A Doctor’s Life on the Front Lines
Chinese doctors are working shifts of 10 hours or more. Many stay in the same hazmat suits the entire time, without food, water or bathroom breaks. Disrobing to eat or go to the bathroom could risk exposure. Medical workers are requesting psychological help to try to deal with the stress. Infectious-disease doctors around the world are trained to handle highly contagious illnesses, and know the risks. But the current outbreak is spreading so quickly that it’s forcing hospitals to deploy staff with limited experience in infectious diseases and, sometimes, insufficient gear to keep them safe. Some hospitals can’t find enough staff willing to take on the risk. In South Korea, some nurses and support staff quit when the outbreak spread, their families begging them to resign. Iran has faced equipment shortages while its deputy health minister—himself a surgeon—has been infected with the virus.
Early days Doctors in China say conditions have improved significantly since the early days of the outbreak. Roughly 42,000 medical staff from around the country has descended upon Wuhan and the surrounding Hubei province. Wuhan has 53,000 beds in hospitals and temporary medical and quarantine facilities for treating patients with the corona virus, with a goal of adding 17,000 more, according to an official media briefing on Feb. 20. Crowds and lines at fever wards have subsided as the rate of infections has slowed. Yet around 100 new cases are still emerging in Hubei province every day. LiuFan, a 59-year-oldnurse at Wuhan Wuchang Hospital, one of the main corona virus crisis centers in Wuhan, died from the virus even though she wasn’t working in a fever ward, according to a Weibo post by the hospital. Her parents died from the virus a few days before her, and her brother, a local film director, died the same day she did, according to Chinese media.
In the early days of the outbreak, Wuchang Hospital’s 51year-old director, a neurosurgeon named Liu Zhiming, had warned colleagues about working too hard and burning out. He worried their immunities would decline. On Jan. 24, a chest scan showed he had a serious infection himself; he later tested positive for the virus. As Dr. Liu lay in intensive care, he kept fielding calls and asking about patients, while colleagues grew more anxious. “I’m worried I can’t do anything,” Dr. Liu texted them, according to an account in official Chinese media. In another message, he said that “if it were any other illness, I would persevere and fight with everyone while sick.” His wife, Cai Liping, a head nurse at another hospital, implored Dr. Liu to let her visit, but he kept saying no, according to official Chinese media. She asked him to call her every day at 2p.m.to re-assure her he was OK. She reminded him to breathe oxygen and not be afraid. On Feb. 18, Dr. Liu died. A colleague sobbed while telling the media: “We really wanted to give him a farewell, but we had so much work to do.” Many of the heaviest burdens are falling on younger doctors and nurses, who are seen as better suited for high risk situations, because of their stronger immune systems. One doctor, Peng Yinhua, died at 29yearsold,according to state media. He was working in a critical care unit, and had postponed his wedding celebration to stay on the job.
LiWenliang, the Chinese ophthalmologist turned folk hero who died after warning about the dangers of the virus, was in his early 30s. Both doctors’ wives were pregnant. Dr. Zhang, who worried about her 9-year-old daughter and sick parents, was more prepared for the crisis than most. AradiologistatZhongnanHospital,a3,300-bedfacilityoverlooking a lake in central Wuhan, she had served on the front lines of SARS in 2003. OnDec.31, Dr.Zhang wason her first day of vacation and planning to take a trip with her parents and daughter to their hometown in Inner Mongolia. That morning, her superiors called, ordering her to attend an emergency meeting. Two patients at Zhongnan had lung infections reminiscent of SARS. Word was spreading among staff that a mysterious illness was sweeping through a sea food market on the west side of town. At the meeting, hospital officials issued new guidelines for staff to disinfect their spaces, unlock windows to ensure circulation of fresh air, and begin wearing goggles and other protection in some areas. Dr. Zhang’s colleagues had asked her to consult on the two patients’ X-rays, and she was worried about what she saw. She warned colleagues that if a virus had spread from animals to humans, then human-to-human transmission would be easy. With the hospital short on supplies, Dr. Zhang made home-made masks out of gauze for her parents and daughter, just like she’d learned to do during SARS. The family canceled their holiday.
A few days later, a technician in the imaging department discovered he had been infected. Sick patients began pouring in. Soon dozens of staff were sick at Zhongnan, and other Wuhan hospitals, as well. Most days, Dr. Zhang reviewed chest X-rays, a relatively low-risk job. Somedays, she’d don a hazmat suit and tend to patients herself. Worried she might bring the virus back home, and overloaded with work, she began sleeping on an office sofa. She barely had time to eat and shower. She figured her parents, who lived in her home, could take care of her daughter. Her husband was living and working hundreds of miles away and unable tojoin them after authorities announced a strict quarantine of Wuhan in late January. Then Dr. Zhang’s 69-year-old mother admitted to feeling sick. Dr. Zhang convinced her parents to get tested for the virus. For her mother’s first visit to the hospital, Dr. Zhang had her meet nearby, so her mother could put on protective gear before going in. Both parents came up negative using the nucleic acid test, a finicky diagnostic tool. Their CT scans told a different story. “When I saw it, I knew,” Dr. Zhang said, recalling her mother’s first chest scan. “My heart sank.” Her father, who had been reluctant to get tested, had a lung infection that turned out to be even worse. Dr. Zhang had been too scared to check her daughter, until the girl volunteered. “Scan me! It’ll be OK,” she said. Her lungs were normal. Still, Dr. Zhang was facing a crisis. Her husband was away, her parents were sick and contagious, and she was needed at the hospital. There was no one to take care of her daughter, whose school was closed. Dr.Zhang planted her in the family’s living room with instructions to look after herself—and to stay away from her grandparents, who quarantined themselves in other rooms. The 9-year-old learned how to heat up canned congee, placing it at each grandparent’s door. As her parents’ conditions worsened, Dr. Zhang struggled to get them admitted to a hospital. Beds were limited and authorities were unwilling to make arrangements for people whose nucleic acid tests had come back negative. Then, 10 quarantine spots opened up for family of Zhongnan Hospital staff, in an empty building slated for demolition. Dr.Zhang raced to grab a number to reserve a spot, while a colleague ran to guard two beds inside. The new location wasn’t designed to provide any medical treatment, but getting a room for her parents was are life for Dr. Zhang. Although authorities had publicly announced there were no more beds there, scores of people had gathered there anyway, desperate to get space. “Some people were clutching their stomach, others holding their heads and others coughing uncontrollably,” said Dr. Zhang. Her heart broke. After the chaos that day, she suddenly remembered her daughter back home. She tried calling and pulled over her car. She was overwhelmed with feelings of guilt and hopelessness. It took a moment for her to calm herself down. She told herself:“It would be a disaster for the family if I couldn’t pull it together.”
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