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Before Zhong Nanshan's speech, the doctor in Wuhan issued an outbreak alert to nearby schools. Original Wang Jiaxing Freezing Point Weekly 1/28 At 3 pm on January 28, a reporter from China Youth Daily and China Youth Network visited the infusion room of the Fifth Hospital of Wuhan. This article is about 4534 words. The estimated reading time is 12 minutes.
Reporter of China Youth Daily and China Youth Daily Wang Jiaxing. This is a self-report by a first-line doctor who is committed to fighting new pneumonia. She experienced the panic of the hospital where she was at the beginning of the epidemic, and the most extraordinary New Year's Eve in her 31 years of medical treatment. In her story, we can see the harsh truth of that special period, and we can also see the adherence of the frontline medical staff to professional responsibility. These are worth remembering. With her consent, we disclosed her real name: Director Lu Xiaohong, Department of Gastroenterology, Wuhan Fifth Hospital. I wish her and her colleagues health and safety, and wish the hospital's order and guarantee to be on track as soon as possible.
She said that on December 25, 2019, she heard that there was a suspected infection by medical staff; on January 2, 2020, she suggested that the hospital set up a fever clinic; from January 6, her hospital received many suspected cases; 1 On the 20th, she sent a text message to the principal of the nearby high school to leave the senior high school students who planned to make up classes; she also said that the video of doctors crying in the office on New Year's Eve was true. Her colleague, an old director in her 70s, sent a text message saying that she would come back to work at any time if necessary. 1 Around December 25, 2019, I heard that two hospitals in Wuhan had medical personnel suspected of being infected with unexplained viral pneumonia, and were isolated, including medical staff in the respiratory department. I realized at the time that the situation might not be simple. In internal medicine, especially in the respiratory department, it is impossible not to know how to protect against viral pneumonia. They themselves are the most cautious and most protective of the medical staff. Even they are infected, indicating that the contagion may be very strong.
Viral pneumonia occurs every year, but when I found out about it with my colleagues, I found that the virus was different this time. Some people did not cough or have a fever. Routine symptoms were all good, but the condition of lung CT films was very bad. At that time, I made my colleagues pay attention and joked that I should buy a mask. Later, the more I thought about it, the more I felt that something was wrong. When I participated in the hospital work report on the afternoon of January 2, 2020, I couldn't help but make suggestions with the hospital leaders. Should I formally open the hot clinic and establish standardized quarantine and guided procedures . Originally, the flu season also arrived, and the emergency department was under great pressure. The leader agreed on the spot. Previously, the fever clinic was attached to the outpatient clinic, and there was a possibility of cross-infection between patients. As far as I know, there are not a few hospitals in Wuhan that do not open hot clinics alone, because there is no profit for hot clinics and outpatient clinics.
The next afternoon, the hospital received a request from the superior to not only set up a fever clinic, but also set up a fever ward to treat patients with unexplained pneumonia. At 3 pm on January 28th, the outpatient hall of the Fifth Hospital of Wuhan Our hospital is not an infectious disease hospital and does not have the isolation conditions. At that time, a floor was vacated and rushed to renovate overnight for isolation treatment. Around January 6th, we received two or three cases of suspected infection from the referral and a family of many suspected cases. In fact, from January 6th, our outpatient and emergency departments have received many suspected cases. On the 10th, we can no longer see the emergency department; the respiratory ward is also full. In order to avoid cross infection, non-viral pneumonia is no longer sent to the respiratory ward. In addition, there are many patients with unexplained fever who enter the gastroenterology, nephrology, cardiovascular department. After January 10, the suspected patient can only be admitted to other wards. But during this period, only the medical staff in the fever wards now wear protective clothing, and other departments, including the respiratory department, only wear white coats and general medical masks. In retrospect, it may be because the protection is not in place, and these patients can move around, resulting in the spread of the epidemic. Later, the news released by the disease control departments of various regions showed that many of the later diagnosed patients were active in Wuhan around January 10th. But at the time, the patients, medical staff, and even the medical profession did not think that this was a very serious matter, and they did not expect a blowout to happen. Around January 18th, I heard that the medical staff at the Wuhan Union Hospital had started to wear protective clothing, and they also vacated a building to treat fever patients. I realized that the situation may be severe. I urge everyone not to go around, suggest zone management and open electronic meetings, but at that time, everyone did not take it seriously.
Medical staff guiding the order January 20 is Monday, at 7 a.m. that morning, I sent a text message to the principal of the nearby high school to inform that the situation was wrong and quickly took a holiday. The students in the third year of the school originally planned to continue to make up classes, and the principal listened to my words and immediately went on vacation. That night, CCTV broadcasted an interview with Zhong Nanshan, and we were convinced that the virus could be passed on from person to person. I realized that we underestimated the enemy. 2 In fact, I understand that the disease is not earlier than everyone, and I also see the confirmed information from the news. We started training for viral pneumonia on January 3rd, but no one said it was new, but just told everyone to note that this pneumonia may be a different disease than before, but at that time I did not know it was a new coronavirus pneumonia.
All along, our supplies are in short supply, with less than 100 sets of protective clothing in stock. On January 21, we received a notice that the hospital should be emptied before 6 pm on the 23rd, and only fever patients would be accepted. As a frontline doctor, I was involved in the prevention and control of SARS in 2003, bird flu in 2009, and influenza A in 2012. I have experience in the prevention and treatment of respiratory infectious diseases, so I also participated in the transformation of hospital wards. We are really too short of equipment. Normally every winter flu season, heart monitors, ventilators, and oxygen oximeters are very nervous, and now it is not enough. We don't even have hooks for infusion. At 5:30 in the evening on the 22nd, the leader suddenly asked us to be consulted in advance. But at this time, the contaminated area, semi-contaminated area, and clean area are only designed, and the entire system has not yet had time to debug. Moreover, we do not have protective clothing, N95 masks and goggles. I vehemently rejected leadership. I said that if the protective equipment was not in place, you wouldn't be allowed to work, otherwise it would mean "stunning" in front of the virus. Later, a head nurse helped us borrow 7 sets of protective clothing from other departments before we started working, but there is still no N95 mask. We can only wear double or triple medical surgical masks. It stands to reason that this does not meet the specifications, but we have no way.
After starting the consultation, the black crowd rushed into the outpatient department. The entire outpatient department is as messy as a vegetable market. The patients whispered to each other, many of them brought their families, and some people recorded videos, blaming us for not isolating them, and feeling that we were infected with us. In the emergency department, 10 infusions were transferred at a time, but everyone asked to call themselves first. This batch has not been processed, and the next batch comes again. Throughout the night, the nurse did not stop the injection. When one was done, the patient took the bottle to find a stool. As a result, some patients were still dissatisfied and scolded, and asked the nurse to take them to their seats. Because the goggles are a bit foggy, the nurse should remove the goggles during the injection. The nurse should have worn a mask so that she could see clearly. But we still don't have a mask.
On the second day, the outpatient department was directly packed with people, and there was no place for the station. How many cross-infections would be necessary. The hospital does not have the power to manage public order, these patients go around. According to rough statistics, it takes 4 hours to see a doctor and 4 hours to wait for a CT scan of the lungs. I am very afraid of trouble. Some patients are really pitiful, some are very serious, family members cry for help, but we have no hospital beds and cannot be admitted. A doctor told me that almost all she sent to the infusions that day were "viral lungs." In the CT film, the lungs are like cotton wool, and the youngest is only 30 years old. But we really have no capacity for admission. Waiting for them to go home after injections will cause more infections. A CT scan of the lungs of a suspected patient is basically "white".
Later I learned that on the evening of January 22, two-thirds of the patients had been seen in other hospitals. However, many hospitals no longer send and receive fever patients, and guide patients to our designated hospitals for treatment. There were also designated hospitals who received a request from their superiors to start the consultation in advance on the evening of January 22, but the hospital's leaders refused on the grounds that they were not fully prepared. Many doctors are not prepared, have not experienced the treatment of infectious diseases, and have no experience. For example, a surgeon in a very good hospital in Wuhan did not take this patient seriously. He went to the hospital's internal medicine and emergency department. He didn't inform his colleagues about the illness in time, and everyone else followed him. Even the doctors were not alert, and the whole situation was completely passively beaten.
3 On January 21, when we received our hospital's intention to switch to a designated hospital for fever patients, a doctor said that the child was still very young and he was very scared and wanted to resign. I understand her very well, and I am also afraid. But for my consideration of her career development, I still advise her to stick to it. I said, I can approve your resignation, but this will leave you a "smudge". In the future, if you go to any unit, you will be regarded as a "destroyer". She did not resign and also experienced the most chaotic scene in the hospital on the evening of January 22 as a first-line doctor. Unexpectedly, after returning home early in the morning, she began to show symptoms of infection. After returning to the hospital for examination, she was considered to be a suspected patient, but the diagnosis was not confirmed because she did not have a kit. I asked her to go home and rest quickly, but she said, "Director, I will find a place to check it. If not, I would like to come back and fight with everyone." I thought at the time, if she was cured, it would only be a pity; She is only in her 20s. In case something goes wrong, how can I survive as her director? How can I compensate a daughter and a mother in this family. This thing made me sad. I was afraid of affecting the military's heart. I hid outside and cried for a long time. We have a doctor, the child is only 7 and a half months old, and could have been home for the Chinese New Year. But after the outbreak, she forcibly cut off the baby's breast milk. Another doctor asked relatives to bring their two children back to their hometown. Her husband, who is also a doctor, had been on the front line for a long time. One night the staff was particularly scarce, and she spent the night in the front line. Considering her health, I did not schedule her class the day after. As a result, after seeing the schedule, she came to me and said that she was on call at any time, and that she should work as often as she wanted. An old director who has retired in his 70s has sent me a text message saying that he can come back to work at any time if necessary. We do not ask for praise, we just ask the patient to be safe, and only ask ourselves to be safe. This is not a pretty word, it is the basic morality of a doctor. To be honest, there is nothing that people here are not afraid of, and they are all afraid of being fake. We know that it is a big polluted area, but they are all on the front line. Everyone chooses to stay in the hotel together and stay in the hospital, just to be courageous and comfort each other.
In the last half month, I can only sleep 2 or 3 hours a day because there are too many things to coordinate. I will return as soon as there is news of doctors and nurses on my phone. I just want to let them know that even if I am temporarily out of the hospital, I will be with them. Many people are afraid of infecting their family members and stay in hotels arranged by the hospital in order to stay on call. However, the canteen of the hospital only provides food for the staff on duty, and the medical staff resting in the hotel eats instant noodles and snacks. My home is near the hospital. When I am free after work, I will cook and send them to them. Because I am a high-risk group, I let my son go out to live, but my relatives are not willing to let his son go to their house because they are afraid of getting infected. But my son doesn't know how to cook, he orders noodles every day, or eats instant noodles. On New Year's Eve, I called my relatives and asked her to fry a dish and put it downstairs in the son's residence. The son went down to pick it up, at least for him to have a good meal for the New Year. I cook food for my doctor at home, but no one cooks food for my son, do you say my heart doesn't hurt?
4 On New Year ’s Eve, several videos of doctors crashing and crying in the office circulated online. This is true, there is a doctor in a video from our hospital. In another video, the emotionally calling male doctor is also from our hospital. In fact, due to excessive tension and fatigue, the doctors in each department did not know how many times they cried. Death made me cry. I took over a patient whose lungs were completely fibrotic. I watched her blood oxygen drop from 80 to 70, 60, and fell a little bit. She grabbed your hand and said that the doctor begged you to save me. You said who can bear it when you see this scene as a doctor. We are willing to work hard, but the basic guarantees must be resolved. After taking off the protective clothing, everyone sweats, but the hospital has hot water only for two periods. Once the time is missed, there is no way to take a shower. In the hotel arranged by the hospital, there are only two rooms in one department, which is not enough to sleep at all, and only two people can be packed in one bed. Some medical staff do not have protective clothing and N95 masks, but can only wear isolation suits and wear multi-layer masks. There are too many patients. We can't keep our peace of mind all the time, but we must want the patients to survive. Everyone is racing against Grim Reaper. An emergency doctor asked the equipment department to provide another ventilator, because the previous one had been sent to the ICU after resuscitating a patient. There are too many patients and the scene is chaotic. I once suggested that you can make a questionnaire to tick the patient, set up several sets of prescriptions, and let the doctor check it, which can improve efficiency; there are two doors in the clinic, you can arrange a door to enter, and a door to exit, just like security ; Fever Department is divided into two areas, one area looks at light heat, the other looks at high fever. But everyone has given up on vacation to get on the front line, and their opinions are too late to be accepted. I understand. In the past few days, the situation has eased a lot. The city ’s new pneumonia prevention and control headquarters has arranged categorical diagnosis and treatment. Some feverish citizens went to the community health service center for screening. The number of outpatients in the hospital decreased a few days ago. At 3 pm on January 28, the patient went to the clinic and took CT scans, which were usually arranged for one to two hours, but the infusion still had to be arranged for three or four hours. Now the security and cleaning staff are also wearing blue isolation suits, and the hospital is in good order. But we still have no idea. N95 masks are still missing. I don't know if the materials behind can keep up.
I started working as a doctor at the age of 21 and became one of the youngest directors of the hospital at the age of 34. I will be 52 years old this year. I sincerely hope that there will be no such experience again, and hope that the hospital management will be better in the future and the prevention and control of infectious diseases will be better. One day before going to work, I told my colleagues that we were going to fight and take care of ourselves. We killed a blood and survived. When the epidemic has passed, we will travel abroad collectively, and I will pay for it alone. I said, as long as I live, it counts.
(Mu Hongju also contributed to this article) This article was independently produced by China Youth Daily and was first published on China Youth Daily ’s client and headlines, joining the tree project. PS: We are looking for interviewees! Whether you are in Hubei or other areas, whether you are in an urban or rural area, as long as you are a medical worker, patient, patient's family member, public official, medical protection equipment manufacturer who is fighting the epidemic ... as long as you notice and learn something about us Please contact us for clues and situations that are very important in responding to the epidemic. Please let the information flow, not "isolate"! The reporter's contact number is as follows (micro