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‘I Felt Like Crying’: Coronavirus Shakes China’s Expecting Mothers ‘I Felt Like Crying’: Coronavirus Shakes China’s Expecting Mothers
(8 days later)
HONG KONG — The hospital waiting room was filled with dozens of women wearing homemade hazmat suits. Their hair was tucked tightly under shower caps. Their rain ponchos zipped taut over winter coats. All of the women, anxious and pregnant during the coronavirus outbreak, had been waiting hours to see the same doctor.HONG KONG — The hospital waiting room was filled with dozens of women wearing homemade hazmat suits. Their hair was tucked tightly under shower caps. Their rain ponchos zipped taut over winter coats. All of the women, anxious and pregnant during the coronavirus outbreak, had been waiting hours to see the same doctor.
“I don’t feel at ease,” said Vigor Liu, who is five months pregnant with her first child. After waiting for three hours, Ms. Liu finally saw the doctor for a 10-minute conversation. His advice: Stop reading the news.“I don’t feel at ease,” said Vigor Liu, who is five months pregnant with her first child. After waiting for three hours, Ms. Liu finally saw the doctor for a 10-minute conversation. His advice: Stop reading the news.
As China deals with the vicious epidemic that has sickened more than 80,000 people and killed more than 2,600, pregnant women say the country’s already overburdened health care system has started to leave them behind.As China deals with the vicious epidemic that has sickened more than 80,000 people and killed more than 2,600, pregnant women say the country’s already overburdened health care system has started to leave them behind.
Maternity nurses and doctors have been pulled from their ordinary duties and shipped off to crisis centers and more than a thousand hospitals newly designated for coronavirus patients. Smaller community hospitals that offer obstetrics and gynecological services are temporarily closed because of staff shortages.Maternity nurses and doctors have been pulled from their ordinary duties and shipped off to crisis centers and more than a thousand hospitals newly designated for coronavirus patients. Smaller community hospitals that offer obstetrics and gynecological services are temporarily closed because of staff shortages.
The swift diversion of resources has left many soon-to-be mothers struggling to get access to the basic prenatal care usually provided in these facilities, often a pregnant woman’s first and only stop for medical attention in China. Reports in state media of infected mothers giving birth have heightened fears of passing on the virus to newborns, even though there is no clear indication that this has happened.The swift diversion of resources has left many soon-to-be mothers struggling to get access to the basic prenatal care usually provided in these facilities, often a pregnant woman’s first and only stop for medical attention in China. Reports in state media of infected mothers giving birth have heightened fears of passing on the virus to newborns, even though there is no clear indication that this has happened.
Women who have given birth since the outbreak also describe a lonely and sometimes terrifying experience of limited medical assistance in understaffed hospitals. New mothers cannot get vaccinations for their babies because entire cities and provinces have shut down clinics. Well baby checkups are being postponed.Women who have given birth since the outbreak also describe a lonely and sometimes terrifying experience of limited medical assistance in understaffed hospitals. New mothers cannot get vaccinations for their babies because entire cities and provinces have shut down clinics. Well baby checkups are being postponed.
Experts say the situation is undercutting the major political effort in recent years to prod Chinese women to have more children amid historically low birthrates and a looming demographic crisis.Experts say the situation is undercutting the major political effort in recent years to prod Chinese women to have more children amid historically low birthrates and a looming demographic crisis.
In the city of Wuhan, the center of the outbreak, pregnant women have faced the daunting prospect of figuring out where to give birth. Their community hospitals are closed, the city’s public transport is shut down and no one is allowed to leave because of quarantine rules.In the city of Wuhan, the center of the outbreak, pregnant women have faced the daunting prospect of figuring out where to give birth. Their community hospitals are closed, the city’s public transport is shut down and no one is allowed to leave because of quarantine rules.
Without volunteer drivers, the women would not even be able to attend their scheduled doctor’s appointments.Without volunteer drivers, the women would not even be able to attend their scheduled doctor’s appointments.
One network of volunteers in Wuhan is trying to help women find hospitals that still offer prenatal and postpartum care. The group — which includes psychological workers and drivers — is working with more than 600 pregnant women and new mothers in and around the city, and offers 24-hour service to help deal with emergencies.One network of volunteers in Wuhan is trying to help women find hospitals that still offer prenatal and postpartum care. The group — which includes psychological workers and drivers — is working with more than 600 pregnant women and new mothers in and around the city, and offers 24-hour service to help deal with emergencies.
Jane Huang was recently connected with the volunteers. The 40-year-old mother of one is 17 weeks pregnant, but the district hospital where she is registered is no longer open to pregnant women. Ms. Huang worries that if she does not find a hospital soon, neither she nor her baby will survive because of her hypertension and fragile kidney.Jane Huang was recently connected with the volunteers. The 40-year-old mother of one is 17 weeks pregnant, but the district hospital where she is registered is no longer open to pregnant women. Ms. Huang worries that if she does not find a hospital soon, neither she nor her baby will survive because of her hypertension and fragile kidney.
“I worry every day about whether my child will die in my belly. I worry if there is an early delivery, it will not be able to survive,” Ms. Huang said by phone. “I worry about the financial burdens if I have to do dialysis or even change my kidney, I worry that if my child has an abnormality, should I bring it into to the world.”“I worry every day about whether my child will die in my belly. I worry if there is an early delivery, it will not be able to survive,” Ms. Huang said by phone. “I worry about the financial burdens if I have to do dialysis or even change my kidney, I worry that if my child has an abnormality, should I bring it into to the world.”
“I think about a lot of things every day,” she said.“I think about a lot of things every day,” she said.
Even in normal times, the array of bureaucratic detail that Chinese women have to deal with before giving birth can be challenging.Even in normal times, the array of bureaucratic detail that Chinese women have to deal with before giving birth can be challenging.
There is no functioning primary care system in China, where coverage can be limited and there is already a shortage of doctors. Pregnant women must find a hospital that offers maternity services and register to give birth there. Some pregnant women have registered at hospitals that have since been turned into virus centers. Those who can afford it consider shelling out thousands of dollars to give birth in a private hospital instead.There is no functioning primary care system in China, where coverage can be limited and there is already a shortage of doctors. Pregnant women must find a hospital that offers maternity services and register to give birth there. Some pregnant women have registered at hospitals that have since been turned into virus centers. Those who can afford it consider shelling out thousands of dollars to give birth in a private hospital instead.
Those who cannot afford it are at the mercy of public hospitals, most of which are severely understaffed.Those who cannot afford it are at the mercy of public hospitals, most of which are severely understaffed.
“People’s anxiety is up in general, and if you are pregnant then you have a whole other set of anxieties,” said Roberta Lipson, chief executive officer of United Family Healthcare, a chain of private hospitals in several Chinese cities.“People’s anxiety is up in general, and if you are pregnant then you have a whole other set of anxieties,” said Roberta Lipson, chief executive officer of United Family Healthcare, a chain of private hospitals in several Chinese cities.
Ms. Lipson said United had seen a surge in women who had previously planned to give birth in a public hospital in China switch, or inquire about switching, to a private one.Ms. Lipson said United had seen a surge in women who had previously planned to give birth in a public hospital in China switch, or inquire about switching, to a private one.
Some 1,774 hospitals have been designated for pregnant women who are infected with the coronavirus. These are the same hospitals that pregnant women who are not sick want to avoid.Some 1,774 hospitals have been designated for pregnant women who are infected with the coronavirus. These are the same hospitals that pregnant women who are not sick want to avoid.
China’s National Health Commission has told hospitals that if pregnant women are registered to give birth at a newly designated virus treatment center they must “make reasonable arrangements as soon as possible” for those women. But many pregnant women say they are not sure what that means for their situation:China’s National Health Commission has told hospitals that if pregnant women are registered to give birth at a newly designated virus treatment center they must “make reasonable arrangements as soon as possible” for those women. But many pregnant women say they are not sure what that means for their situation:
Will they be forced to give birth at a hospital designated for coronavirus patients? Will they be transferred elsewhere? Will they be turned away?Will they be forced to give birth at a hospital designated for coronavirus patients? Will they be transferred elsewhere? Will they be turned away?
“A difficulty is that different hospitals use different platforms to broadcast their information,” said Bin Tu, a volunteer in Wuhan. “For pregnant women, finding information on each hospital, one by one, would be complicated.”“A difficulty is that different hospitals use different platforms to broadcast their information,” said Bin Tu, a volunteer in Wuhan. “For pregnant women, finding information on each hospital, one by one, would be complicated.”
And finding information on the virus itself can sometimes feel impossible.And finding information on the virus itself can sometimes feel impossible.
There is emerging evidence that the coronavirus does not transfer from a sick mother to an unborn baby, but the limited data and unanswered questions have left many pregnant women in China apprehensive.There is emerging evidence that the coronavirus does not transfer from a sick mother to an unborn baby, but the limited data and unanswered questions have left many pregnant women in China apprehensive.
Updated July 7, 2020
The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
In early February, Chinese state media reported a case of a newborn in Wuhan who was found to have the virus. The mother had been infected, but it was not clear if she transmitted the virus during her pregnancy or if the baby was infected immediately after it had been born.In early February, Chinese state media reported a case of a newborn in Wuhan who was found to have the virus. The mother had been infected, but it was not clear if she transmitted the virus during her pregnancy or if the baby was infected immediately after it had been born.
As the authorities continue to try to contain the outbreak, details about the virus have become even more sparse. Citizen journalists have been silenced. Medical workers have been told not to talk to the media.As the authorities continue to try to contain the outbreak, details about the virus have become even more sparse. Citizen journalists have been silenced. Medical workers have been told not to talk to the media.
In this environment, these women have turned to informal channels like chat groups and other online forums to find out what their options are and the latest details on transmission. Some seek advice on missed appointments; others wonder out loud about the virus flying through an open window. Tips and recommendations are posted on Weibo and WeChat, two of China’s most popular social media platforms.In this environment, these women have turned to informal channels like chat groups and other online forums to find out what their options are and the latest details on transmission. Some seek advice on missed appointments; others wonder out loud about the virus flying through an open window. Tips and recommendations are posted on Weibo and WeChat, two of China’s most popular social media platforms.
These forums have become the kind of community that women like Ms. Liu and Ms. Huang say they now depend on. And yet some women who have given birth in recent weeks have little consolation to offer these anxious mothers-to-be.These forums have become the kind of community that women like Ms. Liu and Ms. Huang say they now depend on. And yet some women who have given birth in recent weeks have little consolation to offer these anxious mothers-to-be.
Zhang Chong delivered her second child, a boy, on Feb. 1 at a public hospital in Beijing. The hospital was understaffed, in part because some workers were still stuck in their hometowns following citywide quarantines.Zhang Chong delivered her second child, a boy, on Feb. 1 at a public hospital in Beijing. The hospital was understaffed, in part because some workers were still stuck in their hometowns following citywide quarantines.
Ms. Zhang’s scheduled C-section surgery was delayed by a day because of the staffing shortage. None of her family members were allowed into the room during or after the surgery. Ms. Zhang was then placed in a ward with 40 new mothers and babies and just two nurses and two assistants.Ms. Zhang’s scheduled C-section surgery was delayed by a day because of the staffing shortage. None of her family members were allowed into the room during or after the surgery. Ms. Zhang was then placed in a ward with 40 new mothers and babies and just two nurses and two assistants.
Family was allowed to visit for only an hour a day, a drastic change to normal rules, which allow one family member to always be by the side of the new mother.Family was allowed to visit for only an hour a day, a drastic change to normal rules, which allow one family member to always be by the side of the new mother.
On the first night after the surgery, Ms. Zhang said, she could barely move her body. Her baby was crying and wanted to be fed, but no one was around to help her. For four nights, Ms. Zhang said, she was almost entirely alone.On the first night after the surgery, Ms. Zhang said, she could barely move her body. Her baby was crying and wanted to be fed, but no one was around to help her. For four nights, Ms. Zhang said, she was almost entirely alone.
“There were 100 times a day that I felt like crying,” she said.“There were 100 times a day that I felt like crying,” she said.
Her husband, desperate to help, tried unsuccessfully to bribe a security guard so he could stay with her longer.Her husband, desperate to help, tried unsuccessfully to bribe a security guard so he could stay with her longer.
Wang Yiwei contributed research from Beijing, and Cao Li from Hong Kong.Wang Yiwei contributed research from Beijing, and Cao Li from Hong Kong.