As the pandemic swept up the Nile this spring, doctors lacked protective equipment, often making do with a single mask for a 24-hour shift. Testing kits were in short supply. Egypt had one of the highest fatality rates in the Arab world.

Six years earlier, President Abdel Fattah el-Sisi of Egypt had vowed to put health care reform “at the heart” of his agenda.

It didn’t work out like that.

Egypt’s public health system was straining badly, a doctor, Ibrahim Bediwy, 27, warned in a message posted online in May. “Any doctor in the current situation is not safe,” he said. “And neither is his family.”

Days after Dr. Bediwy’s post, Mr. el-Sisi’s security officials burst into his parents’ home and whisked him away. He now faces a raft of terrorism-related charges.

For almost every nation on earth — including the richest —not only has the coronavirus proved an extraordinary, often humbling challenge, it has brought a political reckoning for their leaders. It lifted the fortunes of some, while endangering the futures of others.

In Egypt, the pandemic offered Mr. el-Sisi a chance to showcase the sweeping health care reforms he promised in 2014, at the start of his presidency. Instead, it exposed chronic weaknesses.

In the early months of the crisis, overstretched hospitals struggled badly. Angry doctors went on strike, and those who dared criticize the government’s efforts were thrown in jail.

At the same time, Mr. el-Sisi continued to cut subsidies to the poor while splurging on arms deals for warships and fighter jets totaling at least $12 billion.

The coronavirus response was “typical of Egypt under Sisi,” said Nadim Houry, executive director of the Arab Reform Initiative. “On the surface, things seem to be under control. But underneath, the story is not so good.”

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