Fang Fang - Wuhan Diary - Dispatches from a Quarantined City

There are a few more things I would like to record: Several countries are now giving out cash payments to their citizens to help them get through this difficult period! This news is going viral online; and the way they are distributing the cash is quite admirable. This has led some people to ask if China will also be making payments like that to its citizens. Will they do it in Hubei? Today I saw that someone suggested that the government should distribute cash vouchers so that citizens would be able to purchase goods once the epidemic is over; this could also help get sales going again and maintain the vitality of the market; that would help us get back on track more quickly. From the message board it looked like a lot of people support this suggestion. I heard that in Wuhan there would be some special policies in place to help underprivileged groups and others who might need additional help. I just saw this news from the Office of Poverty Alleviation and Development: “In order to do our best to alleviate the economic burden that low-income families are facing due to the coronavirus, we have approved a one-time relief payment to benefit urban low-income families and urban and rural flexible workers whose employment has been impacted by the epidemic. One-time payments will be made at four times the average monthly salary rate (780 yuan/month in urban districts and 635 yuan/month in rural areas).” Compared with the payments being provided by other countries, this rate seems quite low; however, I suppose something is better than nothing. Moreover, perhaps there will be more to come?

At this point, hospitals are now gradually starting to reopen their normal departments. But I’m not sure if they are now already back to how they were before the outbreak began. But this is actually an extremely urgent task. In normal times, these hospitals are always brimming with patients. Yet for the past two months all those patients with urgent medical needs and chronic conditions have been putting off their care and waiting until the coronavirus situation is cleared up. But all this waiting comes at the price of damaging their own health. For instance, those cancer patients who interrupted their chemotherapy treatments due to the coronavirus—how are they doing? Those patients with scheduled surgery that needed to be delayed—will they still be able to get their surgery in time?

One of my friends forwarded me a letter written by someone recounting his sister’s experience. It said that his sister used to practice Tai Chi every day, but after more than 50 days stuck at home she ended up having a sudden stroke. They called 110, but no hospitals were initially able to take her; by the time they finally got her to a hospital, they were required to first test her for the novel coronavirus. By the time the test results came back to rule out coronavirus, that most critical window to save her life had already passed, and she died a week later. The letter writer said: “I need to get this out soon; on the one hand I need an outlet for all the sadness and anger inside me, but even more importantly, I need to warn those people in charge here in Wuhan how important it is to immediately resume normal hospital operations. Public transportation in Wuhan is all returning to order, but what about the hospitals; we need to take precautions against the virus but at the same time we also must get back to the normal order of things; if the hospitals don’t get back to normal there will be a lot of wrongful and unnecessary deaths in this city! My sister-in-law’s mother had cancer in her biliary duct, she was unable to eat, and couldn’t get any medical care; we called 110, and 120 numerous times, but no one picked up. She died of the pain on the second day of the Lunar New Year.” He continued, “I truly hate the fact that this coronavirus has been spreading throughout the city. And I hate the fact that the Wuhan Health Commission was not transparent early on and didn’t warn the public; think of how many innocent people died because of that. Before the quarantine, those useless leaders really had no idea how to deal with this crisis; now nearly two months into the quarantine and they still have absolutely no policy for how to help the large number of elderly residents suffering from chronic health conditions, cancer patients, and those dealing with the sudden onset of acute illnesses. The whole situation is really terrible!!!!” This is a direct quote and I have even preserved his punctuation marks.

Seeing people around you dying one after another is indeed a horrific experience. Right now the lack of treatment options for patients with chronic and acute illnesses has become a very real and pressing problem. I passed this issue off to my doctor friend to get his comments. I started off by asking him: “Is it true that all ordinary patients who go in to see a doctor need to have a blood test to first check whether or not they are positive for the novel coronavirus, and they can only register after that step?” My doctor friend responded: “We have implemented security measures for all non-coronavirus patients who come in for treatment; we have implemented security measures which include setting up special safeguard zones in every hospital. If there is a patient who is suspected of possibly carrying the coronavirus, we then admit them to a quarantine room; once we have ruled out coronavirus, they are then transferred to a room in the safeguard zone. Every patient has their nucleic acid level and antibodies checked and they undergo a chest CT scan. If a patient is accompanied by a family member, they will also need to have a chest CT and an antibody test to rule out coronavirus before being allowed to stay with them at the hospital. For patients suffering from myocardial infarction or strokes, our neurologists and cardiologists take them directly into the ER to administer lifesaving procedures and they do not wait for the results of those coronavirus screening tests.” A shame that the sister of the person who wrote that letter couldn’t hang on long enough.

Medical practitioners also have their own concerns; right now, as the coronavirus situation has not yet completely stabilized, there is still some uncertainty when it comes to which patients may or may not be coronavirus carriers; after all, after so many medical workers have been struck down by this virus, it is only natural for them to be traumatized and fearful. But there seems to be a deadlock here. My doctor friend explained it: “If we don’t rule out novel coronavirus in patients and admit them into the hospital, it could lead to other patients getting infected; so we have a huge responsibility here. If we aren’t careful, all that we have achieved with our 50-day lockdown could be wasted in a single day.” Now you see how serious this issue is.

My doctor friend is also worried that doctor–patient relationships are about to start getting tense due to increased cost burden on patients for all the extra tests. My friend says: “Why do you think the public is so happy with the treatment they have been receiving for the novel coronavirus? It’s because the government has been footing the bill. For a low-income family, 1,000 yuan is a huge expense. The cost for just those initial screening tests is close to 1,000 yuan and that doesn’t even mean that you will be admitted right away; this has resulted in a lot of anger toward those ER doctors working on the front lines. Right now all patients go through the ER for normal visits; the ER is basically functioning as an outpatient clinic; currently in the entire city of Wuhan you can only go through the normal medical insurance reimbursement plan if you are admitted to the hospital. When patients register at the ER, they are expected to pay up front and be reimbursed later. If the government were covering these costs up front, we wouldn’t have so many angry patients yelling at us. But when the patients are forced to foot the bill, the doctors are the ones who take the heat.” And then there is the problem of hospitals being understaffed, which is clearly an issue. “During the early stage of the coronavirus outbreak there were large numbers of medical caregivers who were infected and most of them are still recovering at home.”