Originally published in Caijing Magazine (财经杂志) on Feb. 1st, 2020
Caijing Magazine has interviewed more than 10 patients’ families; for most of them, their entire family was infected. They have to go back and forth among various hospitals, carrying their elderlies and pregnant women with them; their lives are hanging in the balance.
Journalists | Fang, Gongyiliu (房宫一柳); Li, Shiyun (黎诗韵); Liu, Yiqin (刘以秦); Xin, Na (信娜); Ma, Kexin (马可欣) (Intern)
Editor | Song Wei (宋伟)
(On January 31, in Wuhan Wuchang Hospital, patients having infusion in a queue.)
On January 26, 2020, Liu Mei’s family received a cremation note. Her 73-year-old mother-in-law stopped breathing at home and passed away after futile resuscitation efforts in the hospital.
Liu Mei told Caijing Magazine that her mother-in-law started showing symptoms suspicious of the COVID-19 on January 21, and the diagnosis from the No.4 Hospital of Wuhan showed that her lungs were highly infected. However, the granny was not admitted to any of the several hospitals that she visited, and could do nothing but to quarantine herself at home until her condition became critical.
After the elderly lady was taken away by the ambulance, the family never met her again. All they received was a cremation note which attributed the cause of death to viral pneumonia. However, according to her family, the death of the elderly lady was not included in the number of confirmed deaths from COVID-19 — even till her death she was not accepted for hospitalisation and was not definitely diagnosed with the novel coronavirus, and thus she was just an unfortunate person who died from “common pneumonia”.
The elder lady passed away hastily, with no decent encoffining of her body and no farewell from her family. Till now her ashes is staying at the funeral home.
That Liu Mei’s family member died without treatment is not a rare case. Caijing Magazine has learned from various information sources that, even though the number of patients at the fever clinics in designated (note: here the designated hospitals refer to those for treating COVID-19) hospitals in Wuhan has declined compared to January 23 when the city was just locked down, and the third batch of the designated hospitals have opened as well, the shortage of hospitalisation availability has not been fully alleviated. While the number of confirmed and suspected cases of COVID-2 has risen, many people excluded from the epidemic statistics are still struggling to survive.
A department director at a designated hospital told Caijing Magazine that during the recent couple of days, their outpatient department received around 120 patients with fever every day. While among these around 80 were diagnosed with lung infections, only 5 of them might eventually get hospitalised.
“We can only let the remaining 75 patients who can’t get in go home. The patients could do nothing about this, neither could we”, said the director.
According to the director, in general, a patient with a dulled-mirror-like lesion on their double-lung CT could be basically considered a suspicious case of COVID-19, but only patients admitted to the hospital could be counted as suspicious cases and are qualified for the nucleic acid paper test. At least 80% of the patients who have completed the nucleic acid paper test would be diagnosed as COVID-19, and then get transferred to other designated hospitals immediately.
Caijing Magazine has learnt that at least five deaths of the suspected cases at this hospital have not been diagnosed, so they are not counted as the confirmed deaths of COVID-19. This means that the public figures of confirmed cases and deaths at present fail to reveal the full extent of the outbreak.
(The current status of major designated hospitals in Wuhan. The information has been double-checked by reporters and volunteers from Caijing Magazine.)
From the current survey, patients can be hospitalised mainly through two available ways. One way is to queue up in the community (center): after the implementation of the “distributing by community” policy in Wuhan on January 24, patients need to be admitted to the hospital with a “hospitalization ticket (住院单)”. They have to first go to the community to submit CT and blood test results, then the community will report to the Street Office, which will then transfer the patients in need based on the severity of their symptoms to the designated reciprocal hospitals. Another way is to go directly to a designated hospital equipped with nucleic acid paper test and to obtain the result in 48 hours. Then the hospital cannot reject the diagnosed patient.
Going through either path is not easy and each may lead to endless waiting. Especially for patients in a critical condition, every minute could be a struggle between life and death.
Caijing Magazine has interviewed more than 10 patients’ families; for most of them, their entire family was infected. They have to go back and forth among various hospitals, carrying their elderlies and pregnant women with them. “The hospital told us that we could only save ourselves.” Several family members of the patients told Caijing Magazine that the lives of their families are hanging in the balance.
Till 24:00 on January 31, 2020, Hubei Province has reported 7,153 cases of COVID-19. Among them, 3,215 cases were in Wuhan.
WHO wrote on Twitter: “We must remember that these are people, not numbers.” Unfortunately, there are still some people excluded from the statistics, and their life and death stories are hidden behind the scene.
“My father kept saying that he did not die on the battlefield 70 years ago, but he may die now of the uncontrolled allocation of medical resources.”
“The doctor made it clear that my father got COVID-19, but the diagnosis could not be confirmed because there was no test kit”, Sun Chen told Caijing Magazine.
According to Sun Chen, on January 26, his father who quarantined himself at home suddenly coughed out blood. Sun Chen hurriedly sent his/her father to Tongji Hospital affiliated to Huazhong University of Science and Technology for an examination. The results showed that the lungs were severely infected. However, the CT did not guarantee his father to be admitted to the hospital because he didn’t go through the whole confirmation process.
The hospital asked Sun Chen’s father to quarantine himself and take medicines at home, but Sun Chen realized, “The cases around me are already very terrible. I must send my father onto a bed in the quarantine ward.”
What does a bed mean? Because of the shortage of beds, Li Kaimeng, who lived in Hanyang, witnessed his father breathing hard the whole night at home and eventually died. His father was an officer who retired from the army and he was the fundamental pillar of the family. After the unfortunate death of his father, it took more than ten hours for the funeral vehicle to arrive. They were also very busy and had to pick up several corpses at one time.
The grandmother of the railway employee Chen Li, who lived in Wuhan, also sat in the outpatient department of Hankou Hospital for three days because there were no beds. She didn’t make it and died after futile rescue. The grandma also did not go through the whole diagnosis process and was not included in the statistics of COVID-19.
A doctor at a designated hospital told Caijing Magazine that there is no specific medicine for COVID-19 at the moment. Therefore the treatment of hospitalisation barely makes any difference from outpatient treatments for patients with slight or moderate symptoms. However, there is a huge difference for seriously ill patients. For those patients who have been quarantined at home but have difficulty sustaining their lives, hospitalisation is their last hope.
“The doctor advised my father and me to figure out a way to get hospitalised, especially my dad who cannot be delayed, it may be life-threatening for him at any time.” From January 27, Du Hongli’s father began to have trouble eating and speaking.
The examination results of Wuhan Liyuan Hospital showed that Du Hongli’s father had severe dulled-mirror-like lesions in his lungs with obvious spots. His blood oxygen levels dropped to only 90%, indicating that the patient had severe hypoxia symptoms.
Du Hongli took his father and tried all the possible ways. On January 27, he went to the community to register but heard no news afterwards. He himself also had lung infections with a low fever. He borrowed a van from a friend and propped his father around to find a hospital for hospitalisation.
Wuhan 672 Hospital, which has more than 300 beds, refused to take any patient without a “hospitalisation ticket”; the newly opened Hanyang Branch of Wuhan Union Hospital, which has 700 beds, also told him to wait.
On January 28, Du Hongli rushed to the Public Complaints and Proposals Administration of the district government and still got an answer of “no bed available”. He then went to the Health Commission and they replied that there was no solution but to wait. It’s not allowed to transfer patients across districts, all the patients could only wait for possible hospitalisation at the designated hospitals in their respective districts.
Du Hongli’s father had served in the army for 15 years and had fought on the battlefield of the War to Resist US Aggression and Aid Korea (the name of the Korean War in China). He had been a personal guard for two senior generals. Du Hongli told Caijing Magazine that the whole family is all infected and his symptoms of dizziness and chest stuffiness are getting worse and worse. He has no idea about how long he could carry on with his father.
(Du Hongli’s father had served in the army for 15 years and had fought on the battlefield of the War to Resist US Aggression and Aid Korea)
His father kept telling him that he hadn’t died on the battlefield decades ago, but could die now from the disordered allocation of medical resources. “Everyday I could only see either ambulances or funeral trucks in front of the hospital, there’s only desperation and helplessness left.”
It is inconvenient for his father to move. Everyday Du Hongli takes his father for the injection treatment at the outpatient clinic of Hanyang Branch of Union Hospital and sleeps in the hotel next door. Or they may go to Wuhan Tongji Hospital and Union Hospital queuing up to get the test strips in the early morning. But the daily limit of the test strips at Union Hospital is 100 only, it’s usually all given out by the time they arrive. Until this moment, Du Hongli’s father is not able to get hospitalised because he still has no chance to go through the complete diagnosis process.
Ms. Wang, a Wuhan citizen, told Caijing Magazine that her mother had been in a shock at home twice. Her mother has been in the community for infusion and medications since the beginning of the year. On January 23, her mother felt unusually uncomfortable, so she went to Hankou Hospital by bike with her father, and queued up for 12 hours before completing the CT. The result showed a double-lung infection.
According to Ms. Wang, at that time the hospital had no infusions and even the oseltamivir, which is used to treat common flu, was not enough. They could only give her mother a dose for a child. After that, her mother could do nothing but go home, quarantine herself, and live on the oxygen machine at home. “There’s one time when my mother was in shock, my dad hugged her and cried, thinking she already passed away.”
Previously, the old couple would never have troubled the others as long as they could tackle the problems by themselves, but two consecutive syncopes left them with no choice but to call their daughter.
But at that moment, Ms.Wang and her husband were also infected. She had to take care of her husband who had a high fever. Her lungs also exhibited the dulled-mirror symptoms. Ms.Wang dialed the emergency number for her parents for the road to their home was blocked, but there were nearly 500 people in line waiting for the ambulance. “At that time, the emergency department said that the people who called in the past two days had not been hospitalised either, and there is no hope.”
After carrying on until three or four in the afternoon, the old couple were exhausted but still struggled to ride a bicycle to the hospital.
Ms.Wang turned to call the Mayor’s hotline. On the second day, the Mayor’s hotline replied finally: “You need to report to your community, the community will report to the Street Office, and the street will report to the Headquarter (of anti-COVID-19). If there are beds in the hospital, the headquarter will inform the hospital to arrange and then inform you to go.”
Professor Yao Lan, deputy director of the Center for China’s Basic Medical Security Research of Huazhong University of Science and Technology, told Caijing Magazine that an effective measure to avoid crowded hospitals and preventing cross-infection would be to fully make the use of the primary health care system to implement layered diagnosis and treatment according to the gravity of symptoms.
However, for severely ill patients, every minute is the torment at the edge between life and death. They don’t know how long it would take for the community to report to the upper agencies. “From the beginning, we reported to the community. They all said that there’s no way, they’re reporting to the upper agencies, but when the news will ever come?” said Ms.Wang.
In the meantime, they tried all the telephone numbers and relationships in their network that they could reach to. Ms.Wang even called the police. Finally, the police gave her a fixed phone number, while this line said that she had to contact the community.
On January 29, Ms.Wang felt that her parents couldn’t make it anymore. Ms.Wang had to ask for help again calling the emergency number. The emergency center made it clear that only when a bed is arranged for a certain patient could they send an ambulance over.
Ms.Wang recalled what she saw on the Internet that the western branch of Union Hospital of Huazhong University of Science and Technology just added 700 beds, so she persuaded the emergency center to take her parents to the western branch. It was already nine o’clock in the evening by the time they arrived at the hospital, and the first-aid personnel said, “(the hospital) is very crowded, and there are many people lying outside the emergency room, There is also no first-aid equipment, so you may not be able to wait until your turn.”
Regarding those added beds, it is said that because the protective suits for the doctors are not enough, not all of them can be opened for the time being. “Because once the beds are opened to the patients, the doctors could get infected without equipment.”
After knowing the situation, the emergency staff asked Ms.Wang to choose a second hospital immediately. She begged the emergency staff to drive her parents to Wuchang Hospital in her region. Ms. Wang also went to the hospital and took a quilt and a hand warmer with her. She met her parents for the first time since January 20.
Their faces were pale, her father had a high fever over 39 degrees, and he could hardly stand still, while her mother was lying in the ambulance taking oxygen. There were no beds and the hospital was not able to accept them. The emergency staff were urging beside because they had spent three hours on this family solely.
At this time, her mother made a decision. She folded her hands together begging the emergency personnel, “I would only wish to die at home. I will no longer come out. There is no hope. Please take me back home.” The emergency staff asked Ms.Wang to sign agreement then took her mother again onto the ambulance and closed the door.
Watching the ambulance leaving, Ms.Wang couldn’t help it anymore. She crouched down, wailing on the quilt she brought for her parents.
A doctor at a designated hospital in Wuhan said that the hospital admitted 600 severely ill patients, but none were confirmed. “The test strip is lacking, but we don’t understand why it is lacking.”
Caijing magazine learned from the current survey that, patients can be hospitalised through two possible ways. One way is to queue up in the community. Patients have to go to the community first to submit CT and blood test reports, then the community reports to the Street Office, which will transfer patients in need to the designated hospitals according to their severity of the symptoms. They need to be admitted to the hospital with a “hospitalization ticket (住院单)”. Another way is to go directly to the designated hospitals equipped with nucleic acid paper test and get the result in 48 hours, then the hospital cannot reject the diagnosed patients.
On January 24, The headquarter of Novel Coronavirus Prevention and Control of Wuhan issued the No. 7 Announcement. All the residents with a fever should be classified and screened. Community is the pressure valve for this outbreak of the virus. It is stipulated in Wuhan that individuals with a fever need to report to their community, with their data collected by the community neighbourhood committee. Then the community committee reports to the community health service center. Finally, all patients with slight symptoms choose either to quarantine themselves at home or go to the designated fever clinics; while the severely ill ones should be picked up by an ambulance.
As a social worker in a community in Wuhan Huaqiao Street, Wang Mu has been dreadfully busy for 8 days since the Chinese New Year’s Eve. They track the conditions of residents in fever every day. Before 4 o’clock, Wang Mu needs to report the list of patients with a fever to the community. He has also to prepare specifically a list of severe patients. This list will be uploaded to the district office to which the street office is affiliated. After an evaluation, the community will be notified when, for which patient to get hospitalised at which hospital”.
The criteria that a patient should fulfil to get reported by the community are as follows:
- The criteria for fever are
- fever above 37.5 degrees;
- The criteria for suspected COVID-19 are
- CT examination results show a dulled-glass-like lesion in the lungs;
- abnormal WBC by routine blood tests;
- All the criteria for fever.
- The criteria for severely ill persons are
- Decreased blood oxygen saturation;
- Difficulty to breathe;
- Having other diseases;
- Older and weaker people;
- All the criteria above for fever and suspected COVID-19.
In fact, many family members of the patients told Caijing Magazine that even if the community and hospitals advise patients to be hospitalised immediately, there is no guarantee that there will be enough beds available.
The requirements of the infectious disease for quarantine have made medical resources unprecedentedly tight. A hospital with thousands of beds available had only one-third or less of the original beds left after setting up isolated single rooms.
A doctor at a designated hospital in Wuhan told Caijing Magazine that there were a large number of patients waiting in line with a hospitalisation ticket, but could not move in due to a shortage of beds.
The person in charge of the community where Wang Mu lives told Caijing magazine that in just one day, the 30th, he had more than 100 phone calls. On the other side of the phone, there’s always wailing or shouting. “I could only comfort them as much as I could, saying something such as ‘have a good mood every day, the immunity will improve, and the health will be better'” said the person in charge.
The other path to hospitalization–the path for patients to go to designated hospitals to line up for a diagnosis is also quite long.
Liu Mei said that after the death of her mother-in-law, her eldest brother, her second brother and her husband were also infected, and their condition became worse in urgent need of hospitalization. They went to Tongji Hospital on February 1 to queue up for nucleic acid tests and were told that there were only 10 tests available per day.
Till this moment, a total of 10 institutions in Wuhan are able to conduct pathogenic nucleic acid test. They are: Wuhan Jinyintan Hospital, Wuhan Pulmonary Hospital, Tongji Hospital Affiliated to Huazhong University of Science and Technology, Union Hospital Affiliated to Huazhong University of Science and Technology, People’s Hospital of Hubei Province, Wuhan University South China Hospital, Wuhan First Hospital, Wuhan Central Hospital, Wuhan No. 3 Hospital, and Wuhan Center for Disease Control and Prevention.
A doctor at a designated hospital in Wuhan told Caijing Magazine that the hospital admitted 600 severely ill patients, but none of them were diagnosed. “The test strip is lacking, but we don’t understand why it is lacking.”
What kind of patients can use the nucleic acid test strips? According to a doctor of Wuhan No. 3 Hospital, only if a doctor thinks that hospitalization is necessary, the patient can be hospitalised and get nucleic acid test.
A staff member at Zhongnan Hospital said: “A nucleic acid test is only possible when a doctor fills in a ‘suspected case report card’, but only in extremely urgent cases would a doctor claim such a report card.”
But what is considered an “extremely urgent case”, Caijing Magazine asked many people at those institutions but did not get any clear answer.
Many patients and doctors are confused: 1. Wuhan Health and Medical Commission stated on the 27th that in principle, nearly 2,000 samples can be tested every day, but why is there always a lack of nucleic acid test strips? 2. The diagnosis report cannot be issued immediately after the test.
According to the doctor from the No. 1 Hospital, the test takes one day. “If I did it today, I will know an approximate result tomorrow”, but the problem is that the No. 1 Hospital cannot issue a confirmed diagnosis report, and currently the designated hospitals can only accept patients based on the confirmed diagnosis report.
When Caijing Magazine asked which institutions could issue a confirmed report, the doctor said: “I don’t know this either, maybe Tongji and the Union Hospital can. It is also because the patients have no access to the diagnosis report and thus cannot be hospitalized that their conditions are getting worse and worse.”
As for the statistics of suspected patients, the doctors’ judgment criteria are “low fever, cough, and CT results of lungs.” The above-mentioned doctor at the designated hospital says that he would report it to the department, but he has no idea about the statistical process later. The director of another designated hospital told Caijing Magazine that only severely ill patients who had been admitted to the hospital could be considered as suspicious cases, which need further concrete diagnosis and treatments.
Since January 30, a designated hospital in Wuhan has begun to report the number of suspected patients who needed to be diagnosed and tested. The reporting process goes from the department to the hospital, then to the district, and finally to the city. A doctor at the hospital said that if a patient dies without a confirmed diagnosis, it would not be counted as the number of confirmed deaths, but only as ” dead of pulmonary infections”.
“As far as my own department is concerned, the mortality rate is much higher than the discharge rate. At the same time, many discharged patients are not fully cured but require a long-term observation,” said the doctor.
This also means that a large number of patients are excluded from the diagnosis process and statistics and can only survive on their own.
Li Li told Caijing magazine that after contacting community members, her father was finally hospitalised in Wuhan No. 8 Hospital. But Wuhan No. 8 Hospital is not a designated hospital, it was a hospital specialised in anorectal disease before.
The hospital diagnosed that his father’s lungs were infected and necrotic, and the oxygen supply had been tuned to the maximum limit. He needed to be transferred to a designated hospital as soon as possible. However, Wuhan No. 8 Hospital did not have a test box, so it was always impossible for the patient to be diagnosed; while without a diagnosis confirmation he could not be transferred.
“Wuhan No. 8 Hospital has been reporting for many days without hearing any response,” said Li Li. She dialed the emergency number, and the response was that she could only be transferred to the designated hospital through the community report, but the hospitalisation in Wuhan No. 8 Hospital was owing to the effort of the community already.
What happened to Li Li’s father seemed to constitute an endless loop with no solution.
Till now, Caijing Magazine has called all the designated hospitals in Wuhan one by one and successfully got through to seven hospitals while they all said that they had “no beds for the time being”.
“If possible, we could centrally quarantine and treat patients with mild symptoms so that the epidemic could be controlled more effectively.”
In the view of countless family members of the patients, Wuhan’s rapid construction of Huoshenshan Hospital and Leishenshan Hospital is their only hope.
Caijing Magazine has learned that on February 3, the construction of Huoshenshan Hospital with 1,000 beds must be completed as planned, but the opening will require the cooperation of property management, electricity department, medical equipment, etc. At present, most hospitals interviewed by Caijing Magazine have not yet received notification of patient transfer.
During these few days waiting for Leishenshan Hospital and Huoshenshan Hospital to function, some critically ill patients’ life has been on the line. Caijing Magazine has learnt that even if both diagnosis report and community hospitalization ticket were obtained, it still could not guarantee the patient to be admitted to the hospital at the earliest time.
The two hospitals have around 2,000 beds in total, which are not sufficient for the emerging cases in Hubei Province in two days.
Roaring for help at Weibo (Chinese social media platform, similar to Twitter) publicly became the final attempt for some people. A family member of a pregnant patient living near a kindergarten in Jiangxia District, Wuhan City told Caijing Magazine that the lady had been pregnant for 8 months and the latest diagnosis showed a severe infection of both lungs.
However, pregnant women are not accepted at the designated outpatient department, nor is fetal heart rate monitoring available there. Maternity And Child Health Hospitals at both the district and the province level don’t receive fever patients. A few days after the family roared for help at Weibo, they got the attention of the community and the district government on January 31 and were carried by the community vehicle to several hospitals. Finally, they were admitted to the East Branch of Wuhan University Renmin Hospital.
This is good news for this family. But for other families, the news makes them feel complicated. “Is it already the time that only who shouts loudly can survive?” A family member of another patient told Caijing Magazine.
Those who can find a bed are called the “lucky dogs”. Six people in Liu Xiaoqing’s family were ill, and only three of them got hospitalised successfully. “In most of the cases, they relied on their own networking and channels.”
Liu’s family might be infected at a family reunion. The epidemic was not yet considered to have “human-to-human transmission” till January 18, and the family had dinner together outside. Soon afterwards, the family members began to have a fever one after another. It started with the parents, then the auntie, the 90-year-old grandma, and finally to the elder auntie and her husband who just returned home. On January 21, Liu Xiaoqing’s mother had a CT scan, which showed viral infection of both lungs.
After that, her mother had a high fever for four days and was almost in a syncope. “We contacted many people and found a bed at Hankou Hospital for her to live in.”
On January 28, her grandma began to have symptoms, and they tried Hannan Hospital, Union Hospital West Branch, but failed to get her hospitalised. Grandma waited for a day in queue at the clinic and finally got an injection. But she “trembled immediately as if she got epilepsy and couldn’t walk and speak normally.” The doctor left her in the observation ward to inhale oxygen. But after returning home, she still had difficulty breathing.
“We contacted a lot of people in our network to be able to send her into the ICU at No. 6 Hospital. At that time, we were also urging the community and Wuhan Union Hospital all the time, but we didn’t get any feedback or news.”
Her father also had difficulty breathing after the injection and was dependent on an inhaler. Liu Xiaoqing posted the situation on Weibo and when she got up at seven the next day, she finally received some useful information and sent her father into the ICU.
Her father said that others might think it is a medical injustice that they called for attention at Weibo and finally got hospitalised. “But after all, life matters.” Later, she deleted the post on Weibo.
At 4 am on January 29th, Chen Xiaowei, who lives in Shangyi Community, Wansong Street, Jianghan District, Wuhan City, struggled herself to the hospital and finally got examined by the test strip at Wuhan Union Hospital. The test result came out on February 1st, with two positive items, (showing that Chen Xiaowei was diagnosed), but when she and her family went to the community to ask for the hospitalisation ticket, they saw that there was indeed someone at the service office yet the person refused to open the door for them. The family could only choose to call the police.
The police did not arrive, but it was the Street Office to which the community is affiliated found a solution. Chen Xiaowei said that just this afternoon, the Street Office helped them find a bed at Wuhan Union Hospital. “I’m finally saved,” she said.
In the evening, when Chen Xiaowei and her husband arrived at the Wuhan Union Hospital for hospitalisation, they were told that they have to turn to Red Cross Hospital. At the moment, they are still waiting for beds in the observation room of Red Cross Hospital.
Professor Yao Lan, deputy director of the Security Center of Huazhong University of Science and Technology, said she saw that Macau had requisitioned hotels relatively far from the crowd as a centralised management area for people with travel histories to Hubei. She suggested that similar measures could be taken in Hubei and other regions to effectively control suspected cases.
Shen Jun, chief assistant of the emergency center and director of emergency surgery of Zhongnan Hospital, told Caijing Magazine that patients at Zhongnan Hospital all exhibit severe symptoms. “They are all patients with unstable vital signs such as bad oxygenation, tachycardia, hyperventilation or Respiratory Distress Syndrome(RDS), etc.” There is a shortage of beds, and those suspected or with mild symptoms are both quarantined at home.
(The Zhongnan Hospital team where Shen Jun works successfully treated a severely ill patient with ECMO (Mobile Cardiopulmonary Apparatus). This is the first case in the province.)
It is reported that there are almost no beds in the hospital, and the emergency department is also filled with patients. The emergency observation room is also full. “Once there is a bed available in the ward, one patient at the emergency observation room will get in immediately.”
Shen Jun said that the allocation of beds does not depend only on the needs of the community, but more on the conditions of the patients. “Some patients, for example, have been taken to the hospital by their families and are very sick. Obviously, I can’t let them go back to the community to wait there in line. I would just arrange them at the emergency observation room if there’s space. It is not likely for me to just refuse them until they get a place at their community report, or I simply ask them to go home and arrange the beds for the patients reported by the community but with lighter symptoms.”
Regarding the test stripes, he said that Zhongnan Hospital can perform nucleic acid tests in fever clinics, and the results come out in about 2 hours, but because of the shortage of the test stripes, only patients with viral pneumonia manifestations on lung CT could get tested.
Shen Jun suggested that the epidemic can be effectively controlled if patients with mild symptoms could be centralised, quarantined and treated. He also suggested that patients at home take two medicines: antiviral drugs and anti-infective drugs, and try to reduce body temperature once the patient is with a fever exceeding 38.5 °C. “Because there is no specific medicine to treat this disease, you cannot follow what is said online and buy whatever netizens suggest. Inpatient treatment is also a supportive treatment for severely ill patients. If we could make it through this period, it will be over, and that’s it.”
(Dr. Shen Jun and Dr. Hu Ming from ICU of Wuhan Pulmonary Hospital are exhausted and sweating after surgery)
During this couple of days, he attended a 45-year-old patient, who had a family of five. Her parents had died of COVID-19, and her son was infected as well. The patient’s condition was very critical. She used high-flow oxygen inhalation and non-invasive mask ventilation, but the blood oxygen saturation was only 50%. Finally, she had to be anaesthetised and intubated with ECMO.
“Before intubation and anaesthesia, she watched us preparing, tears kept flowing down, and that fear made people feel heartbroken,” said Shen Jun. There are still many cases like this, “We doctors are highly determined to do everything possible to treat all patients.”
Sun Chen, who has been waiting for the nucleic acid test strip with her father, does not allow herself to be sleepless and cry anymore. She knows that she has to continue to urge the community, to find a hospital for hospitalisation, and have to cook for her parents. There is too much work to do, and she cannot fall. She expects that the Huoshenshan Hospital and the Leishenshan Hospital will be completed soon. “We must be hospitalised. This is our last hope.”
(In the text, Liu Mei, Sun Chen, Li Kaimeng, Chen Li, Liu Xiaoqing, Li Li, and Wang Mu are aliases. Intern Zhang Fan and volunteer Geng Peng also contributed to this article.)