Six front-line Shanghai doctors in their own words: perhaps the biggest challenge in three years, we must give it our best shot

Read Time:19 Minute, 33 Second

Seemingly earlier and faster than expected, the first wave of infections in Shanghai since the “new Article 10” has begun.

On December 22, Zhang Wenhong, director of the National Center for Infectious Diseases, said that the number of positive infections in Shanghai is expected to peak within a week.

On the other end of the shockwave, health care workers are holding the line on life support. Medical institutions are supposed to be high-risk areas for the epidemic, and many health care workers have been infected one after another recently. Now, most of the health care workers in the first wave of infections are quickly returning to their posts after their symptoms have subsided, making every effort to ensure the orderly operation of medical services.

On December 22, six front-line doctors from Shanghai’s tertiary hospitals, district hospitals and community health service centers told reporters about the current situation in hospitals and the state of medical care at this time. Some of the doctors had also been infected with the new coronavirus not long ago and had not yet fully recovered, with slightly hoarse voices coming from the other end of the phone; between short interviews, they were still busy handing over work matters.

Pressure, responsibility, worry, risk, mission …… at this time each doctor shoulders carrying too many things, busy, but also become a state of no matter what. Perhaps they speak in a weaker voice than usual, but the power that emanates is even more awe-inspiring.

On Dec. 22, the number of consultations in the emergency building of Shanghai Changhai Hospital was much higher than before the current outbreak.

Infection in medical staff is earlier and faster than in the community, but emergency care can’t stop for a moment

Narrator: Wang Meitang, director of the emergency department at Shanghai Changhai Hospital

I haven’t left the hospital or the emergency department since the outbreak, and I was infected with the virus on December 16. Because the emergency department has been very busy and stressful lately, I really didn’t have time to rest much. My symptoms have been much better in the past two days, with nasal congestion and sore throat, which basically does not affect my work anymore.

On December 21, the number of emergency room visits reached 1,517, compared to the usual 800 or 900 emergency room visits a day before the epidemic, but now it’s almost doubled and still climbing. In the emergency building, most of the patients will leave after seeing the doctor, and the seriously ill patients will be triaged to the inpatient wards after resuscitation. The temporary stay patients who are stranded in the emergency clinic usually have about 20 people, but now they also reach more than 50 people. These patients are the ones we have to take care of.

On December 22, the number of consultations in the emergency building of Shanghai Changhai Hospital was much higher than before the current outbreak.

On the other hand, health care workers were infected earlier and faster than the social side. I think this is understandable, one, because healthcare workers are themselves members of the community and have the same risk of infection in the community as the general population. The second is that with the surge in attendance, the hospital environment is a higher risk than the social side, and health care workers are exposed to that risk every day.

In the past week, we have had more than 100 staff in the emergency department, and nearly 80% of them have been infected with Newcastle, which is really cruel. Most of the medical staff in the emergency department are young and strong and have been vaccinated. The symptoms are generally in the upper respiratory system, such as fever, cough and headache, but there are still medical staff who have high fever for four or five days, which is very heartbreaking.

It’s remarkable that most of the health care providers are currently back at their posts after their symptoms have subsided, and we all know that emergency care can’t be stopped for a moment. The hospital has also been sending staff to support the emergency and fever clinics, but to be honest, working here for two or three days still puts you at risk of infection very quickly.

As the head of the emergency department, my responsibilities speak for themselves and I dare not slacken off in the slightest. In addition to management matters, I now insist on checking in every day and am always on the front line, doing my best to ensure the smooth operation of the emergency department with my colleagues.

Under such a high-pressure environment, our colleagues have become “yang” one by one!

Narrator: Gao Jiamin, a doctor in the emergency department of Huashan Hospital, Fudan University

On December 7, a photo of Dabai’s back was circulated in the circle of friends, and the three big words “the end of the whole drama” behind it hit the cheerfulness that had been suppressed in our hearts for three years. However, we know that after the “liberalization”, the health care system, especially the first gateway to the hospital, the fever clinic and the emergency department, will be the biggest challenge in three years.

The isolation ward on the 2nd floor of the fever clinic was the first to receive inpatient admissions, and while the situation in the fever clinic was manageable on December 12, the “picture” began to change on December 13, when not only were there more and more people with high fever, but also new patients with positive coronary artery disease who needed to be hospitalized.

At 16:50 on December 13, I received a message from the fever clinic doctor about a 27-year-old female patient with neurogenic bladder, positive antigen, left-sided nephrectomy and ureteral bladder reconstruction, and high fever with back pain and painful urination for 2 days. When I saw this patient in the lobby, she was sitting in a chair in a very depressed state of mind. I learned that her parents were far away in Beijing, and her whole family, including her elderly grandmother, was currently suffering from hyperthermia. Her own situation was unique in that she had very pronounced lumbar pain after hyperthermia, and she was very worried that her only kidney would be affected.

After admission, we actively evaluated her condition and her urinary tract infection was quickly controlled through medication. As the back pain still persisted, she was very anxious and mentioned a lot of needs, and we communicated with her fully every time. Eventually, her condition was completely relieved. Before she was discharged from the hospital, she said she wanted to send a banner to our fever clinic and emergency department, and said, “Maybe you don’t think it’s necessary, but for me, you saved my life.

Recently, in Huashan Hospital of Fudan University, the isolation ward of the fever clinic received a banner from a positive patient.

Since then, we have been involved in the treatment of other positive patients. There were so many patients, including those with serious underlying diseases, that we had to help them perform lumbar puncture and deep vein puncture in the isolation ward …… Under such a high-pressure environment, our colleagues became “positive” one by one, and some of them had to take a short break under high fever. Some colleagues had to take a short break under the high fever.

I and Dr. Wang Xinxin, who just joined Huashan Hospital this year, encouraged each other to drink more water, drink more milk and eat more fruits to preserve our strength and strive for a “late sun”. While many of our comrades were down around us, the two original teams in the isolation ward had been working overtime for a week to collect patients and write medical histories to ensure the orderly treatment of positive patients. At the same time, under the protection of the isolation ward, colleagues who were completely asymptomatic also continued to persist in their work.

At the end of the night check, I passed by the transitional resuscitation room, and when I saw the patients who were still temporarily in the room, looked at the brothers and sisters who were holding on to their posts, looked at the busy figures on each post, and then looked at the first banner of the isolation ward, I felt infinite emotions in my heart. Perhaps this challenge is unprecedented, this rainstorm is wild, but as long as we work together, this will eventually be the last darkness before the dawn, break through the darkness will see the light.

The whole department was almost “wiped out”, but we can’t stop working because of fever

Narrator: Zhang Jiaxiong, Director of Department of Otolaryngology, Shanghai Tenth People’s Hospital

This wave of the epidemic was so severe that when we examined patients, almost all of them had to take off their masks, so our otorhinolaryngology department was considered a high-risk position. Of the dozen or so employees in the department, only one is not infected with the new coronavirus, but she also has a mild sore throat. My wife, children and I have also been infected. In the past two days, I have had a fever of almost 39 degrees and a very sore throat, and I feel that the disease is still developing.

However, everything in the department is still running as usual. We can’t stop working because of the fever, we still have to see the specialist clinic, and we have to see the surgery and the emergency room as usual. Basically, we are all working and on duty with fever and illness. If a colleague has serious symptoms and cannot hold on, those of us with less severe symptoms will help him to cover the shift and make some adjustments to the schedule.

The number of doctors, nurses, anesthesiologists and patients are now infected and feverish, and our number of visits continues to increase. The risk is higher than in the fever clinic because of the specialty features and the need for patients to be examined with their masks off. At the same time, because many people in this wave of new coronavirus infections have symptoms like sore throat and dry itchy throat, our outpatient and emergency clinics are under a lot of pressure, which is all the more reason why we can’t stop.

Recently, Zhang Jiaxiong (first from right), director of the Department of Otolaryngology at Shanghai Tenth People’s Hospital, performed surgery on a patient.

During the treatment process, we take the “first level plus” protective measures, that is, wearing a hat, mask, face screen, plus back-wearing clothes. The longest duty time for emergency doctors is 24 hours, from 8:00 a.m. until 8:00 a.m. the next day, and they can’t get off work if they have surgery. In my case, I sit in the specialist clinic in the morning, and I have to handle surgery in the ward in the afternoon. Wearing a mask to work for a long time with a fever is definitely uncomfortable, but we must insist, insist, and insist again.

I think at the moment, it is incumbent on us as medical professionals to grit our teeth together, tide over the difficulties and face the impact of the epidemic together. If we say that in the past, prevention and control were mainly on the social level, now is the time for hospitals to really face the test.

Therefore, at this time, as a medical staff, as a member of the Communist Party, as the department director, I must also be in the front, forward command. If I’m hiding behind, the other employees are looking at me, so I’m the first to arrive at the unit and the last to leave the unit every day, no matter how much fever I have, also in order to give everyone a demonstration and become the backbone of the staff in the department.

The peak of infection has not yet arrived, and the number of intensive care and resuscitation beds is being actively expanded

Narrator: Chen Kang, Director of Emergency Department, Fengxian District Central Hospital, Shanghai

During this recent period, the number of acute and critical cases received by the emergency department has increased significantly.

The reason why there are more patients who need to be resuscitated comes mainly from two parts. One is that some patients with underlying diseases are sent to resuscitation because the weather turns cold and their conditions worsen. The other part is that patients with underlying diseases combined with respiratory system diseases are sent for resuscitation. So, the overall number of patients is now double or more than the number before this outbreak.

Seventy to eighty percent of the medical staff in our department have been infected and generally return to duty soon after they are symptom-free. Of course, the department and the hospital will consult with the recovered staff, and they will return only if their physical symptoms are relieved and they have the will to return to work, and at the same time, they will arrange for the returning staff to do what they can.

Recently, Fengxian District Central Hospital.

I am under a lot of pressure as a department head in management. For example, scheduling, there are new situations and new problems every day. In the past, scheduling was once every two weeks or a month, but now it is once a day or even half a day, and I have to coordinate people every day.

Patient admissions are also one of my priorities recently. With the increase in patients, beds and wards have become very tight, and it is definitely not possible to keep all the patients pressed into the emergency department, and problems such as hospitalization and discharge need to be solved.

I am now more worried about the movement of peak infection and when it will come, we need to be prepared in advance. At the moment, although the number of seriously ill patients has increased, the peak has not yet come, and the elderly and people with underlying diseases will be relatively later than the peak of infection in the community for about two weeks. When these people are infected, the pressure on medical institutions to resuscitate them will be great. We are actively making preparations to expand critical care and resuscitation beds.

There’s not much else to say. When it comes to an epidemic of the century like this, we definitely have to rush, and it’s the duty of healthcare workers to do their best, or else what? It’s not just the health care workers who are under pressure either, everyone is facing challenges, and only by working together and being united can we work together to get through this epidemic.

I really want everyone to go back to rest, but what about the residents when the medical staff goes back to rest?

Narrator: Zhang Jianmin, Deputy Director of Changbai Community Health Service Center, Yangpu District, Shanghai

In the past few days, I felt very deeply that it was really hard for everyone. I found that many people’s voices were “strained” when I met with them.

Last week we were notified to start the deployment, and on Monday (December 19) our fever sentinel clinic was officially opened, and 54 people were seen that day. In order to serve as many residents as possible, we can only make some dynamic adjustments.

At the same time, the statistics of our community health service center today are: 97 medical workers, 49 on duty; 16 logistics workers, 4 on duty, and the rest are infected. Among the workers on duty, there are still some who have symptoms, but they are really “not injured in the fire”.

To be honest, I really wanted to let everyone go back to rest, but what about the residents when our medical staff went back to rest? I was touched by the fact that we were all very united in our hearts, and we wanted to go to work as long as we could. We also have two doctors, Yuan Jin and Zhang Lei, who actively responded to the call of the municipal government and joined the emergency formation of the temporary medical aid team, really came forward at a critical moment.

Recently, Changbai Community Health Service Center recently received the scene of medical treatment.

Now our manpower is very valuable, and the more tired, the easier it is for viruses to take advantage of the situation, so we also want to adjust the workload of everyone as much as possible, such as patients are more concentrated in the morning to see the doctor to prescribe drugs, we try to let the staff with less on hand go home to rest in the afternoon. The center is also trying to give everyone some additional supplies, yellow peaches frankly not very good to buy, we gave the staff lemons or something.

I myself have been doing mainly management level work during this time, and it is actually the 6th day of the infection, and I am officially returning to work today, but I also had to deal with work at home a few days ago.

Frankly speaking, I am quite worried every day, except for sleeping time, things are jam-packed. In the morning, I mainly look at the situation of outpatient clinics and whether there are enough people on the post; in the afternoon, I look at the situation of medicines and how many days are left; I also attend the scheduling meetings of the higher authorities and communicate with the staff.

Recently, in the Changbai Community Health Center medical staff friends group and WeChat group, we encourage each other.

Including our community health service center still has vaccinations and other work to do. In special times like now, this part of the work may also face attrition, and we have to find ways to deploy and arrange the limited staff to the most needed positions to ensure the operation of our center. After consultation with the streets, we had to stop the vaccine home visits, but the work at the vaccination sites is still in progress.

In addition, in order to deal with the emergency treatment of serious patients that may come later, our community also has to undertake some research surveys and health monitoring of high-risk and susceptible people, including the elderly, infants and children, pregnant women, people who need hemodialysis, tumor patients, etc. Of course, we are also carrying out this part of the work on a daily basis. We need the cooperation of family doctors and neighborhood councils to carry out this work, and now both of them are facing the problem of staff reduction, so the workload of colleagues who are still on duty will also increase.

I think the hardest part is just these two weeks, I believe that when the peak is over, the back will slowly return to normal. My lover is also a doctor and has been very busy lately. She still had to go to the hospital during the days when I had a strong fever, and she especially told our first-grade son not to come to my room. The child still understands and can read. Last week, he drew me a greeting card, which I only saw later.

As long as my physical condition allows, I will always stick to the frontline post

Narrator: Liu Guanghui, an endocrinologist at Shanghai Tongji Hospital

After the introduction of the “new ten” optimal prevention and control policy, our hospital opened the positive clinic, the Internet hospital fever clinic and the new crown positive patient ward at the first time. As an internal medicine doctor, I was also deployed to support the positive clinic and the emergency department.

In the first half of this year, I participated in the rescue and treatment work of three squares during the Great Shanghai Defense War, and later this year I signed up to support the Sanya square in Hainan, with some experience in fighting against the epidemic. In the positive consultation area, I was mainly responsible for helping some positive infected patients with chronic diseases to dispense medication, giving patient answers and professional treatment. In the epidemic, these patients are at risk of progression to severe disease if their medication is interrupted and their underlying disease is not controlled. In addition, these patients are already infected with the new coronavirus, and if they go to the outpatient clinic to dispense medication, there is bound to be a risk of cross-infection, and the opening of the positive consultation area helps reduce the risk of infection in the entire outpatient area.

Liu Guanghui, an endocrinologist at Shanghai Tongji Hospital, used to work in the Shanghai Fang Cabin (file photo).

I met many patients who had panic about the new crown. I would first give them comfort, assess their condition, and give guidance on medication, and for some mild cases, I would suggest that they could first apply antipyretics, cold medicine or cough medicine at home to reduce their trips to the hospital and avoid cross-infection This will reduce the risk of cross-infection. For people with underlying diseases, I will make a comprehensive judgment on whether they need to come to the hospital for further treatment according to their conditions.

With the increase in the number of fever clinic and emergency room visits in recent times, the work intensity has increased steeply, and many medical and nursing staffs have successively developed infections and are facing combat “attrition”, so I was first assigned to support the emergency room and have been working for a week now. In the emergency resuscitation room or temporary observation room, most of the recent arrivals are positive infections, they may be combined with coronary heart disease, slow branch, emphysema, diabetes and other underlying diseases, or even the risk of sudden death at any time, we need to identify these critically ill patients and prevent them before they die.

Every shift, we not only have to deal with the patients handed over from the previous shift, but also have to receive new patients from time to time, so our nerves are very tense throughout the work. The whole medical process requires the full cooperation of all aspects of medical care, from pre-screening and triage to final diagnosis and treatment, each step needs to be meticulous. As Wu Xianzheng, the director of the Department of Emergency Medicine, said, Tongji emergency doctors spend sleepless nights to protect every patient, risking high risks and always fighting in the front line of the epidemic. “243650” – 24 hours 365 days zero rest, this is the solemn commitment of Tongji emergency medical personnel!

As long as my physical condition allows, I will always stick to the front-line post. I am also a party member, and I will go to support wherever there is a need. I would also like to appeal to some patients with chronic diseases to pay attention to the observation of their condition during their home, and to come to the hospital in time once they have wheezing and breathing difficulties. If your condition is stable, you can do some moderate home exercise at home, but with less intensity than usual, while maintaining regular work and rest and good eating habits.

Together, we hope we can win the battle against the epidemic soon!