[LINK] O/T Coronavirus .. in the beginning?

[Stephen Loosley]

https://terminus2049.github.io/archive/2020/03/10/fa-shao-zi-de-ren.html   (see ‘For information’ below)

Whistleblower

2020-03-10 Coronavirus disease
Original text from: Whistleblower
Author: People reporter (Translated from Chinese by Google)


Last December 16th, our Nanjing Road Hospital Emergency Department in Wuhan received a patient. Inexplicably high fever, medication is no good, high body temperature does not move. On the 22nd, he was transferred to the Department of Respiratory Medicine, where we performed a fiberoptic bronchoscope to take the alveolar lavage fluid and sent it outside for high-throughput sequencing.

Later, it was reported orally as a coronavirus. At that time, the colleague for the specific tubes bed chewed in my ear several times that a person had reported the coronavirus.

Later we learned that the patient was working in South China Seafood.

Immediately on December 27, another patient came to the Nanjing Road Campus, a nephew of a doctor in our department. He was in his 40s and had no underlying disease. The lungs were in a mess. The blood oxygen saturation was only 90%. The hospital has been in treatment for almost 10 days and there has been no improvement. The patient received a hospital stay in the respiratory care unit. The fiber bronchoscope was also taken and the alveolar lavage fluid was taken for testing.

At noon on December 30, my classmates working in Tongji Hospital sent me a screenshot of the WeChat dialogue. The screenshot reads: "Don't go to South China recently, there are many people with high fever ..." He asked me if it was true. Yes, at the time, I was looking at the CT of a very typical patient with lung infection on the computer. I just passed an 11-second video of the CT to him and told him that it was a patient who came to our emergency department in the morning and was also in South China Seafood market.

Just after 4 pm that day, my colleague showed me a report that said: SARS coronavirus, Pseudomonas aeruginosa, 46 oral / respiratory colonization bacteria. I have carefully read the report many times, and the following note reads: SARS coronavirus is a single-stranded positive-strand RNA virus. The main mode of transmission of the virus is close-range droplet transmission or contact with patient's respiratory secretions. It can cause a kind of special infectious pneumonia that is obviously contagious and can involve multiple organ systems. It is also called atypical pneumonia.

At that time, I was scared out of cold sweat, this is a terrible thing. The patient was admitted to the Department of Respiratory Medicine. It should be reported to the Department of Respiratory Medicine, but for the sake of insurance and attention, I immediately called the report to the Department of Public Health and the Department of Sense of Hospital. At that time, the director of the respiratory department of our hospital happened to pass by my door. He was a person who had participated in SARS. I caught him and said, "We have a patient who received your department and found this thing." He said at first glance that it would be troublesome. I knew it was trouble.

After calling the hospital, I also passed on this report to my classmates, specifically drawing a red circle on the words "SARS coronavirus, Pseudomonas aeruginosa, 46 oral / respiratory colonization bacteria" for the purpose of It is to remind him to pay attention to it. I also sent the report to the group of department doctors to remind everyone to take precautions.

That night, this thing was spread all over. The screenshots that were circulated everywhere were the photos I painted in the red circle, including the one that I later learned that Li Wenliang passed on in the group. At that time, I thought it might be a bad thing. At 10:20, the hospital sent a message, which was transferred to the Municipal Health and Welfare Committee. The main idea was about unexplained pneumonia. Do not arbitrarily publish it to avoid causing panic among the masses. If the panic is caused by information leaks, you should be held accountable.

I was very scared at the time, and immediately passed this message to my classmates. About an hour later, the hospital came with another notice, re-emphasizing that relevant news in the group could not be passed out. One day later, at 11:46 pm on January 1, the chief of the hospital's supervision department sent me a message to let me pass the next morning.

I didn't fall asleep that night. I was worried and thought over and over, but I felt that there were always two sides to everything. Even if it caused an adverse effect, it was not necessarily a bad thing to remind medical staff in Wuhan to take precautions. The next morning was a little more than 8 o'clock. Before I finished my shift, I urged me to call in the past.

After the interview, I suffered unprecedented and very severe rebuke.

At that time, the leader of the conversation said, "We can’t hold our heads up when we go out for a meeting. Director XX criticized the Effen in our hospital. As the director of the emergency department of Wuhan Central Hospital, you are a professional. How can you be a student without rules and discipline? " This is the original words. Let me go back and communicate with the more than 200 people in the department one by one orally. We can't send WeChat or SMS messages. We can only chat or call in person, not to say anything about this pneumonia. ...

I was ashamed all at once. He didn't criticize you for not working hard, but it seemed that the great situation of the development of Wuhan was destroyed by me. I had a very hopeless feeling at that time. I am a person who is serious and diligent at work. I feel that everything I do is done in accordance with the rules and it makes sense. What have I done wrong? I saw this report, and I also reported it to the hospital. My classmates and I exchanged information about a patient's situation without revealing any private information about the patient, which is equivalent to discussing a medical case between medical students. As a clinical doctor, you already know that a very important virus has been found in patients. If other doctors ask, how can you not say it? This is your instinct to be a doctor, right? What am I doing wrong? I did what a doctor and a person should normally do, in exchange for anyone I think would do it.

I was also very emotional at the time, saying that I did this thing, and it had nothing to do with the rest of you. You just took me to jail. I said that I am not suitable for continuing to work in this position and I want to take a break. The leader did not agree, saying this is the time to test me.

When I came home that evening, I remember quite clearly. After I entered the door, I told my husband that if something happened to me, you would take the children well. Because my second treasure is still very young, I was just over 1 year old. He felt inexplicable at the time, and I didn't tell him that he was being disciplined. On January 20th, after Zhong Nanshan talked about people from person to person, I told him what happened that day. During that time, I just reminded my family not to go to crowded places and wear masks when going out.

Peripheral department

Many people worry that I am also one of those 8 people called to admonish. Actually, I was not admonished by the Public Security Bureau. Later, a good friend asked me, are you a whistleblower? I said that I am not a whistleblower, I am the whistleblower.

But that interview hit me very hard, very big. After I came back, I felt that the whole person's heart was broken. I was really struggling and doing things seriously. Later, when all the people came to ask me again, I couldn't answer.

All I can do is make the emergency department attach importance to protection. We have more than 200 people in the emergency department. From January 1st, I asked everyone to strengthen protection. All people must wear masks, hats, and fast elimination with their hands. I remember one day when a male nurse didn't wear a mask during the shift, I immediately scolded him on the spot "Don't come to work without wearing a mask in the future."

On January 9th, when I was off duty, I saw a patient coughing at everyone on the pre-screening desk. From that day on, I asked them to send a mask to the patient who came to see the doctor. No one has passed on, and I want to emphasize that wearing masks to strengthen protection is very contradictory.

That period of time was really depressing and very painful. Some doctors suggested that the gown should be worn outside. The hospital said in a meeting that the gown would cause panic. I let the people in the department wear the isolation suit in a white coat, which is not in line with the norms and is ridiculous.

We watched as there were more and more patients, and the radius of the spreading area became larger and larger.

First, the South China Seafood Market may be related to it, and then it spread that the radius is getting larger and larger. Many are transmitted by the family. Among the first 7 people, there is the disease that the mother gave the son a meal. The boss of a clinic got sick, and the patient who came to get the injection was passed on to him. I knew there must be someone passing on. If there is no succession, the South China Seafood Market will be closed on January 1st. How come there will be more and more patients?

Many times I was thinking, if they did not reprimand me like that, calmly asked about the ins and outs of this matter, and then asked other respiratory experts to communicate together, maybe the situation will be better, at least I can communicate more inside the hospital a bit. If everyone was so vigilant on January 1, there wouldn't be so many tragedies.

On the afternoon of January 3, in the Nanjing Road Campus, urology doctors gathered to review the work history of the old director. Dr. Hu Weifeng, who was 43 years old, is now in rescue; on the afternoon of January 8, Nanjing Road Campus On the 22nd floor, Director Jiang Xueqing also organized a rehabilitation party for patients with breast milk in Wuhan; on the morning of January 11th, the department reported to me that Hu Ziwei, a nurse in the emergency department, was infected. Called the Chief of the Medical Services Department for a report as soon as possible, and then the hospital held an emergency meeting, instructing to change the report of "two lung infections, viral pneumonia?" To "Two lungs scattered infection"; At a weekly meeting, a deputy dean was still saying: "Everyone must have a little medical knowledge. Some senior doctors should not make themselves scared to death." Another leader went on stage and continued: " There is no one to pass on, and it can be prevented, treated, and controlled. "One day later, on January 17, Jiang Xueqing was hospitalized. After 10 days, he was intubated and enrolled in ECMO.

The cost of the central hospital is so great that it is because our medical staff has no transparency in information. You see the fallen person, the emergency department and the respiratory department are not so heavy, because we have a sense of protection, and quickly rest and treat as soon as we get sick. The most important ones are peripheral departments, Li Wenliang is an ophthalmologist, and Jiang Xueqing is a nail specialist.

Jiang Xueqing is really a very good person, with high medical skills, and one of the two Chinese physician awards in the whole hospital. And we are neighbors. We live in a unit. I live on the 40th floor and he lives on the 30th floor. The relationship is very good. But because I am too busy at work, I can only meet when I have a meeting or a hospital event. He is a workaholic, either in the operating room or in the outpatient clinic. No one will deliberately run to tell him, Director Jiang, you should pay attention and wear a mask. He also didn't have time and energy to inquire about these things, he must have been careless: "What does it matter? It's pneumonia." This is what the people in their department told me.

If these doctors can get timely reminders, perhaps there will be no such day. Therefore, I am very regretful as a person concerned. I knew that today, I would n’t criticize him or not. "Laozi" said everywhere, right?

Although I was in the same hospital as Li Wenliang, I didn't recognize him until my death, because the hospital had more than 4,000 people and was usually busy. The night before his death, the director of the ICU called me to borrow a cardiac press from the emergency department and said that Li Wenliang was going to be rescued. I was shocked at the news. I did n’t understand the whole process of Li Wenliang, but his condition was affected by him. Does it matter if I feel bad after the reprimand? I have to put a question mark here, because I feel the same as being trained.

Later, when things developed to this point, it proved that Li Wenliang was right. I can understand his mood very well. It may be the same as my mood. It is not excitement and joy, but regret, which should continue to scream out at the beginning. When people ask us, continue to say. I have been thinking many and many times, how good it would be if time could come back.

Alive is good

On the night before the closure of the city on January 23, a friend from a related department called me to ask me the real situation of emergency patients in Wuhan. I said that you represent private or public. He said that I represent private. Let me tell you the truth on behalf of an individual. On January 21st, our emergency department received 1,523 patients, which was three times the usual maximum. Among them, 655 had a fever.

At that time, the situation of the emergency department will never be forgotten by people who have experienced it, and will even subvert all your views on life.

If this is a war, the emergency department is at the forefront. However, the situation at that time was that the subsequent wards were saturated. Basically, none of the patients were admitted, and the ICU also refused to accept it, saying that there were clean patients in it, and they were contaminated as soon as they entered. The patients kept going to the emergency department, and the road behind them was blocked, so they were all piled up in the emergency department. The patients came to see the doctor. It took a few hours to wait in line. We couldn't get off work at all. There was no distinction between hot clinics and emergency clinics. The hall was full of patients, and the emergency room was filled with patients everywhere.

Some family members of the patients came and said that they wanted a bed. My dad couldn’t do it in the car because the underground garage was closed at that time, and his car was blocked. I couldn't help it. I ran into the car with people and equipment. At first glance, people are dead. What do you think it is? The man died in the car, and there was no chance of getting off.

There is also an old man whose wife just passed away at Jinyintan Hospital. Her son and daughter were infected. She was getting an injection. Her son-in-law was taking care of her. As soon as I saw that she was very ill, I contacted the respiratory department for admission. At first glance, her son-in-law was an educated and qualitative person, and came over and told me to thank the doctor and so on. As a result, he died. Thank you for a few seconds, but it also took a few seconds. This sentence of thankfulness weighs on me.

When many people send their family members to the guardianship room, it is the last side they see, and you will never see them.

I remember in the morning of New Year's Eve I came to hand in shifts. I said we would take a photo to commemorate this New Year's Eve and sent a circle of friends. That day, no one said anything about blessings. At this time, being alive is good.

In the past, if you made a mistake, for example, if you did not get the injection in time, the patient may still go to trouble. Now no one is there, no one is arguing with you, no one is making trouble with you, everyone is struck by this sudden blow It's confusing.

The patient died, and rarely saw family members crying very sadly because there were too many, too many. Some family members will not say that the doctor begged you to save my family, but told the doctor, "Ah, let's get rid of it quickly, it has reached this point." Because at this time everyone is afraid of being infected.

The queue at the entrance of the hot clinic every day needs to be queued for 5 hours. A woman was standing in a row and fell down. She was wearing a leather jacket, carrying a bag, and wearing high heels. She should be a very elegant middle-aged woman, but no one dared to come forward to help her and lay on the ground for a long time. I had to call nurses and doctors to help her.

I came to work in the morning on January 30. The son of a white-haired old man died at the age of 32. He stared at the doctor and gave him a death certificate. No tears at all, why cry? There is no way to cry. Looking at his dress, it may be a foreign worker, there is no channel to reflect. Without a diagnosis, his son becomes a death certificate.

This is what I want to call for. The patients who died in the emergency department were all cases that were not diagnosed and could not be diagnosed. After this epidemic has passed, I hope to give them an explanation and give some comfort to their families. Our patients are very pitiful, very pitiful.

After being a doctor for so many years, I have always felt that there is no difficulty that can knock me down. This is also related to my experience and personality.

My father died of stomach cancer when he was 9 years old. At that time, I thought about growing up to be a doctor to save someone's life. Later, during the college entrance examination, all my volunteers were filled with medical majors, and I finally passed the Tongji Medical College. After graduating from university in 1997, I arrived at the Central Hospital. Before that, I worked in cardiovascular medicine. In 2010, I became the director of the emergency department.

I think the emergency department is just like one of my children. I made it so big that it made it difficult for everyone to unite and make this situation, so I cherish it very much and cherish this group very much.

A few days ago, one of my nurses sent a circle of friends and said, I miss the busy busy emergency department before. That kind of busyness and this kind of busyness are completely two concepts.

Before this epidemic, myocardial infarction, cerebral infarction, gastrointestinal bleeding, trauma, etc. were the scope of our emergency department. That kind of busyness has a sense of accomplishment. It has a clear purpose. It has a smooth process for various types of patients. It is very mature. What to do next, how to do it, and which one to go if there is a problem. This time, there were so many critically ill patients unable to deal with it, unable to accept hospitalization, and our medical staff were still at this risk. This busyness was really helpless and very sad.

One day at 8 o'clock in the morning, a young doctor in our department sent me a WeChat message, and he was also quite characterful, saying that I would not come to work today and was uncomfortable. Because we all have rules here, if you are uncomfortable, you must tell me in advance to make arrangements. You will tell me at 8 o'clock where I will go to find someone. He lost his temper in WeChat and said that a large number of highly suspected cases were put back into society by the emergency department led by you. We are doing evil! I understand that he is because of the doctor's conscience, but I am also anxious. I said you can sue me. If you are the director of the emergency department, what should you do?

Later, after a few days of rest, the doctor still came to work. He did not say that he was afraid of death or tiredness, but that he was in such a situation, and he was very disappointed to face so many patients at once.

As a doctor, especially many doctors who come to support later, they can't stand it psychologically. When this happens, some doctors and nurses cry. One is crying for others, and the other is crying for himself, because everyone does not know when it is their turn to infect.

Around mid-to-late January, the hospital leaders fell ill one after another, including the director of our door office and three deputy deans. The daughter of the chief of the medical department is also ill, and he is also resting at home. So basically, no one was in charge of you for a while, you just fight there, that's the feeling.

The people around me also started to fall one by one. On January 18th, at 8:30 in the morning, the first doctor we fell, he said that the director I was recruited, without burning, only CT, a large ground glass in the lungs. After a while, a responsible nurse in charge of the isolation ward told me that he also fell. At night, our head nurse also fell. My very real first feeling at the time was-fortunately, because it fell early and I could get off the battlefield earlier.

I have been in close contact with these three people. I just work every day with the belief that I will fall down. Everyone in the hospital thought I was a miracle. I analyzed it myself, probably because I have asthma, and using some inhaled hormones may inhibit the deposition of these viruses in the lungs.

I always think that those of us who are in emergency department are considered to be people with feelings. In Chinese hospitals, the status of emergency department should be relatively low among all departments, because everyone thinks that emergency department is nothing more than a passageway. Too. In this anti-epidemic, this neglect has always existed.

In the early days, the supplies were insufficient. Sometimes the quality of the protective clothing assigned to the emergency department was very poor. I was very angry when I saw our nurse wearing this kind of clothing to work. I was angry at Zhou Huiqun. Afterwards, many directors gave me the clothes hidden in their own departments.

There is also the problem of eating. When there are many patients, the management is chaotic. They simply do n’t think that the emergency department still has something to eat. Many departments have food and drink after work. "We only have diapers in the emergency department ..." We were fighting on the front line, and the result was this, sometimes we were really angry.

Our collective is really good. Everyone gets off the line only when they are sick. This time, more than 40 people in our emergency department were infected. I built a group of all sick people, originally called the "emergency sick group", the head nurse said unlucky, and changed to "emergency cheering group". Even those who are sick do not have a very sad, desperate, or complaining attitude. They are all very positive, that is, everyone helps each other and spends the difficult time together.

These children and young people are very good, just follow me wronged. I also hope that after the outbreak, the state will increase its investment in emergency departments. In many countries' medical systems, the emergency department is highly valued.

Unattainable happiness

On February 17th, I received a WeChat message sent to me by a classmate from Tongji Hospital. He said "I'm sorry" to me. I said: Fortunately, you have spread the word and reminded some people in time. If he didn't pass it on, he might not have Li Wenliang, the 8 of them, and even fewer people would know.

This time, we had three female doctors infected the whole family. The father-in-law and mother-in-law of two female doctors plus her husband are infected, and the father, mother, elder sister and husband of a female doctor plus five of her own infection. Everyone thinks that the virus was discovered so early, but the result is this, causing such a large loss, the cost is too great.

This price is reflected in all aspects. In addition to those who died, the sick are also suffering.

In our "emergency gas station", people often communicate their physical conditions. Some people ask that the heart rate is always 120 beats / min. Does it matter? That must be important, and it makes me panicked as soon as I move. This will have an impact on their life. This is hard to say. In the future, others may go hiking and travel, and they may not be able to do that. It is all possible.

And Wuhan. You said that our Wuhan is a very lively place, and now it is quiet along the way, many things can't be bought, and it has been supported by the whole country. A few days ago, a nurse from a medical team in Guangxi suddenly fell into a coma while working, and rescued. Later, when the heart beat, he was still in a coma. If she doesn't come, she can live well at home without accidents. So, I think we owe everyone a favor, really.

Having experienced this epidemic has hit many people in the hospital very hard. Several medical staff below me have the idea of ??resignation, including some backbones. Everyone's previous ideas and common sense about this profession are inevitably a little shaken-is it that you work so hard, right? Just like Jiang Xueqing, he works too hard and treats his patients too well. He performs surgery every New Year and Chinese New Year. Today someone sent a WeChat written by Jiang Xueqing's daughter, saying that her father's time was all given to the patient.

I have thought about it countless times myself, haven't I returned home to be a housewife? After the epidemic, I basically didn't go home and lived outside with my husband, and my sister helped me take care of the children at home. My Erbao didn't recognize me anymore. He didn't feel it when I watched the video. I was very lost. It was not easy for me to give birth to this second child. When he was born, he had 10 kg. I had gestational diabetes. , Weaned this time too-I was a little sad when I made this decision. My husband told me that he said that a person can encounter such a thing in his life, and you are not only a participant, you also have to Bringing a team to fight this battle is also a very meaningful thing. It will be a very valuable experience for everyone to remember when everything is normal in the future.

In the morning of February 21st, the leader talked to me. Actually, I want to ask a few questions. For example, do you think I was wrong in criticizing that day? I hope to give me an apology. But I dare not ask. No one said sorry to me on any occasion. But I still think that this time it is more clear that everyone still has to stick to their own independent thinking, because if someone wants to speak the truth, there must be someone, and the world must have different voices, right?

As a Wuhan citizen, which of us does not love our city? We now recall how extravagant happiness we had in the most ordinary life before. I now feel that holding the baby, accompany him to go out to play a slide or go out to watch a movie with her husband, it used to be normal, but now it is a kind of happiness, and it is all unattainable happiness.



For information:

“Chinese internet users who uploaded coronavirus memories to GitHub have been arrested”

2 hours ago  By Jane Li, China tech reporter
https://qz.com/1846277/china-arrests-users-behind-github-coronavirus-memories-page/

A group of volunteers in China who worked to prevent digital records of the coronavirus outbreak from being scrubbed by censors are now targets of a crackdown.

Cai Wei, a Beijing-based man who participated in one such project on GitHub, the software development website, was arrested together with his girlfriend by Beijing police on April 19. The couple were accused of “picking quarrels and provoking trouble,” a commonly used charge against dissidents in China.

On April 24, the couple’s families received a police notice that informed them of the charge, and said the two have been put under “residential surveillance at a designated place.” There is still no information about Chen Mei.It is unclear whether the arrest of the couple and the disappearance of Chen are directly linked to their GitHub project, named “Terminus2049.” The Beijing police could not be reached for comment.

Chinese citizens had been turning to Microsoft-owned GitHub after the outbreak began, as it remains one of the few major foreign websites that can still be accessed in China. Now, volunteers linked to these GitHub pages are facing the growing risk of reprisals from authorities ...