By Lu Yan
Source: NO.3 JAN19, 2023 BeiJing Preview
A patient is wheeled in on a stretcher as others receive intravenous drips at the emergency department of Peking University Third Hospital on January 3 (WEI YAO)
On December 28, 2022, Peking University Third Hospital (PUTH) received a thank you letter from the daughter of a patient they had treated four days earlier. In nearly 1,000 Chinese characters, the sender surnamed Shi gave an emotional and detailed account of how she had rushed her father to the emergency department as he was showing symptoms of a heart attack.
"I was very shocked to see so many people waiting in the emergency room and was concerned my father would not be treated in time," Shi wrote. In December last year, with a rapidly rising number of patients pouring in with COVID-19 symptoms, hospitals across China were swamped, their emergency departments in particular.
Shi said the hospital had offered them a fast-track channel and immediately did an electrocardiogram without requiring her to register beforehand. Thanks to the doctors' swift and resolute actions, her father quickly stabilized after getting a stent—all within the hour.
"At this difficult time, I would like to thank all the doctors. Some were still recovering from infection themselves but still put their own wellbeing on the line to save people's lives," Shi said.
In early December last year, China issued a notice on optimizing its COVID-19 response, leading to the lifting of quarantine requirements and travel restrictions across the country. The number of patients infected with the virus' Omicron variant has since surged in many places. While many of them, usually with mild symptoms, choose to just take medication and recover at home, some do have to seek hospital treatment, leading to mounting pressure on these institutions. Medical workers have gone above and beyond to offer timely treatment, making adjustments as the situation changes, to ensure the wellbeing of all patients.
Divide and conquer
PUTH is a large general hospital with the largest number of outpatient and emergency visits in Beijing. In December last year, its outpatient department received more than 260,000 patient visits, with the average daily number of fever outpatients exceeding 1,200.
Frontline clinicians and representatives from supporting departments have been on a tight schedule. Standard doctor duties aside, their daily routine now also includes meetings to discuss the imminent challenges stemming from the current influx of Omicron patients.
"Today we had our 150th such regular meeting, ensuring all the problems we face are solved promptly," Tang Yida, assistant to the dean and chief cardiologist with the department of cardiology at PUTH, told Beijing Review on January 3.
Issues, big or small, are discussed at these meetings as soon as they emerge. For example, when Beijing's demand for fever medication grew exponentially in December and ibuprofen, one of the most popular medications, was in short supply, the hospital's pharmacy department began splitting the packages into smaller portions so that more patients could have access to the medication.
A working group on pandemic prevention and control was also available 24/7 to deal with a range of emergencies. Other groups, including a COVID-19 expert group, an emergency treatment expert group and a supply allocation working group, were also set up, pooling the wisdom and professionalism from all departments, rather than sticking to the hospital's original setup.
When the number of patients showing COVID-19 symptoms increased late last year, the nephrology department, which focuses on the treatment of diseases that affect the kidneys, divided its dialysis room into sections to separate infected patients from others, ensuring both groups could receive treatment. "Any changes could happen anytime. And patients cannot wait for their dialysis. Our nursing staff also volunteered to take on more shifts. We were almost worn out, but we made sure the department could operate normally. It was difficult, but we pulled through," Su Chunyan, the department's head nurse, told Beijing Review.
But doctors and nurses, too, can get sick. Over the course of last December and early January, many medical staff at PUTH got infected, one after another.
In last December, Zhang Yixuan, a resident doctor with the neurology department, worked in several posts at various departments, including the infectious diseases department and the department of respiratory and critical care medicine. "Any department that was understaffed, I would go to and work there the next day," she remembered.
A doctor checks on a patient on a ventilator at Peking University Third Hospital on January 3 (WEI YAO)
Rolling with the punches
The changes taking place in hospitals have reflected the country's array of active adjustments to its COVID-19 response policy.
In November last year, China announced 20 updated prevention and control measures, minimizing the number of people under quarantine or requiring health monitoring. On December 7, the country issued 10 more measures to ease restrictions on visits to public venues and domestic travel, and to reduce the scope and frequency of mass nucleic acid testing.
On January 6, the National Health Commission and the National Administration of Traditional Chinese Medicine issued a new edition of the COVID-19 diagnosis and treatment protocol. According to this latest playbook, those infected with the virus can stay at home or seek medical attention at medical institutions. The centralized quarantine of positive cases no longer applies.
The downgrading of COVID-19 management measures also comes through in the updated Chinese term for COVID-19—from "novel coronavirus pneumonia" to "novel coronavirus infection."
"When an infectious disease poses less harm to people's health and leaves a lighter impact on the economy and society, adjusting the intensity of prevention and control measures is a science-based decision," Liang Wannian, head of the COVID-19 response expert panel under the National Health Commission, said.
"The focus of the new COVID-19 response is on protecting people's health and preventing severe cases," Tang said. Vulnerable groups, including seniors, pregnant women, children and patients with underlying diseases, remain a top priority for hospitals.
Authorities have urged hospitals on all levels, from central to county, to guarantee fever clinics are available for those in need. Meanwhile, health departments and hospitals, including PUTH, have distributed flyers to educate the public on how to properly deal with infection.
China has also made efforts to increase vaccination rates and facilitate the development of related medication. Medical authorities are also adjusting the insurance policies to address and ease the financial burden for COVID-19 patients, for example by specifying the reimbursement rates for medical bills stemming from COVID-19-related outpatient and inpatient treatment and online medical services.
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