2020.3.4 The 42rd Day of the Wuhan City Closure
As of today, the Wuhan city closure has already lasted three half-months.
Yesterday, the number of new confirmed cases fell to one hundred. Many people got very excited hoping that the city closure will end soon. Some people optimistically estimate that we will be able to go back to work on March 10.
I am not so optimistic however because those figures are not very reliable.
Suitable epidemiological history (there are four possibilities);Suitable clinical presentation (three types of symptoms with a CT scan image being one of them).
Both conditions must be satisfied at the same time. If the first condition cannot be satisfied then all three clinical presentations must be satisfied. For there to be a confirmed diagnosis, in addition to the conditions for a suspected diagnosis being satisfied, the nucleic acid test must be positive as well.
What are the consequences of setting such standards? If an infected person does not have clinical symptoms, even if the nucleic acid test is positive, then that person is not included as a suspected case. Or if an infected person has all the clinical symptoms, including a CT scan showing lung lesions but the nucleic acid test is negative then that will not be counted as a confirmed case. The worst thing is that the nucleic acid test is only 30% to 50% accurate.
When we get this point, things are like someone whose underpants have been stolen but are still covering their ears not to hear the burglar alarm. What good does that do?
My only hope is that they do not give us false hopes.
The hospital hardest hit by this epidemic is probably the Wuhan Central Hospital. According to press reports, over two hundred workers there have been infected by the coronavirus, including three deputy hospital heads, one deputy director of nursing. Many department directors are on Extracorporeal membrane oxygenation (ECMO), many physicians are on respirators. Three physicians there have already died in the line of duty: Li Wenliang, Jiang Xueqing, and Mei Zhongming.
I have always felt that the top management of this hospital are bureaucrats. From the very beginning of this epidemic when decisive corrective action was taken against the rumor-mongering physician of that hospital, the hospital has manifested a strong “Party character”. “All medical personnel are ordered not to discuss among themselves in public the medical situation and not to leave any trace in written or graphic form that could serve as evidence of discussions of the medical situation”.
Another physician who was reprimanded was Ai Fen, director of the Emergency Department, said in an interview that she “had informed the hospital of the admission of patient but did not get any response. After she didn’t get any response, all she did was order the medical personnel in her own department to wear N95 face masks.” Not only was there an insensitivity to medical matters, there were not even any measures taken to increase protection for medical workers.
From all these many details, we can see that the effort has not focused on reducing the effect the contagious disease has on the hospital staff, ordinary people and the people of the city. Instead the focus has been on reducing insofar as possible the effect the outbreak has on political security and on their own official careers. That way of doing things is completely in line with the way bureaucratic factionalism works in the Chinese Communist Party. That is incompatible with being a medical professional. Or even less, not even the way a modern person with any common sense would have acted. Sure enough, I learned from a friend who knows this hospital that the party secretary of Central Hospital came out of the public health sector, was previously a department head of the Wuhan Municipal Health Commission and certainly lacks a specialized medical background and experience as a front-line physician.
Even more astonishing is that the latest propaganda from Central Hospital unexpectedly stated that “during the course of this epidemic, over twenty physicians and nurses from the Oncology Department, 19% of the staff, were infected by the coronavirus. Most were husbands and wives both working on the front-line against the epidemic. Director Wang Chun, despite the infection of many family members including his father-in-law, mother-in-law, and child took the lead is remaining at his post diagnosing fever cases. An Oncology Department nurse returned to the front-line just ten days after her miscarriage. Nurse Guo quarantined herself at home because there were no hospital beds available. Dr. Yang after serving a shift in relief diagnosing fever patients did all kinds of support tasks including working as a porter….” So many medical workers were infected. They don’t see them as shameful. Instead they see it as an honor. Those references of a “couple both medical workers”, “several family members infected”, “ten days after her miscarriage”….. when I came across those words I felt that they were bloody words. All these very terrifying things they list one-b-one, flaunting them.
I am really frightened for those doctors and nurses.
On the Weibo microblogs under the category “Coronavirus Patients Asking for Help”, I see very many postings from coronavirus patients looking for someone to help them. Recently I saw a posting about a three-year-old patient who was diagnosed with a malignant tumor in 2019. Before the epidemic began he had already had seven chemotherapy treatments and 25 radiotherapy treatments. He needs five more chemotherapy treatments. After the outbreak of the epidemic, however, the hospital where he was getting his treatments was requisitioned and so he was unable to continue his chemotherapy treatments. He had looked everywhere to get help without any result. Therapy had already been delayed for a month and his condition might take a turn for the worse at any time.
I can never understand why prisoners who have completed their sentences are allowed to leave the city while seriously ill people who are not infected cannot be smoothly transferred to a hospital in another province to get treatment?
I don’t know what to say. Should I be just heart-broken? Or sad that the lives of the people are so difficult? Why, after an entire month has gone by, why is there still so many clear gaps and chaos? I don’t know.
3月4日 武汉封城第42天
截止到今天，封城已经3个14天了。
昨天武汉的新增确诊人数降到一百多了，很多人感到振奋，解禁指日可待，还有人乐观的预计3月10日可以正常复工。
不过我没有那么乐观，因为这个数字的水分太大了。
按照现在的标准，可计入疑似病例的条件：第一，满足流行病学史（有四种可能情况），第二，有临床表现（有三种症状，CT影像为其中之一），两个条件需同时满足，如果无法满足第一条，则第二条的三种临床表现须全部符合。而计入确诊病例者，是在满足疑似病例的要求的基础上，还需要核酸检测为阳性。
这个标准会造成什么情况呢？如果一个感染者没有临床症状，即便ta的核酸检测为阳性，也不计入疑似或确诊病例；或是即便一个感染者出现了所有的临床症状，包括CT影像也显示出了肺部病变，但是核酸检测为阴性，也不会计入确诊病例。最糟糕的是核酸检测的有效率只有30%-50%。
都到了这个地步，底裤被扒得不剩了，还在掩耳盗铃，何必呢。
我现在唯一的希望是，不要给我们虚假的希望。
这次疫情中最为惨烈的医院大概就是武汉市中心医院了，看到报道，现在已有200多名职工感染，其中有3个副院长、1个护理部主任，好几个科室的主任都在用ECMO维持，已有多位主任医师上呼吸机，还有已经殉职的三位医生：李文亮、江学庆、梅仲明。
我一直感觉这家医院的主管领导应该是官僚出身。从疫情之初果断对本院“造谣”医生的及时训诫就表现出了极高的党性，“要求医务人员之间不许公开谈及病情，不得通过文字、图片等可能留存证据的方式谈论病情”，另一位被训诫的医生、急诊科主任艾芬接受采访时曾说“她向医院反应这个病人传人，但没有得到任何回应，反映情况无果后，艾芬只得要求自己科室的医护人员先戴起了N95口罩”，不仅缺乏医学敏感，甚至没有为医护人员升级保护措施。
林林总总可以看出，ta的行事逻辑，不是在尽可能减小传染病对本院职工和普通病人、市民的影响，而是尽量降低疫情突发对政治安全以及自己仕途的影响。这样的做法完全是CCP的官僚做派，实在不像医学专业人士，甚至，不像一个有常识的现代人。果然，从了解这家医院的朋友那里得知中心医院的党委书记是公卫出身，曾经担任过武汉市卫建委人事处处长，确实缺乏医学专业背景和一线医生经历。
更魔幻的是，中心医院最近在宣传的居然是“本次抗疫过程中，肿瘤科超过20名医护被新冠病毒感染，全科医护感染达19%左右。多对夫妻双职工支援抗疫一线。王纯主任在岳父岳母、儿子等多位家人感染等情况下仍然坚守发热门诊岗位，身先士卒。肿瘤科黄护士流产10天后重回一线；郭护士等感染后因为没有床位，在家自我隔离；杨医生支援发热门诊轮休后又以一个搬运工等身份投入到捉襟见肘的后勤工作中……”这么多的医护人员感染，不以为耻反以为荣，“双职工”“多位家人感染”“流产10天”……这些文字光是敲出来我都觉得带着血，心里慎得慌，他们却得意洋洋的罗列出来炫耀。
真替这些医生护士们心寒啊。
在微博的“肺炎患者求助超话”里常常能看到好多非新冠肺炎病人的求助，最近看到一位3岁的小病人，他在19年确诊换上恶性肿瘤，疫情发生前已经经历过7次化疗、25次放疗，后面还需要最少5次化疗，可是随着疫情爆发，就诊的医院被征收，无法再进行后期治疗，四处求助无果，小朋友已经脱疗一个多月，随时都有恶化的可能。
我无法理解，为什么感染病毒的刑满释放人员可以出城，未感染的重症病人却不能协调转移到外省进行救治？
我不知道能说什么。悲伤吗，哀民生之多艰？愤怒吗，为什么一个月多了依然有这么多明显的漏洞和无序？我不知道。
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