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A picture taken on May 5, 2020, shows a truck driver preparing an Iftar, the evening meal that ends Muslims' daily Ramadan fasting, beside his truck. He has been waiting for five days to be tested for COVID-19 before entering Kenya, as is mandatory for all drivers at Namanga, northern Tanzania.FILBERT RWEYEMAMU/AFP/Getty Images

Hospitals in Tanzania are becoming overwhelmed by a dramatic rise in COVID-19 cases despite official secrecy on the crisis, the U.S. embassy has warned in a highly unusual statement.

The warning was issued Wednesday after weeks of growing rumours about a wave of hidden deaths in Tanzania, where videos on social media have documented a number of mysterious night burials by mask-wearing gravediggers and pallbearers.

Tanzania, one of the biggest countries in East Africa and a major recipient of Canadian foreign aid, stopped issuing any official updates on the coronavirus in late April after a surge of new cases.

President John Magufuli, unlike many other African leaders, has refused to close churches, bars or restaurants to stem the spread of the virus. Instead he has advocated prayer, hot steam and herbal remedies such as an unproven beverage from Madagascar.

He did not attend an online summit of East African leaders Tuesday on responses to the pandemic and has cast doubt on coronavirus testing kits that have been verified by international specialists.

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The secrecy has sparked a flood of rumours about deaths and illness, with some health care workers saying that hundreds have died.

“Many hospitals in Dar es Salaam have been overwhelmed in recent weeks,” the U.S. embassy said, referring to Tanzania’s biggest city.

“The risk of contracting COVID-19 in Dar es Salaam is extremely high,” it said. “Despite limited official reports, all evidence points to exponential growth of the epidemic in Dar and other locations in Tanzania.”

The embassy warned of the risk of “life-threatening delays for medical care” because of the situation in hospitals. It said that the government has not released any data on coronavirus infections since April 29.

The embassy urged U.S. government employees and their families to remain at home except for essential activities and to “substantially limit into private homes the entry of anyone but regular residents.”

The statement is unusual because embassies are normally reluctant to criticize or contradict their host governments so bluntly.

The last report from the Tanzanian government in late April said there were 480 confirmed cases of the virus in the country, a 60-per-cent increase over the previous report. But the Africa Centres for Disease Control and Prevention later disclosed that Tanzania had conducted only 652 tests, meaning that three-quarters of those tested were found to be infected.

Zanzibar, a semi-autonomous region of Tanzania, later disclosed an additional 29 cases. In total, 21 deaths have been confirmed in Tanzania.

Tanzania’s neighbouring countries have reported dozens of coronavirus cases among truck drivers who have crossed the border from Tanzania. Zambia has already shut its border with Tanzania because of the cases, and Kenya has said it is considering the same option.

One Tanzanian hospital worker, whom The Globe and Mail is not identifying because he was afraid of reprisals, said the government is concealing hundreds of deaths. A friend of his father recently died with coronavirus symptoms, and the family was ordered to incinerate the body for safety reasons, but the hospital was instructed to list the cause as cardiac arrest, he said.

Mr. Magufuli has questioned the accuracy of Tanzania’s test kits, demanding an investigation into the national health laboratory after the spike in confirmed cases. But the World Health Organization and the Africa CDC have insisted the tests are accurate and reliable.

After three Tanzanian parliamentarians died recently in mysterious cases that were suspected of links to the coronavirus, opposition members refused to attend Parliament, saying it was unsafe. The government responded by threatening to arrest any MP who failed to sit in the National Assembly.

A bank official, whom The Globe is not identifying because he fears his bank could be targeted for reprisals, said the government refused to allow a coronavirus test for a bank employee whose spouse had died of the virus. Bank employees are afraid to question the government’s decisions because of the threat of arrest, the official said.

Last month, authorities suspended a journalist and a daily newspaper for allegedly violating rules for reporting on the pandemic. Three other media organizations were fined and ordered to apologize for reporting “false information” about the coronavirus.

The government is “choosing to censor journalists and media outlets who report on the disease,” Amnesty International said in a report. “These recent reprisals are clearly politically motivated.”

A lawyer in Arusha was arrested on April 29 for statements he made about the pandemic – just hours after a local official ordered the police to arrest anyone who publicly questioned the government’s official information on the virus.

The lawyer, Albert Msando, had reportedly told journalists that they must report truthfully on the virus because the government was underreporting the number of cases.

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