling the narrative, the government has been accused of not enforcing preventative measures such as mask wearing and fines for employees who don't get the vaccine.
Cases rose once again in Egypt in September as the country grappled with its fourth wave. The Egyptian medical union announced that month that 600 doctors had died since the start of the pandemic.
The World Bank report states how underfunded health systems left the Middle East and North Africa "ill-prepared to respond to the pandemic," and that the cumulative cost of GDP losses by the end of the year will be almost $200 billion.
It also predicts that 13 of the 16 countries in the region will have lower living standards than before the pandemic after 2021.