February 3rd, The 12th day of Wuhan Quarantine
My cough has improved significantly over the past two days. Although I still cough a little, it is much better. My mother had a fever for the last few days but her temperature is back to normal now. These days even a slight change in their physical condition can make people panic.
My aunt has been hospitalized. I heard that her fever has been under control these past two days.
Colleagues in home quarrantine are also improving. Their fevers are under control, they are coughing less and their appetites are improving.
Recently, I have come to feel that there are huge problems and many risks with the nucleic acid detection kits.
First, there is a shortage of kits (don’t know why). If you are lucky, you only have to wait for two or three days to get tested. If a critically ill patient dies while waiting to be tested, they cannot be counted as either a confirmed or a suspected case.
Second, the tests are inaccurate. According to my doctor friend, they aren’t accurate. The test kits are much less accurate than I expected (because I have no supporting evidence I won’t mention specific values here). That is, many cases tested negative by the kit may be false negatives. We have seen some examples of this in the news lately. There are indeed many cases in which a person first got a negative result from the nucleic acid test but later a positive result.
This is very bad. Why?
Firstly, given the severe shortage of hospital beds, we need to confirm the diagnosis with the test kits. If the nucleic acid test result is negative, to the best of my knowledge, get admitted to the hospital is very difficult, even if the patient is already very sick (absent any special arrangment made for them);
Secondly, according to current policy, you have to be confirmed to be sick in order to get free treatment. This may cause people who test “negative” to refuse treatment for fear of high medical bills. This not only may be fatal to the patient, it could also make it harder to prevent the spread of the virus.
Thirdly, if a person is actually infected but not quarantined because the test was negative, it will lead to a wider spread of the virus;
All this greatly reduced the number of cases that are officially reported.
Hospital beds are the most critically short resource. You can’t get them simply by standing in line. Some people get a bed by “going through the back door”. Some people get a bed through a social media post – they are “going through the back door” that way. That means that someone else, who has neither personal connections nor can make a social media post, doesn’t get a bed. But in these times I can’t be criticizing people who “go through the back door” because if it were for a member of my own family I think I would do whatever it takes.
The day before yesterday one of my friends said that five members of one family were infected but there was only one hospital bed available for them. The parents gave the bed to the youngest child. That amounted to sacrificing their own chance to survive. I am not sure that particular story is true but what I am sure of is that there are true stories like that taking place these days. Some time ago I saw the movie “Sophie’s Choice”. I thought that story was incredibly cruel. I was relieved to think that stories happened in the past, that they belong to history, and could never happen in my neighborhood in the year 2020. History doesn’t belong only to the past.
The centralized quarantine of mild cases and of suspected cases began these past two days. I asked some friends who work for their community’s local authority about it. The community they live in has requisitioned some nearby hotels for the centralized quarantine of patients. There are mostly people who have been diagnosed as infected by CT scan, although not yet by the nucleic acid test so their diagnosis has not been confirmed. Now what I worried about is actually happening. There are not enough medical personnel and the community authority lacks sufficient staff. No expert personnel are caring for these people in quarantine. Each patient has different symptoms so it is very doubtful that they will get appropriate care.
There are also serious issues concerning those people who have “suspected cases” of coronavirus pneumonia. Some of them may have the flu or some other type of pneumonia since the symptoms as seen a CT scan closely resemble those of new type coronavirus pneumonia. If these people are quarantined together with people who actually do have coronavirus pneumonia, they may get infected. Moreover, some of the close contacts of people with suspected cases may be virus carriers. Shouldn’t they be quarantined as well?
My friend couldn’t give me a definite answer. They are overwhelmed. I can well understand the predicament that community grassroots workers like my friend are in. After all, they are not professional medical personnel, they do not have specialized medical knowledge, and they lack medical supplies. Most of the patients they face already have confirmed diagnoses of new type coronavirus pneumonia. They are afraid and even more important, they lack the authority to make decisions. Both beds and testing kits are in short supply. They can’t solve those problems. On top of that, they must confront the fears, criticisms and panic of all the residents in the community under their jurisdiction.
I couldn’t think of anything to say to reassure him. I repeatedly told him that he should protect himself and not get into direct confrontations with patients. My other concern is that resources, management quality, implementation and how humanely people are treated vary widely from one community to the next. For example, In my friend’s community, officials have worked overtime for days, following up on residents by going door by door in their in their district. This arrangement is only as strong as its weakest link. Severe consequences could result. In my community however, the local authority hasn’t yet reached out to my family. But that isn’t the worst of it. A friend tried to call the community service center of his local authority. The number was disconnected.
A friend from another city, a journalist, told me she was planning to come to Wuhan. I told her not to come but I’m also aware that we don’t get to decide for ourselves many of these things.
The Chinese Communist Party has done quite a brilliant job oppressing lawyers and journalists in recent years. They have done such a brilliant job that I once believed that medias and journalists worthy of the name “professional” were already extinct in Mainland China. The excellent performance of many media during this crisis has made me rub my eyes in astonishment. I don’t know how long it can last though. Possibly the words they they risked their lives to write risking their lives will be erased from the entire Chinese Internet tomorrow. Even if that happens I will still remember them.
Many people worry about the safety of medical worker. Unfortunately very few focus on the safety of journalists. I understand that quite a few front-line journalists have been infected. I hope that people will notice that, will remember them and will never again slander them.