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    Thursday, May 09, 2024

    At ground zero of China's virus outbreak, plenty of stress, shortages of everything else

    In this Friday, Jan. 24, 2020, photo released by China's Xinhua News Agency, a medical worker transfers a patient out of the intensive care unit at Zhongnan Hospital of Wuhan University in Wuhan in central China's Hubei Province. China expanded its lockdown against the deadly new virus to an unprecedented 36 million people and rushed to build a prefabricated, 1,000-bed hospital for victims Friday as the outbreak cast a pall over Lunar New Year, the country's biggest, most festive holiday. (Xiong Qi/Xinhua via AP)

    BEIJING - There is the infectious disease specialist who, having treated bird flu and influenza A and tuberculosis over the years, was felled during the coronavirus outbreak. An exhausted Jiang Jijun died of a heart attack Thursday while tending patients. 

    There is the seven-months-pregnant nurse who still went to work to treat those with coronavirus, only to be infected with it herself. When her 70-year-old mother got it, too, the nurse had to complain on social media to attract the attention needed to get her admitted.

    There are the health care workers wearing adult diapers because they do not have time to go to the bathroom. Then there are those with the ever-whiter hands, bleached by all the disinfectant.

    As hospitals around the coronavirus ground zero of Wuhan struggle to deal with the outbreak, accounts are emerging of shortages of just about everything.

    There are not enough hospitals and not enough beds, not enough doctors and not enough nurses, not enough rubber gloves and not enough face masks.

    Hospitals are so short of space that a pop-up quarantine facility with 1,000 beds is being rapidly built on the outskirts of Wuhan. State media broadcast footage Friday of four dozen excavators and bulldozers working to prepare land for the temporary hospital, which will be completed within six days.

    "The site being built is to remedy the shortage of existing medical resources," the state news agency Xinhua said in a report Friday. "Because it will use prefabricated buildings, it can be built fast and also won't cost much."

    Many people are at breaking point in the city at the center of an expanding quarantine zone in central China.

    "I don't want do this job any more. Just fire me! Kick me out, send me back home," a doctor at Wuhan No. 5 Hospital yelled into the phone, frustration and exhaustion exploding out of him.

    "Don't I want to go home to celebrate the new year?" he screamed in his Wuhan accent, presumably at his boss, that he had done four back-to-back shifts as China made plans for the Lunar New Year holiday, which began Friday. "Don't we want to live, too?"

    A video of the unnamed doctor, filmed by a patient, was widely shared on Weibo, the microblogging site, this week but could not be independently verified by The Washington Post. Several people in Wuhan, however, vouched for its authenticity, and there were many others like it that emerged from the quarantined city.

    Together, they provide a window into the extreme levels of stress in the overburdened hospitals of Wuhan as they battle a new pneumonia-like coronavirus.

    The virus emerged last month from a squalid Wuhan market that sold wild and exotic animals for consumption. Some scientists believe the virus most likely came from snakes or bats, but no firm origin has been announced by health officials.

    It took, however, three full weeks for authorities to realize the seriousness of the virus, which they initially said was mild and could not be passed between humans. This week, health officials said it can move from person to person and that it has an incubation period as long as 14 days.

    Hubei's provincial government declared a Level One emergency on Friday, the highest category for a public health event. It means the local government can mobilize personnel and equipment; set up a perimeter for the epidemic and enforce a regional blockade; forcibly quarantine infected people and suspected cases; institute price controls and punish "rumormongers."

    Four other provinces and four cities - Beijing, Shanghai, Tianjin and Chongqing - have also imposed Level One emergencies.

    The outbreak underscores the challenges in China's health care system and, in particular, the severe shortage of primary-care physicians. There are just 60,000 licensed general practitioners, accounting for only 3.5 percent of all doctors, in a country of 1.4 billion people.

    But for now, hospitals have neither the space nor the equipment or the personnel for the worried patients seeking diagnostic tests and treatment for suspected infections.

    "The situation out here is grim," one nurse who works at Wuhan Xincheng Hospital wrote in a private group on WeChat, a popular messaging app.

    "All major hospitals in Wuhan are full to the brim and have run out of space," the nurse wrote. "There is simply no room to admit any more new cases."

    Medical facilities are running extremely short of protective equipment like surgical masks, full-body hazmat-style suits and protective goggles. Current supplies would last only three to five days, ThePaper.com, a Chinese news site, reported Friday, citing officials from multiple hospitals.

    On social media, hospitals and health authorities have been issuing urgent requests for donations of basic supplies like masks.

    The central government has allocated $144 million in emergency funding, but they may not have anything to spend it on. At the beginning of the week, before the full extent of the outbreak was known, one surgical mask company had received orders for 80 million masks.

    While some workers are wearing diapers because they do not have time to answer the call of nature, others are wearing diapers so they do not have to take off their hazmat suit, potentially ripping it.

    "We know that the protective suit we wear could be the last one we have, and we can't afford to waste anything," a Wuhan Union Hospital doctor, who only identified himself as "Mr. Do," wrote on Weibo.

    On the personnel front, it is all hands on deck.

    Orthopedic surgeons have been called in to treat the pneumonia patients. The People's Liberation Army has deployed 40 medical staff from a military hospital to work in a special pulmonary facility in Wuhan. More than 130 medical staff have arrived from the southwestern province of Sichuan.

    The outbreak was first reported on Dec. 31 and recognized as a previously unidentified pathogen on Jan. 7. But it was not until Jan. 21 that the National Health Commission confirmed the virus could be transmitted from person to person.

    In the interim weeks, medical staff were treating patients without proper protection.

    The Chinese Center for Disease Control said 15 hospital staff in Wuhan had contracted the virus in the course of their work. Fourteen of them - one doctor and 13 nurses - were infected by just one patient, a person with coronavirus who underwent brain surgery.

    Five medical workers in the nearby city of Huanggang had also been infected, the Hubei Health Commission said.

    But medical personnel in Wuhan fear many more have the virus. "Definitely more than 15 medical workers [in Wuhan] are infected," said one doctor, speaking to the South China Morning Post on the condition of anonymity.

    "Many were not initially informed about the potential for people-to-person transmission, and even now we don't have enough protective gear, test kits and other supplies," he told the paper.

    The doctor said at least one hospital dormitory was being used to house quarantined medical workers, while the nurse in Wuhan said whole wards are being used for infected doctors and their families.

    Fears about health care workers' exposure to the virus is, in some places, leading to them being treated like pariahs. Domino's Pizza in Shanghai has refused to deliver to hospitals and has also stopped allowing in-store collection.

    The outbreak is exacting a heavy mental toll, too.

    Candice Qin, a therapist based in Beijing and co-founder of a psychological consultation service called "Xingzhi Online," said she had talked to four people in Wuhan who had or suspected they had the virus, including a 30-year-old doctor who was infected by a patient.

    "She was devastated, but realizing that her hospital had no more beds, she chose to isolate herself in her apartment, without even telling her parents about it. She said the most scary part was the sense of helplessness and loneliness," Qin said.

    The doctor told the therapist she was afraid of dying young and not getting to see more of the world. But all she could do was take some anti-virus medication and hope her symptoms subsided.

    "I think it is a strain for every doctor and every nurse in Wuhan, both physically and mentally," Qin said. "We know that patients are worried, but we should bear in mind that doctors are just as human as well."

    - - -

    The Washington Post's Lyric Li and Wang Yuan contributed to this report.

    In this Friday, Jan. 24, 2020, photo released by China's Xinhua News Agency, a medical worker attends to a patient in the intensive care unit at Zhongnan Hospital of Wuhan University in Wuhan in central China's Hubei Province. China expanded its lockdown against the deadly new virus to an unprecedented 36 million people and rushed to build a prefabricated, 1,000-bed hospital for victims Friday as the outbreak cast a pall over Lunar New Year, the country's biggest, most festive holiday. (Xiong Qi/Xinhua via AP)

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