by Fang Fang
Shouting slogans like “by any means necessary” is not based on good science.
Today it is cloudy and overcast but not too cold. Outside my window you can see signs of spring everywhere. I let my dog out to play in the courtyard; it has been a full month since he had a bath and is starting to get stinky. Unfortunately, the corner of his dog tub is cracked, so it can’t hold water anymore and the pet store is still closed so I can’t buy a new one. It is another annoying little item that I’ll have to deal with in the next couple of days.
My doctor friends keep sending me updates about the situation with the coronavirus. I decided to summarize what they told me, along with some reflections based on my own understanding of the main issues, into seven points:
The number of patients in Wuhan who have made a full recovery and been discharged from hospitals continues to increase. It is clear that as long as infections don’t turn critical, there is a very high rate of recovery. One of my classmates was just discharged from the hospital yesterday and has now checked into a hotel for a 14-day quarantine period. She is clearly feeling much better about her situation than before.
The number of people dying from the coronavirus is clearly starting to decline. This is excellent news. Humans are quite tough, after all. One girl I know who used to live across the street told me that her uncle just died. Before that, her aunt had also been taken by the coronavirus. That’s another two people in one family. I basically watched her grow up when she used to live by me. She told me that her aunt and uncle went to the hospital on the 30th, but since there were no cars or public transport available, they were forced to walk all the way there. Just thinking about that scene is almost too much to bear. At first she was too scared to tell her parents, since she knew how close her mother was to her uncle; she didn’t know how to break it to them. My god, after hearing so many stories like this, I’m really at a loss as to what I can say to console her. All the doctors are working so hard; they are really doing everything in their power, but we need to urge them to keep going in order to spare the world from even more heartbreak and pain.
For the past week the number of newly confirmed patients and suspected new cases has continued to fluctuate. I checked the numbers and yesterday there were 401 new confirmed cases of coronavirus in Wuhan. But the total number of new cases in Hubei Province, not counting Wuhan, was less than 40. Outside of Hubei Province, there were less than 10 new cases reported nationwide. That is to say, right now the coronavirus is more or less under control all over the country, with the exception of Wuhan. This brings me to something that I am still rather confused about. Everyone in Wuhan has been quarantined at home for the past month, so where are all these new patients coming from? I asked another one of my doctor friends for her take on this phenomenon. She feels that there are still some blind spots where there are even more unreported cases. For instance, no one anticipated there would be a huge spike in infections inside the prison system, nor did anyone anticipate the large number of infections in nursing homes. These are all places that were initially overlooked during the early stages of the outbreak. Moreover, both nursing homes and prisons have robust numbers of staff and workers, so when they go home each day, how many people are those staff members in contact with? I’m afraid that these may be sources for many of the infections. Besides this, there is also a floating population, and I’m sure that some of them must also be infected, but no one knows just how many. All these people are somewhat marginalized vis-à-vis mainstream society; however, when you add them all up, the total numbers are not at all insignificant. And then there is that fact that when the elderly get infected, unless they have severe symptoms, they cannot be admitted to those temporary hospitals (there is an age restriction), so that many of them never get into the hospital system. This is also a problem. The only thing to celebrate right now is the fact that almost all the new infections are mild cases, and they tend to have a very high recovery rate.
The availability of hospital beds has continued to improve. When I followed up about the issue of older patients’ being unable to get admitted into hospitals, my doctor friend said that now things have finally eased up and elderly patients with minor symptoms are now allowed to be admitted. Actually, I have heard from other sources that there are a lot of patients and their families who have been particularly picky about which hospitals they go to; there are only certain hospitals that they will even agree to be admitted to. Often they decide not to be admitted if they can’t get into the hospital of their choice. I figure that amid this novel coronavirus outbreak, the treatment you receive in all these hospitals must be fairly consistent? You should just get in where you can and start getting treatment first. If you put off treatment, you will have a much greater chance of getting worse; if you wait for a bed at your preferred hospital, you might not even be alive by the time you get in! So for all those people out there being picky about which hospital to go to, I would recommend just focusing on getting into any hospital you can get into; after all, it is your life at stake.
The outbreak in Wuhan is still not yet under control. (There are some people who don’t agree with this doctor’s views and think it is under control. But my doctor friend refuted that by asking, “Then where do you think these hundreds of new patients a day are coming from?”) Up until now, it has been very difficult to get to where we need to be. My doctor friend said that after several government officials were fired in Huanggang, their disease prevention measures have markedly improved and good measures are now properly in place. Huanggang is a poor region with a high population; due to its close proximity to Wuhan, medical personnel are able to go back and forth quickly, and they have been able to swiftly get a handle on the outbreak in Huanggang. Overall, Huanggang has done an excellent job in managing this outbreak. The national forces that were called in to provide support for Huanggang have already left the area for Luotian Hot Springs, which is basically announcing that they have emerged victorious against the coronavirus in Huanggang. This reminds me of a text I received this morning about Liu Xuerong’s “Five Firsts”: He was the first to expel the Municipal Director of the National Health Commission from office; he was the first to close districts, villages, and roads; he was the first to require all residents to have mandatory temperature checks; he was the first to have the police line up to salute and welcome medical teams and supplies that were coming into the city; and he was the first to send exhausted medical teams to Luotian Hot Springs Hotel and Resort for a much-needed two-week vacation to reward them for all their hard work. The name Liu Xuerong sounded quite familiar, but I couldn’t remember who he was. I searched him online and realized that he is a graduate of the Huazhong University of Science and Technology electrical engineering program and currently serves as the Huanggang Party Secretary.
After having the city of Wuhan under quarantine for such a long period of time, the people have been forced to put up with all kinds of inconveniences, which have really pushed us to the very limit. Yet the results have still been far from ideal. We need to immediately start trying to figure out just how those hundreds of new cases got infected. There is no way they have all been in incubation for a full month and suddenly now just started to show symptoms—they must have newly contracted the disease somewhere. A hundred new infections a day is not a small number; we should be paying a lot of attention to this! Further extending the lockdown long-term isn’t a solution, as it will lead to a chain reaction of other serious problems. We need to get to the bottom of these new infections and start quarantining people with laser-like precision. If we are able to quarantine everyone who falls into the four categories (confirmed cases, suspected cases, patients with a high fever, and close contacts of patients), everyone else should be safe and we can start restoring society to its normal functioning order. This entire section consists of comments from my doctor friend, relayed here, almost verbatim.
The first group of medical volunteers from outside Hubei has been working hard for more than a month,
and many of them have already reached their breaking point; they are now in desperate need of rest and reorganization. But where are the backup troops? There is no way the country will be able to send another 30,000 medical workers to relieve them! If we don’t get this outbreak under control soon, things will start to turn very dangerous. These are also comments taken word-for-word from my doctor friend.
I read a really interesting interview in Caijing magazine with Professor Wang Liming from Zhejiang University. Many of the ideas that Professor Wang expressed in this interview were quite smart and helped me understand some of the things I had been confused about. These are a few highlights from the interview:
As a scientist, it seems that conspiracy theories are taking over, to the point that they are now becoming a regular part of our world. The modern world is becoming increasingly complicated, and science and technology are becoming increasingly specialized and non-intuitive; it is getting to the point that your average person can no longer find their way in this confusing modern world.
Ever since the Enlightenment, humankind has felt that everything in the world is able to be understood through the existing framework of human knowledge. Of course, you can see this as the triumph of human knowledge, but it can also be seen as a sign of human arrogance.
When attempting to control this public health threat, we must first respect science and the opinion of specialists in the field; we must not let political motivations displace the guidance of specialists.
I want to again emphasize that, while it is wonderful that the nation has been funneling all its energy and resources to fight this outbreak, in the process of determining the problems that need to be addressed, and as we adjust our focus over the course of this struggle against the coronavirus, we must respect the principles of basic science. Shouting slogans like “by any means necessary” is not based on good science.
I think that at this stage of the outbreak, what we really need are infectious disease specialists who can help us analyze the unique characteristics of the novel coronavirus. We need them to look at how this virus differs from other infectious diseases and then make scientifically based predictions about how this virus will likely behave, moving forward, so that we can adjust our strategies for future containment. Our strategy for controlling this outbreak cannot be guided by haphazard decisions.
Since the outbreak of the novel coronavirus, tens of thousands of people have been infected, several thousand patients have died, and with that we have suffered economic losses totaling several hundred million yuan. During this time, we have not seen a single responsible party stand up and accept any of the blame for what has happened; no one has accepted even a portion of the blame, and no one has apologized to the people. It is as if everyone has silently accepted the fact that no one is to blame for any of this. During this period of struggle against the coronavirus, we need to be brave, and we need “positive strength.” Of course, it is correct that we shouldn’t only focus on the negative aspects of this, but we should also not forget where the responsibility falls and should use this to improve our system.
Today one of my classmates sent me a message, hoping that I might respond to a post online imploring the physician-husband of the recently deceased Dr. Xia Sisi to step back and stop treating patients on the front lines of the outbreak. According to my classmate: “We want to try to do something like they did in Saving Private Ryan. Someone responded by suggesting that we should establish something like the Sole Survivor Policy that the United States enacted after the five Sullivan brothers were all killed in action during World War II. Perhaps if you can say something about this in your diary, you can help prevent other doctor families from suffering multiple losses on the front lines of this epidemic.”
I completely understand the thoughtfulness and kindness behind this request; however, I’m not entirely in favor of this appeal. First, I feel we need to respect the wishes of Xia Sisi’s husband; only he can decide whether or not he wants to go to the front lines; second, Xia Sisi was infected early on, before we knew that the novel coronavirus was contagious and before medical personnel were wearing proper protective gear. Back then, many doctors were, in fact, not taking any special precautions when dealing with patients. Things are very different now; medical personnel are fully equipped with protective gear, and there is now a very low rate of infection among doctors and nurses; and third, there isn’t a hospital out there that is not part of the front line. Although that is not to say that everyone needs to have direct contact with coronavirus patients. And so I feel that perhaps it is best if Xia Sisi’s husband tries to carry on with his normal routine, whether that means going to work at the hospital or taking some time off to deal with his loss.
February 27, 2020
That’s right; there is nothing better than staying alive.
Overcast again with a chill in the air, although it really isn’t that cold. If you were to go outside and look up, you’d discover that the absence of the sun leaves the sky feeling dark and gloomy.
The diary post that I uploaded yesterday on WeChat got deleted again. It was also blocked on Weibo. I thought my account might be completely blocked, but I tested it and figured out that they had only blocked that one entry, but I was still able to send out other messages. I suppose I should be happy about that. My god, I have grown so apprehensive that I’m not even sure what to say anymore. It feels like I can’t say anything. Fighting the coronavirus is the most important task before us; we should all be doing everything in our power to cooperate with the government and follow its lead. Do I really need to shake my first in the air and swear my allegiance to the cause? Will that be enough?
Here we are still locked up in our homes, unable even to set foot outside the door, yet others have already begun to chant victory songs about how we vanquished this outbreak! I even saw an image of a book cover of a new publication about how we emerged victorious over the coronavirus (I’m not sure if that cover was real or a parody)! What can the people of Wuhan say? No matter how anxious or restless we may be, we have no choice but to bear it, no? Victory will be shared by all. Today I saw another meme online: When you hear people say, “We will sacrifice everything at any cost,” don’t misunderstand “we” as meaning “us”—you are actually the “cost.”
What’s the point of saying anything else? We just have to wait. We need to try to remain calm and steady and just wait. To borrow my big brother’s way of describing it in simple language: “It’s boring as hell, but you have no choice but just stay home and binge-watch TV miniseries to help pass the time.”
Today my doctor friend told me that quite a few patients have just been released from the hospitals. So far, more than 2,000 patients have recovered; mild cases are fairly easy to treat. There are now quite a few hospital beds available. The number of patients dying has also dropped considerably. I looked up the figures and discovered that during the previous couple of days there were around a hundred deaths each day, but yesterday that number dropped to 29. How I hope we can get that number down to zero soon! Then all those anxious and worried families will finally be able to rest easy again. As long as we can stay alive, everything else can be figured out later. If it takes longer to treat people, it’s okay; take your time, we can handle the wait. I just watched an episode of Southern City News that profiled the process of a doctor trying to save a coronavirus patient. The episode included interview footage with both the doctor and the patient, and it was quite moving. The patient who survived said that he needed to rely on his own willpower, along with the faith his doctor had in him to get through it. Another patient said that after surviving this entire journey he feels that he will now treasure each and every day that lies ahead. That’s right; there is nothing better than staying alive.
What continues to stump people is the continuing high numbers of new infections that we are still seeing, which has left Wuhan in something of a stalemate position with the virus. Just yesterday the number of new and probable infections was u
p to 900. This is not the result we have been looking for. All these people must have gotten infected after the citywide quarantine went into effect. We need to know who these people are, where they live, the circumstances of how they got infected; it would be good if the coronavirus report that comes out every day could include more details like this. If some of these details were made public, perhaps others would be better able to protect themselves. Also, based on location, perhaps the government could start relaxing the quarantine for areas located far away from the hot spots. Another doctor friend of mine feels that the coronavirus outbreak is already under control; almost all the new cases are confined to jails and nursing homes. If that’s the case, then how come so many people still need to be quarantined to their homes? Perhaps we’ll be getting some good news soon? But that is just a hopeful guess!
From the perspective of infectious diseases, 900 is a fairly large number, but when you look at it in relation to a population of tens of millions of people who live in Hubei Province, it is just a tiny fraction. But this tiny fraction of the population is holding tens of millions of healthy people hostage in their own homes; when you think about it like that, who wouldn’t be upset? And what will those healthy people be facing down the road? Will the price they have to pay be even greater? I can’t say for sure.
And then there are those five million people from Wuhan who are stuck outside the city unable to return home; I wonder how they have been getting through all this. They faced a lot of prejudice early on; I wonder if that has improved at all? There are also those people from other provinces working in Wuhan who are stuck here and unable to get out of the city. I saw a report the other day about some of them who don’t have enough money for a hotel or simply couldn’t find a hotel and ended up sleeping in the train station. Others don’t have enough to eat and end up going through the garbage and eating other people’s leftovers. Those people in change of steering the ship often neglect these small details; those in charge of looking after the majority often overlook those more marginalized individuals. One good bit of news was that I did later see a report about a “help hotline for individuals from out of town stuck in Wuhan during the coronavirus outbreak.” Each district has its own hotline for people to call. I just don’t know if when you call, those hotline operators really have the power to help these people out. I know that a lot of those types of hotlines are only set up as a show to make the political leaders look good. If you actually call these numbers, you’ll find they are basically useless. Just give it a try. If you call, you’ll just get the runaround, but no real help; in the end you’ll just waste the price of the phone call. The world of officialdom is filled with people who have never learned a damn thing in their entire lives, but one thing they have mastered is the art of putting on a show; and they have ways to deal with you that you would have never imagined even existed. Their ability to shirk responsibility is also second to none; if they didn’t have a good foundation in all these worthless skills, this outbreak would have never grown into the large-scale calamity that it is today.