Exclusive in-depth interview: From the discovery to the closure of the city, why the epidemic broke out in Wuhan's front-line medical care recovery

【Southern People Weekly】

"The secretary of the Hubei Provincial Party Committee said, 'We must not let Huanggang become the second Wuhan'. I hope other cities will not repeat the tragedy of Wuhan!"

"I went to work! My protection is absolutely professional, don't worry! You write down everything I said, and say that no matter how difficult it is, the front-line medical care in Wuhan can continue to work for a while, and ordinary people who are locked in the house should not worry. Go to work, let's persevere together and get our happy life back."

Lunch consisted of two dishes and one soup. Sun Ping (pseudonym) made it for herself. She is a front-line medical nurse in a tertiary hospital in Wuhan. "Fighting against this virus depends entirely on immunity and must eat well."

After eating, she rode an electric car to the hospital to go to work. After the traffic control, this was her most efficient means of transportation. Seven hours in a class, "I don't drink water, I don't eat, I don't even go to the toilet." Being busy is one aspect, and more importantly, protective clothing and N95 masks are issued in limited quantities.

Wearing a mask for a long time, a deep streak was pressed on her face. "The rope was strangled at the bottom of her ear, like a knife."

But this is also a kind of "happiness" - only the highly protected medical N95 can exert such an effect. "N95 can only be worn by those who have direct contact with the patient at the front line, and only one is issued a day."

The hospital provided dormitories for front-line doctors and nurses. Sun Ping stayed for two days and couldn't stand it. Their hospital is a typical small 3A hospital, and there are more than 1,000 people in total with administrative logistics. Twenty out of 20, there are several suspected cases in our department." Living in the dormitory, she dared not take off her mask when she slept, "Because you don't know who might be 'hit', many people are asymptomatic now."

A colleague has no symptoms for the time being, but due to the doctor's self-examination, he feels that he has been recruited, and "felt uneasy". The CT scan of the lungs for three consecutive days showed, "the first two days were normal, and on the third day, the lungs showed There is really a problem. Do you think it is scary or not?" When there is no condition to do a kit test for a diagnosis, lung CT is a more accurate test method.

She was separated from her family very early, and her daughter advised her not to go to work anymore, "Mom, don't go to work! Aren't you afraid? Even if you resign, your professional qualification certificate will be confiscated, and our family is not without money to live soon. I can work and support my family.”

Sun Ping burst into tears, "Of course I'm afraid, can I be afraid? People around me fall one by one. I don't even know if a small hospital like ours can hold up."

"I want to tell the real situation I have seen and know. I don't want to create panic, and I don't want to blame anyone. I just want ordinary people to know the real situation, and all parts of the country can take it seriously." .

She also opened up all WeChat Moments to me. On the National Day in 2019, when the family went on a trip, she smiled brightly in the photo, "Before the epidemic, my life was very happy."

In addition to a happy family, she also has a friendly and friendly small environment in the department. "The atmosphere of our department is one of the best in the hospital."

Seeing that Director Lv Xiaohong of Wuhan Fifth Hospital told the media about her personal observation of the Wuhan epidemic in her real name, she praised the integrity and courage of this colleague.

"The secretary of the Hubei Provincial Party Committee said, 'We must not let Huanggang become the second Wuhan'. I hope other cities will not repeat the tragedy of Wuhan!"

Dressed neatly and closed the door, she shouted on WeChat, "I'm off to work! My protection is absolutely professional, don't worry! You write down everything I said, and say that the front-line medical care in Wuhan can persist no matter how difficult it is. For a while, the ordinary people who were locked in the house should not rush to go to work, let’s persevere together and get our happy life back.”

Sun Ping said:

1. At the end of December and the beginning of January, we have found that this virus is completely different from before. At that time, we called it "viral lung"

At the end of December 2019, we saw a "white lung" dynamic CT from a large general tertiary hospital, and the patient's lungs were all eroded by the virus. The ten-second video made people's scalp tingle. I asked the professional lung CT diagnosis doctor in our hospital if this display could be a viral cold or other diseases.

"Completely different, none of the others are as full and diffuse as this," he answered affirmatively.

At that time, some people thought it was "suspected of SARS", everyone was very sensitive, and immediately put on standard protection - masks, hats, gloves.

Around December 30, it was reported at that time that "the pneumonia of unknown cause in Wuhan has been quarantined, and the result will be announced as soon as possible." We are also paying special attention and waiting for a confirmation notice.

Within a few days, the hospital organized training, and the notice said "viral pneumonia of unknown cause", which was later referred to as "viral lung". All departments are required to participate, and the training materials are strictly confidential. The notice states that those who take photos and spread the word will be held accountable for serious consequences.

In early January, suspected patients appeared in various hospitals one after another, and some small hospitals did not accept fever patients and pushed them to other hospitals. This situation was jointly reported to the Wuhan Health and Health Commission by several other hospitals, which issued a notice that the patients admitted by each hospital must treat themselves, which blocked the referral opening.

As Director Lv Xiaohong of Wuhan No. 5 Hospital said, most hospitals are not infectious disease hospitals and do not have isolation conditions.

The isolation ward can only be vacated urgently, and the respiratory medicine department, emergency department, fever clinic, and intensive care unit of the hospital can be integrated and dealt with together.

At that time, I already felt that we were going to fight a tough battle. I believe that all hospitals were prepared, but there were no announcements or reminders to the outside world.

According to the infectious disease management regulations, hospitals do not have the authority to report suspected cases, and all public announcements must be followed by the Wuhan Health Commission. At that time, we were required to not allow any samples to be sent out. At that time, there was no special "viral lung" nucleic acid detection reagent. We could only rule out whether it was caused by other known viruses one by one. Coupled with the CT diagnosis of the lungs made by the radiology department at the first visit, it was determined to be "suspected viral lung".

2. In mid-January, "patch infection lesions" became a common description among doctors. Medical staff have been infected and sick, but hospitals have no right to raise the level of protection

In mid-January, our general practice was in a state of high tension. At that time, we had heard that some suspected patients admitted to hospitals had died.

The emergency department of each hospital is full of people, and the communication between the hospitals is not good. At that time, it was not allowed to write "viral pneumonia" on the diagnosis certificate, and some hospitals wrote "patch infection lesions". Multiple patchy infection lesions in both lungs” (equivalent to high suspicion), I came to see a doctor, and basically understood what it meant and how to deal with it.

The medical staff in the fever ward have already put on protective clothing. However, the protection level of the entire hospital has not been adjusted uniformly. Only by reaching the third level of protection can medical staff be protected from infection to a greater extent.

However, from January 6 to January 10, the Wuhan Municipal Health and Health Commission did not issue any further notices on "pneumonia of unknown cause". As of January 5, we have received a notification from the Health and Health Commission: "59 patients with unexplained viral pneumonia diagnosis, no clear evidence of human-to-human transmission was found, and no medical staff infection was found."

At that time, there was no hospital in Wuhan that could adjust the protection level without authorization. During this period, when medical staff were most infected, several colleagues in our hospital were infected.

The most deplorable is the infection of more than a dozen medical staff caused by the patient of the Concord Neurosurgery. In fact, on the night of the operation on January 7, the doctors had already told each other to be careful about protection, but because at that time, the Health and Health Commission's notification of the virus pneumonia was that "no clear evidence of human-to-human transmission was found", and the patient did not show any respiratory symptoms. Only operate in accordance with the hospital's routine surgical protection requirements.

In the end, the patient became ill. On January 15, the new coronavirus infection was diagnosed. The medical staff was very aggrieved, because there was no "negligence" as the outside world said, and the protection that could be done (at that time) had been done the best.

In the circular issued by the Wuhan Municipal Health and Health Commission on the 16th, there was no mention of the infection of medical staff. Like many medical staff in other hospitals, I only learned about this on the 20th. We all said that if Academician Zhong Nanshan hadn't brought this out, the doctors still don't know how many people would have been poured out.

The front line is still like this, and ordinary people are completely unaware of the dangers that lie in ambush. On January 18, the New Year's Eve, Wuhan still attaches great importance to this festival. Relatives and friends will have dinner together. The subway is full of people, and no one wears a mask.

The unit asked me not to speak out, but I have been reminding the neighbors to pay attention to this matter in the owner group of our community. I believe that I am definitely not the only one doing this among the medical staff, but it is too small to rely on personal strength. We also dare not publish it online, for fear of being labeled as "rumoring" and "panic creation".

On January 20, Academician Zhong said in an interview with Bai Yansong that "human-to-human transmission is certain", and the common people paid attention to it, and more and more people wore masks.

We are on the front line, and we have seen clearly before that this virus is contagious. There are three patients in a ward, and there is no communication and contact with each other, and all three are virus lungs. There is also a handsome young man. He said that the local media reported it so lightly, and he continued to work after the infection, which ended up infecting everyone in the same office.

I was separated from my family at that time.

It was the saddest day for me, I felt suffocated. As a healthcare worker, I have to be disciplined. But I don't know why we can't say anything.

3. Since January 23rd, after the city was closed, the hospital was surrounded by swarms of patients, and the admission and treatment were under great pressure.

After Academician Zhong issued the warning, many citizens rushed into the hospital and demanded inspection. Have you seen the video of the crowd crowded into the fever clinic on January 23 at the Union Medical College Hospital?

Although on the 22nd, seven new hospitals were urgently added to treat patients with fever, and two batches were added in a row, hoping to achieve special treatment, but due to the loss of control in the early stage and the spread of the epidemic, the idea of special treatment could not be realized at all.

From the closure of the city on January 23 to the start of traffic control at 0:00 on January 26, at least 500 or 600 people were doing CT scans in our hospital every day in those days, and there was no way to maintain order at the scene.

In the past two days, the number of people has been slightly less, and the suspected cases detected in one day also have a small number of 200 people. Our entire hospital has only about 200 beds in the isolation ward. Now the general departments are basically closed, and we are doing our best to deal with fever. .

Are you saying this situation is urgent or not?

Other hospitals are similar, you just need to see how difficult it is to be hospitalized. There are relatives and friends looking for it, but I want to be hospitalized at this time. To be honest, it is not easy for the hospital leaders to come forward.

I have been practicing medicine for so many years, and my heart has not been hardened. Yesterday, I saw an old couple who came to the hospital tremblingly without their children. The filming showed that the situation was very bad, but there was no bed, so they had to go home. How to do? I don't know, I can only tell them how to quarantine at home. It is so pitiful that this disease is a great test for the elderly and infirm.

I don't want to cause panic, but we must let everyone know that this virus is so deadly that it is not as deadly as SARS. You may not get sick, but you are also very likely to be a very virulent source of infection.

Between hospitals, peers are all connected, and they have meetings and study together, or if they are a professional, there are large groups across hospitals. I heard that there is a large group in the province that has a radiology department. In the past month, no one dared to dare. Talk, maybe you don't know what to say.

Radiology is so critical. After the media publicity, people all agreed that the nucleic acid test was confirmed to be confirmed. In fact, everyone in the hospital knew that lung CT was very telling. As long as the lung film showed "high suspicion", the proportion of confirmed diagnosis by nucleic acid test was very high. The medical staff in our hospital are also filming, and if they are suspected, they will start treatment directly. Early isolation, early treatment, and early recovery. There is a shortage of front-line personnel. It is too slow to go to designated testing institutions and wait in line for nucleic acid testing. Front-line medical staff cannot afford to delay their time.

In the past two days, the voices of front-line medical care have come out one after another, the reports on TV have also increased, and various business groups have become a little more active.

The protection level of our hospital has been upgraded to three levels in a row, and the common people must be fully informed about the spread, risk and pathogenicity of the epidemic.

These are the whole process from the discovery to the spread of the epidemic as far as I know. Of course, it is only an observation in a small area where I am, but I think it can also explain a lot of problems.

I don't blame anyone, I don't want to blame anyone, and I don't want to make the people panic. Now the country attaches great importance to it, and all parties are fully supporting it. No matter how difficult it is on the front line, we must persevere. I don't know if I can hold it all the time. I hope people in other cities don't pay such a high price like Wuhan did.