Sunday, 9 February 2020

Coronavirus: doctors are reduced to tears as they turn away patients
Philip Sherwell, Asia Correspondent
Sunday February 09 2020, 12.01am GMT, The Sunday Times


Some doctors wear nappies inside their protective suits. Others go without food and drink for 12 hours at a time to avoid bathroom breaks. Some go “naked” — wearing no hazmat suits despite risking near-certain infection — because protective gear has run out. The harrowing truth about the grim conditions in which dedicated medical staff are fighting the coronavirus epidemic at ground zero in Wuhan emerged yesterday from China.
In a gripping account, a senior doctor in Wuhan recounted the remarkable bravery of the stricken city’s frontline medics, about 1,000 of whom have been infected. He also revealed how the city authorities tried to hamper medics as they tackled the crisis.
Even for those with access to protective gear, the 12-hour shifts take their toll. “We refrain from eating or drinking during our shift because the gear is no longer protective once we go to the washroom,” said Peng Zhiyong, of Wuhan University’s Zhongnan Hospital. “The gear is thick, airtight and tough on our body. It felt uncomfortable at the beginning, but we are used to it.”
Some doctors have resorted to wearing adult nappies, not only because the hazmat suits can be easily torn or contaminated if they are removed in a toilet, but because they are too overworked for bathroom breaks anyway.
None of Peng’s intensive care unit (ICU) medics have taken leave for a month, he said, and few even manage to go home, partly because of the long shifts but also because of concern about infecting their families.
“We rest in a hotel near the hospital or in the hospital itself,” he said.
He also described being reduced to tears as patients begging for treatment had to be turned away. “They wailed in front of the hospital,” he said.
“Some patients even knelt down to beg me to accept them into the hospital. But there was nothing I could do since all beds were occupied.
“I shed tears while I turned them down. I have run out of tears now. I have no other thoughts but to try my best to save more lives.”
Peng revealed the gruelling conditions in an interview he gave to Caixin Global, a Chinese media outlet, which has published a series of exposés about the epidem2
It offers a rare glimpse of what is really going on in China, where the regime had appeared to relax its grip on the media as a safety valve for public anger but now seems to be tightening it again.
In his interview, Peng also detailed the concerted effort by the Wuhan health authorities to play down the threat of the virus in the crucial early weeks of the outbreak, which made its impact all the more dangerous just before the lunar new year, a peak travel period.
His frank portrayal of the early cover-up comes as grief and anger rise across the country over the death of Li Wenliang, a whistleblower doctor at another Wuhan hospital.
When Li raised the alarm online about a mystery virus in late December, he was detained by the police and punished for “rumour-mongering”.
He returned to work and contracted the disease. On Friday he paid with his life, one of the youngest victims at the age of 34.
Peng told Caixin that, like Li, some 40 members of his ICU team have contracted the disease from patients. But the rate was much worse at another hospital in the city — not Li’s — where two-thirds of ICU staff have reportedly been infected. Many medics there have been working without protective gear because of shortages.
Peng said that when his hospital received its first patient on January 6 he recognised the seriousness of the new virus, closely related to the Sars outbreak of 2002-03. He oversaw the ICU’s remodelling to “Sars standard” with isolation and contamination zones.
Four days later, all 16 beds initially set aside for patients with the new disease were full and it was clear that the situation was “dire”.
Peng was certain there would be person-to-person transmission — a risk that the Wuhan authorities were to rule out even when they later went public about the new virus.
After repeated calls from hospital chiefs, Wuhan’s health department sent a team of specialists on January 12. That was already nearly two weeks after Li had alerted his former medical school friends of a new “Sars” and even longer since word had spread of the first cases.
The specialists acknowledged that the clinical symptoms “resembled Sars”, but they set deliberately “stringent” reporting standards so that the official tally of patients would be severely under-reported, Peng said.
“Very few people would get diagnosed based on those criteria. The head of our hospital told them this multiple times during this period. I know other hospitals were doing the same,” he said.
He spelt out the fatal risks of this approach when inspectors visited again six days later.
By then only two of the 16 patients in his unit had been officially diagnosed with the virus, while others with infections had already been sent away.
“If you made the criteria too high and let patients go, you’re putting society in danger,” he told them.
However, it was another week before Wuhan came clean about the scale of the outbreak.
Peng’s decision to speak out reflects what Richard McGregor, a China expert at the Lowy Institute think tank, has called a “rebellion of the professionals” — Chinese doctors and journalists going public with their criticisms, despite the risks to them in doing so.
“The virus isn’t going to change based on man’s will,” said Peng. “I felt we needed to respect it and act according to science.”
The UN World Health Organisation has taken a very different approach, lavishing praise on China for its response, apparently fearful of antagonising one of the most powerful member states.
Even as Li’s strength slipped away in his hospital bed last week, he was still highlighting the failings of the system.
In his own, final interview he told Caixin: “A healthy society should not have just one voice.”

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