Some who have helped others fight for their lives on the front lines have become infected themselves
Nurses tend to a patient at a Hong Kong-funded hospital in Wuhan, Hubei province. (PHOTO PROVIDED TO CHINA DAILY)
Medical professionals in Wuhan, capital of Hubei province, have emerged deeply traumatized after witnessing life-and-death struggles in isolation wards where patients with the novel coronavirus are being treated.
Zhou Huili, a senior nurse at the Hong Kong-funded Wuhan Asia General Hospital in the city, which was regarded as the epicenter of the outbreak in China, was tasked with overseeing 17 isolation beds for critically ill patients.
Before the epidemic was announced in January, the 39-year-old was head nurse at the hospital’s heart disease center, but she was reassigned to the intensive care unit on Jan 20.
She said many of the patients were elderly, barely breathing and unable to speak, and the infection in their lungs usually spread to the heart and other vital organs.
“I was trained to treat patients with heart disease. In the past, I always used my training to help save lives — even seniors with heart failure. This time, I was desperate. Even with younger patients, I felt helpless in the face of a deadly virus never seen before,” she said.
“Sometimes I stood by a patient’s bed and said a quiet prayer for them to survive,” she said in a phone interview with China Daily.
Between late January and the end of February, Zhou saw more than 10 patients die. In 20 years of nursing, she had never lost a patient during an emergency rescue procedure. Losing so many patients in a month shook her.
One was a 60-year-old man with a history of good health. The oxygen level in his lungs was dangerously low when he was sent to the ICU and he could hardly breathe.
Even when he was put on a ventilator, his health failed to improve.
“We encouraged him to breathe as hard as he could. He tried, but it was a struggle,” Zhou recalled. She remembers his face “exhausted beneath the oxygen mask, but determined to fight”.
On her rounds one day, Zhou looked on as the man showed her his hand. He could not speak, but he had written the words xiang huo — “I want to live” — on his palm.
“He was the toughest patient I’ve ever seen,” Zhou said. “I thought no matter how hard it would be, we had to save his life.”
She directed the nurses to try to feed him with milk, eggs, whatever he could take. “If it was too much for one nurse, I would assign two,” Zhou said.
The patient cooperated with the nurses, fighting to stay alive. Sometimes as Zhou watched him, tears came to her eyes.
Occasionally, the medical staff members helped set up video calls with his family. His wife told him, “You can’t abandon me.” His daughter urged, “Dad, please stay strong,” Zhou recalled.
Zhou kept telling him he had many years left. The chances of recovery were good and the whole country was behind the effort in Wuhan. She told him how many patients had recovered and were discharged every day.
Despite all the efforts, the man died. “Maybe he was too sick to make it. He passed away after three weeks,” Zhou said.
She was prepared for the worst when she entered the isolation ward.
Zhou Huili, head nurse in the intensive care unit at Wuhan Asia General Hospital, oversaw 17 isolation beds for novel coronavirus patients. (PHOTO PROVIDED TO CHINA DAILY)
Imminent risk
On Jan 24, Lunar New Year’s Eve, she called her oldest daughter into the bedroom alone.
She said she could not look the girl directly in the eye because she was on the verge of tears. She told the 14-year-old where she could find the title deeds to their house.
When the girl showed alarm at the tenor of the conversation, Zhou told her: “It’s nothing. It’s just to keep you informed.”
That same night, Zhou learned that a doctor she knew had died from the virus.
“I was shocked and saddened,” she said. “As a medical worker, I was scared. I cried in secret for a long time, hiding under my quilt.”
Zhou was supposed to have the next day off, as it was Lunar New Year’s Day. Instead, she went to work.
“My mind was filled with the epidemic. The situation wouldn’t get any better if I stayed at home, so I might as well go to the hospital,” she said.
She asked her husband to take their two daughters, one just 15 months old, to stay with her mother-in-law. She did not want them put at risk. She has not seen her family since.
She led a team of about 80 nurses. There was a heavy workload, so the pressure was enormous. Materials had to be distributed and she had to train and manage nurses who were treating severely ill patients and dealing with death on the wards.
Many of the nurses had been trained in other fields, so they worked in other departments. Now, all their attention was turned to the virus. They were full of questions for Zhou about medical procedures.
From late January to early February, the number of coronavirus patients in Wuhan surged by about 20,000. The emergency rooms were full. Thousands of those thrown into panic showed real symptoms.
“It was like there was no end in sight. We didn’t know when the outbreak would be brought under control. There was a feeling of desperation,” Zhou said.
She remembers a doctor in her department asking her to take a photo of him before he entered the isolation ward.
“He said it might be his last photo in protective clothing. We didn’t know if we would be infected and what would happen to us,” she recalled.
What Zhou did not expect was that the virus would find her first. On Feb 2,
she felt weak and short of breath. Prompted by another nurse, she had a computed tomography scan on her lungs.
A nurse told her that the diagnosis was suspected viral pneumonia and the scan showed abnormalities in one lung.
“The nurse handed me the report, crying,” Zhou said. “I had to be strong in front of my subordinate. So I told her I was alright, and not to worry about me.”
The nurse left. Zhou found a quiet corner, squatted down and cried.
“I called a friend who is a nurse. I said, ‘I can’t die. My daughter just had her first birthday’,” she said.
Despite the bleak outlook that came with the diagnosis, Zhou tested negative for the coronavirus. She went home for a week and took drugs to manage the deterioration of her lung. She worked from home because so much needed to be done.
Medical team members from Beijing present Yu with an apple in February to express the hope that she stays healthy. (PHOTO PROVIDED TO CHINA DAILY)
On Feb 9, she had another CT scan. It showed no deterioration, but no improvement. She returned to work.
Zhou was living at the hospital, working from 7 am to midnight and wearing protective gear many hours a day.
In late February, the outbreak in Wuhan slowed. The number of new patients fell to less than 500 a day. At the peak, the number had risen by a few thousand every day.
Zhou and her team got through the toughest times without a single member becoming infected. However, her ordeal was not over.
On Feb 26, Zhou felt a pain in her chest. She had been coughing. Another CT scan showed that the abnormality in her lung was getting worse. She was placed in isolation.
She had seen the worst: some patients died, but many others recovered. She faced her crisis with renewed optimism.
Zhou was not sure when she got infected, as she always wore protective gear at work. She thinks it may have happened during her period, when her immunity was low.
She always approved requests for time off from nurses who felt unwell. However, as head nurse, she felt that option was closed to her.
From Feb 26 to March 24, she spent 13 days in the hospital, then 14 days alone in a quarantine camp.
Zhou did not tell her family at the time because she did not want them to worry about her, especially as her mother-in-law is prone to depression. Only close friends, her boss and a few nurses knew she was infected. If her family requested video calls with her, she would say she was too busy to talk.
Zhou stayed strong. Her final diagnosis did not come until March 6. She was positive for the antibody to the virus, after about half a dozen earlier tests had shown she was negative for the virus.
On March 3, China updated its diagnosis standard, stipulating that the antibody of the virus also indicated infection.
Zhou had clung to the belief that she was just a suspected case. That helped her to stay positive.
She noted that one of her classmates from nursing school, a close friend, also had the virus.
“She told me that if we were too scared to get through this, what had been the point of us attending nursing school?” Zhou said, adding that the friend, a nurse at Hubei General Hospital, helped to keep her spirits up.
After completing quarantine, Zhou was pronounced free of the virus. She returned to work on April 8, and is taking care of 35 recovering coronavirus patients in the isolation ward.
She plans to write a paper summarizing her experiences.
“I told my daughter that at my age, I am no longer working to make a living. If my experience can help the patients, even a little, it will be enough.”
Zhou said many things seem less important now. “Those tasty foods, amusing activities and good-looking things are not that important to me right now,” she said.
“It’s more important to stay healthy, breathe normally, and have family and colleagues around. I will cherish everything I have.”
By early March, more than 3,000 Chinese medical workers had become infected, many as a result of inadequate protection.
Yu Mingfeng, senior nurse in the intensive care unit at Wuhan Asia Heart Hospital, trains colleagues. (PHOTO PROVIDED TO CHINA DAILY)
Staying strong
At the start, people knew little about the transmissibility of the virus. That lack of knowledge helped spread the infection.
On Jan 22, Yu Mingfeng, a 34-year-old nurse in the intensive care unit at Wuhan Asia Heart Hospital, was confirmed as being infected. At work, she had only worn a surgical mask, the lowest level of protection in the ICU.
“At first I thought I just had a cold,” she said, adding that people knew little about the virus and did not expect it to spread the way it did.
“I got muddled and terrified the moment I knew the diagnosis,” said Yu, who has a 4-year-old daughter. Her first concern was whether she had infected family or colleagues.
Luckily, the infection was discovered before the onset of fever, which signals that the virus has become highly infectious. No one close to Yu came down with the illness.
There is no specific medication for the coronavirus yet, but Yu stressed the importance of a positive mental attitude to help natural immunity fight the disease.
She recalled a 40-something fellow patient in the isolation ward, who came close to panicking when she noticed doctors cutting back on her medication.
“I told her that it was a sign of recovery,” Yu said. As the conversation unfolded, the woman learned that Yu was a nurse. “I encouraged her to stay positive and trust the doctors,” Yu said.
The woman was relieved. “The encouragement and companionship helped us defeat the virus,” Yu said.
She praised the Beijing medical team that treated her.
“They came all the way to Wuhan,” she said. “Some told me they could hardly understand patients with Hubei accents. They also had trouble acclimatizing to the cold, moist winter climate.”
One nurse from Beijing posted a note on the wall of Yu’s ward: “Staying optimistic is the beginning of any treatment. Your recovery is our happiness. Let’s fight together!”
On Feb 13, Yu was pronounced clear of the infection and discharged from the hospital. After being quarantined at home, she has almost recovered and is waiting for confirmation to return to work.
