“There was no time. I had to take action”
In early January, while the western world recovered from New Year’s Eve celebrations and embarked on 2020 with high spirits, people began arriving in the hospitals of Wuhan complaining of a persistent cough and fever. Li Wenliang, an ophthalmologist, had tried to warn colleagues in December that a viral outbreak seemed to be underway but he was swiftly reprimanded by police and forced to sign a letter agreeing to keep his mouth shut. “I understand, I can,” he wrote.
But new patients continued to arrive and the hospitals had been filling up for weeks when the national Commission of Health finally announced on 20th January that the virus was being transmitted from human to human. Doctors in Wuhan were called on to prepare for an epidemic.
To neurologist Dr Zhang Junjian, the disease sounded like the SARS virus which had flared up in China’s southern Guangdong province in 2002 and gone on to affect people in 26 countries. “I experienced the SARS outbreak and, in my personal view, this was [similar] a pneumonia caused by a respiratory disease,” says Zhang. He continues wearing a facemask, even after the epidemic has died down in China. Above the mask, his eyes look grim. “There is no magical treatment. But it was possible to control it.”
Zhang is vice president of the Zhongnan Hospital, one of the largest medical facilities in Wuhan, a Chinese city in the central province of Hubei with a population of 11 million. At the local clinics he administers he started training doctors in how to isolate patients and encouraging them to build up supplies of protective equipment. The disease rapidly disrupted all other hospital business. Complaints came from cancer patients missing their chemotherapy and scheduled operations were postponed.
At the time the news came out about human to human transmission of the virus, 17 people had died and almost 600 had been infected. “Don’t come back to Wuhan,” Zhang advised his son, who works in Shanghai and was about to return home for Spring Festival, the Chinese holiday celebrating the beginning of a new year. The next day, in a sharp turn in national policy, the city was closed off. Planes were grounded and trains were no longer allowed to leave the station.
Wuhan became a black hole. A dark, gloomy image emerged via social media, bloggers and the few journalists who decided to stay. Public transport ceased to operate and private cars were banned from the street, meaning people often had to walk several kilometres to reach a hospital. Due to a shortage of beds many of those trips were in vain.
“With the basic instinct of a doctor I was looking for a cure, a treatment for patients suffering from the virus… But there was no cure”
Some elderly Wuhan residents were refused entry by petrified hospital guards, some victims collapsed and died before getting inside. Bloggers like Chen Qiushi, a lawyer and citizen journalist who had travelled to Wuhan to bear witness, published images of patients who had succumbed to the virus and were being taken away in body bags. The outside world was confused. Wasn’t the coronavirus just a type of flu? Why were people becoming so badly ill?
Mortal fear took hold of Wuhan. It wasn’t clear how long the virus stayed alive when it floated in the air or settled on a surface. Wuhan residents hid themselves away. Most people who went outside, however briefly, wrapped themselves in a raincoat with hoodie, plastic gloves, plastic boots, facemask and goggles. When returning home a family member would spray them down with an alcohol solution.
Zhang’s wife, a teacher, was anxious: the neighbourhood they live in is home to many hospital employees, and more than 100 people had become infected. She decided to stay away from her husband and self-isolate elsewhere. “Several of my colleagues died,” says Zhang. “With the basic instinct of a doctor I was looking for a cure, a treatment for patients suffering from the virus… But there was no cure.”
Local clinics had tried to prepare for the outbreak, as Zhang and other doctors had instructed. “But the mistake was that their beds were not meant for isolation,” he says. “Patients were sent away, back home into society. It led to them spreading the virus.” Field hospitals would have to correct that mistake. On 2nd February, the authorities introduced a policy that anyone who had symptoms or had been in contact with someone infected with coronavirus would be isolated from their healthy family members.
Zhang got the call on the evening of 3rd February. To comply with the new policy, the local government assigned him the construction of a field hospital in the Dongxihu district. It was up to him to make sure that those who had become infected locally could not contaminate others.
There was no blueprint. Zhang had to come up with everything himself and he had no idea where to start. He raced around consulting designers, medical experts and engineers. Between them they worked out how to isolate thousands of people from the outside world. Builders worked around the clock and improvements were made as they went along. Zhang worked for four days and nights straight to turn the Wuhan Reception Hall, a convention centre that in happier times served as a concert stage, into a field hospital with 2,000 beds. “There was no time. I had to take action,” says Zhang.
There were three parts to the new emergency hospital. The first was the ‘clean district’, for those testing negative for the virus. The second was the ‘infectious district’ that housed the patients with Covid-19 and the staff that cared for them. The third was the ‘transitional district’, a series of winding corridors set up to bring people from one area to the other. Fitting room mirrors were set up at each corner to help people avoid bumping into each other.
Zhang dreaded the reaction of the new arrivals. The convention centre didn’t exactly have a cosy feel. His staff placed barriers between rows of steel beds, and between each bed they set up a desk with a plastic box for storing personal items. Gigantic Chinese flags were hung up on the barriers to help raise morale.
On 7th February, the field hospital let in its first patients. On the same day it was announced that Li Wenliang had died of Covid-19. His death was greeted with anger, sadness and desperation across the country. Young people wrote ‘bu mingbai, bu neng’ – ‘I don’t understand, I can’t’ – on their facemasks. It was also on that day that Chen Qiushi’s mother was told by authorities that her son had been detained in an undisclosed location for quarantine.
Inside the hospital, meanwhile, there was a whirlwind of activity. Family members were assigned beds next to each other. Staff members danced with the patients in the spaces between the sleeping areas: simple routines to simple songs, but with the dance leader dressed in a hazmat suit.
Patients wrote thank you notes to the staff and folded flowers from coloured paper. “Singing and dancing brings us joy and calm,” wrote Yue Xielin. “We are patients suffering with trauma from the virus, the medical staff allows us to see the sun and have hope. The virus is ruthless, but there is love on earth. Keep up, Wuhan, keep up, China!”
Zhang noticed that it gave patients comfort to know that the doctors keeping an eye on them had come to Wuhan from the best hospitals in China. In all, 21 medical teams with 1,200 medical staff had been sent to the city to help out.
Zhang ran his organisation from a tent in front of the convention hall. His day consisted of training doctors and setting up an organisational structure. He placed endless calls to secure medical material and protective equipment. “We used gear [made] for everyday use, not the medical level. We felt nervous for lacking this, because we really knew little of this virus,” he says.
At times he felt bad for being strict and snapping at his staff, but it was crucial that people listen to him. “I’m a doctor, an expert. I see what goes on. Later they will understand me”, he told himself. He was proud of the faith that the police, the volunteers and the medical staff put in him.
Patients generally stayed between two and three weeks in the temporary hospital, during which time they were closely monitored. Sometimes they were given the anti-malarial drug chloroquine, even though Zhang didn’t see much effect from it. He was careful in prescribing it, because of the potential side effects. Other patients reacted well to Chinese medicine, or were given psychological help. Only when they had tested negative for the virus twice and registered a week without fever or lung problems were people allowed to leave. They then still had to be quarantined in a special hotel for another two weeks.
The Wuhan doctors had expected the impact of the virus to be similar to SARS. “But as time went by, we learned that the virus spreads a lot faster and is a lot more severe than SARS,” says Zhang. “There were many more coronavirus patients in a grave state.”
Infections in China began to fall in mid February but it was only when Zhang’s field hospital in Wuhan was closed, on 8th March, that he had time to take stock. None of the patients had died and none of the medical staff had been infected. Only five percent of the patients with light symptoms had turned into more serious cases. They were quickly transferred to the Jinyintan Hospital across the road where they were put on a ventilator. The officially-reported death toll from Covid-19 in China as of mid June stands at 4,645, with 97 percent of those recorded in Hubei province.
Zhang is proud to have been part of an operation that he believes helped to save lives, albeit by depriving some people of their freedom. “Human beings have different values, but the coronavirus is our common enemy,” he says as he guides me and other visitors through the now-abandoned convention centre. One month after his field hospital closed, the city of Wuhan opened up again. The hospital has been disinfected but hasn’t been dismantled just yet. Wuhan is ready for a possible second wave of infections.
In May, the Communist Party announced that the coronavirus was under control. In order to dispel tensions over Li Wenliang’s death, it crowned him a martyr. The public was allowed to openly discuss Dr Li’s heroic actions, responsibility for his silencing was placed firmly at the feet of the local police and the government in Beijing regained control over the story. Chen Qiushi, meanwhile, has still not been released.
It frustrates Zhang that the suffering of Wuhan was not considered sufficient warning for the rest of the world. “In the beginning no one knew about it, and it allowed the virus to spread quickly. The lockdown, wearing facemasks, testing, contact tracing… all of these methods are based on knowledge of the virus. However, American and European experts, humans like we are, didn’t want to use the same methods. A month or even longer after Wuhan they were still against isolation, against masks, against social distancing,” Zhang says with regret.
“Rule number one is isolation, isolation, and again: isolation,” he says. “And testing, testing, testing.” He fears experts in other countries didn’t trust the research and experience of Chinese medical professionals like himself. “Many people died, and as a doctor I felt sad,” he says. “We all pay for this prejudice.”
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