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‘No Way Out’: In China, Coronavirus Takes Toll on Other Patients ‘No Way Out’: In China, Coronavirus Takes Toll on Other Patients
(3 days later)
WUHAN, China — The 3-year-old boy was anxiously waiting for yet another round of chemotherapy. Then the new coronavirus outbreak hit, and doctors suddenly turned him away.WUHAN, China — The 3-year-old boy was anxiously waiting for yet another round of chemotherapy. Then the new coronavirus outbreak hit, and doctors suddenly turned him away.
The boy, Fu Haoran, who has leukemia, is one of many seriously ill people struggling to get urgent, lifesaving treatment as China pours nearly all its resources into the coronavirus epidemic. Some have not survived. Others like Haoran are in limbo, and their families fear for their future.The boy, Fu Haoran, who has leukemia, is one of many seriously ill people struggling to get urgent, lifesaving treatment as China pours nearly all its resources into the coronavirus epidemic. Some have not survived. Others like Haoran are in limbo, and their families fear for their future.
In Wuhan, many hospitals have been converted into facilities for treating only patients with the coronavirus. Elsewhere, other facilities have closed amid shortages of medical workers or rejected patients because of fears of cross-infection in the wards. Elective surgeries have been postponed indefinitely. Many cities have imposed travel restrictions and quarantine requirements that, for many critically ill patients, mean delays they cannot afford.In Wuhan, many hospitals have been converted into facilities for treating only patients with the coronavirus. Elsewhere, other facilities have closed amid shortages of medical workers or rejected patients because of fears of cross-infection in the wards. Elective surgeries have been postponed indefinitely. Many cities have imposed travel restrictions and quarantine requirements that, for many critically ill patients, mean delays they cannot afford.
[Read: China pushes back as the coronavirus crisis damages its image.][Read: China pushes back as the coronavirus crisis damages its image.]
“The country is in a state of crisis — this we understand,” said the boy’s father, Fu Hetian, in Wuhan, the city at the center of the outbreak. “But when will it end?”“The country is in a state of crisis — this we understand,” said the boy’s father, Fu Hetian, in Wuhan, the city at the center of the outbreak. “But when will it end?”
Since the coronavirus outbreak took hold in late January, it has killed nearly 3,000 people and sickened over 80,000 people in China. With the daily tally of new coronavirus infections now on the decline, Chinese officials have begun to tout the country’s efforts to combat the epidemic as a victory.Since the coronavirus outbreak took hold in late January, it has killed nearly 3,000 people and sickened over 80,000 people in China. With the daily tally of new coronavirus infections now on the decline, Chinese officials have begun to tout the country’s efforts to combat the epidemic as a victory.
But the outbreak is straining a health care system that was overburdened even before the coronavirus surfaced, and many patients with other illnesses are now falling through the cracks. The concern is the country’s containment efforts may be saving some lives at the expense of others.But the outbreak is straining a health care system that was overburdened even before the coronavirus surfaced, and many patients with other illnesses are now falling through the cracks. The concern is the country’s containment efforts may be saving some lives at the expense of others.
“There are so many medical conditions out there that require timely care,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “You’re going to have people die or they are going to get really bad outcomes if they don’t get care.”“There are so many medical conditions out there that require timely care,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “You’re going to have people die or they are going to get really bad outcomes if they don’t get care.”
Chen Xi, an assistant professor of health policy and economics at the Yale School of Public Health, said he thought it was likely that preventable deaths from strokes, heart attacks and other acute diseases could outnumber the lives saved from treating coronavirus patients.Chen Xi, an assistant professor of health policy and economics at the Yale School of Public Health, said he thought it was likely that preventable deaths from strokes, heart attacks and other acute diseases could outnumber the lives saved from treating coronavirus patients.
Many patients and their family members say they have been left to fend for themselves, so have turned to Chinese social media, posting desperate messages to find care.Many patients and their family members say they have been left to fend for themselves, so have turned to Chinese social media, posting desperate messages to find care.
One such post on Sina Weibo, a Twitter-like microblog platform, described the dire situation that 19-year-old Tian Guanglin was in when his condition from a rare and aggressive form of muscle cancer took a turn for the worse in early January.One such post on Sina Weibo, a Twitter-like microblog platform, described the dire situation that 19-year-old Tian Guanglin was in when his condition from a rare and aggressive form of muscle cancer took a turn for the worse in early January.
Doctors in the southern city of Shenzhen recommended an immediate transfer to a better hospital in a bigger city, but no facility would take him, his mother said.Doctors in the southern city of Shenzhen recommended an immediate transfer to a better hospital in a bigger city, but no facility would take him, his mother said.
The teenager died on Tuesday morning.The teenager died on Tuesday morning.
“We had no way out, we had no choice but to delay his treatment,” said Zhao Huaqing, the boy’s mother. “If he had been admitted to a better hospital, then he wouldn’t be dead now.”“We had no way out, we had no choice but to delay his treatment,” said Zhao Huaqing, the boy’s mother. “If he had been admitted to a better hospital, then he wouldn’t be dead now.”
In Wuhan, one woman wrote that her 62-year-old mother who had leukemia had been turned away by several hospitals because of concerns about cross-infection. Blood banks in Wuhan have experienced severe shortages because of the extended lockdown, according to China Newsweek, a state-run magazine, and other news outlets. This made it next to impossible for her mother to get the weekly blood transfusions she needed to stay alive.In Wuhan, one woman wrote that her 62-year-old mother who had leukemia had been turned away by several hospitals because of concerns about cross-infection. Blood banks in Wuhan have experienced severe shortages because of the extended lockdown, according to China Newsweek, a state-run magazine, and other news outlets. This made it next to impossible for her mother to get the weekly blood transfusions she needed to stay alive.
“My family has given up,” the woman said over WeChat, a messaging platform, while declining to give her name. “All we can do now is wait for her death.”“My family has given up,” the woman said over WeChat, a messaging platform, while declining to give her name. “All we can do now is wait for her death.”
In an update on Weibo last week, the woman wrote that days after waiting at home for help that never came, her mother had died in a hospital emergency room.In an update on Weibo last week, the woman wrote that days after waiting at home for help that never came, her mother had died in a hospital emergency room.
Mr. Chen, the Yale expert, said that the Chinese government could have possibly made the crisis worse in Wuhan by suddenly imposing a security cordon.Mr. Chen, the Yale expert, said that the Chinese government could have possibly made the crisis worse in Wuhan by suddenly imposing a security cordon.
“The decision to lock down was hasty and did not allow for sufficient time to think about how long medical resources and resources in general may last,” he said in an email.“The decision to lock down was hasty and did not allow for sufficient time to think about how long medical resources and resources in general may last,” he said in an email.
The government has acknowledged the problem. Last month, the Wuhan health commission said it would open six hospitals specifically for treating patients with illnesses other than the coronavirus. The National Health Commission has also ordered hospitals to begin normalizing operations, and some hospitals in Shanghai and Guangzhou announced that they were reopening their outpatient clinics this week.The government has acknowledged the problem. Last month, the Wuhan health commission said it would open six hospitals specifically for treating patients with illnesses other than the coronavirus. The National Health Commission has also ordered hospitals to begin normalizing operations, and some hospitals in Shanghai and Guangzhou announced that they were reopening their outpatient clinics this week.
But for many patients in Hubei Province, just getting to a hospital has been a challenge. Cities there are on a strict lockdown and public transportation has been suspended.But for many patients in Hubei Province, just getting to a hospital has been a challenge. Cities there are on a strict lockdown and public transportation has been suspended.
Since the lockdown began in late January, patients seeking treatment in Wuhan have been forced to walk for several hours. People with severe and chronic diseases have found themselves cut off from vital supplies of medicine because of the lockdown, including more than 400,000 patients in Wuhan, according to the state-run Xinhua news agency.Since the lockdown began in late January, patients seeking treatment in Wuhan have been forced to walk for several hours. People with severe and chronic diseases have found themselves cut off from vital supplies of medicine because of the lockdown, including more than 400,000 patients in Wuhan, according to the state-run Xinhua news agency.
A survey of H.I.V.-positive people in China conducted last month found that nearly one-third were at risk of running out of their antiretroviral treatment in the coming days because of lockdowns and restrictions on movement, according to a United Nations agency that combats AIDS.A survey of H.I.V.-positive people in China conducted last month found that nearly one-third were at risk of running out of their antiretroviral treatment in the coming days because of lockdowns and restrictions on movement, according to a United Nations agency that combats AIDS.
One 27-year-old man with H.I.V. who was visiting his family in the city of Huanggang, in Hubei, for the Lunar New Year holiday, had brought antiretroviral drugs to last him only two weeks. When the government abruptly imposed the lockdown, he started to panic. Finally, he found a volunteer who helped to deliver a supply of medicine from a hospital.One 27-year-old man with H.I.V. who was visiting his family in the city of Huanggang, in Hubei, for the Lunar New Year holiday, had brought antiretroviral drugs to last him only two weeks. When the government abruptly imposed the lockdown, he started to panic. Finally, he found a volunteer who helped to deliver a supply of medicine from a hospital.
“Oh my god, it was like a welcome rain after a long drought, like coming back from death’s door,” he said in an interview. He spoke on condition of anonymity because of the stigma attached to the virus.“Oh my god, it was like a welcome rain after a long drought, like coming back from death’s door,” he said in an interview. He spoke on condition of anonymity because of the stigma attached to the virus.
Updated June 5, 2020 Updated June 12, 2020
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.
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.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.
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.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.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
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.
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.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.
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 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.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
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.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.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Some patients are finding themselves in a bureaucratic mess as they are bounced between hospitals and coronavirus testing facilities.Some patients are finding themselves in a bureaucratic mess as they are bounced between hospitals and coronavirus testing facilities.
Last month, Liao Jiahao, 23, went to a hospital in the southern Chinese city of Guangzhou hoping to get surgery for a detached retina which, if left untreated, could result in blindness. But doctors said he could not be treated until he tested negative for the coronavirus.Last month, Liao Jiahao, 23, went to a hospital in the southern Chinese city of Guangzhou hoping to get surgery for a detached retina which, if left untreated, could result in blindness. But doctors said he could not be treated until he tested negative for the coronavirus.
The second hospital he was referred to refused to test him for the virus because he wasn’t showing any symptoms. Finally, a doctor at a third hospital agreed to do the test. But days after Mr. Liao submitted the results to the first hospital, he learned that his case had been dropped. Calls for help to the police and to a local government hotline went nowhere.The second hospital he was referred to refused to test him for the virus because he wasn’t showing any symptoms. Finally, a doctor at a third hospital agreed to do the test. But days after Mr. Liao submitted the results to the first hospital, he learned that his case had been dropped. Calls for help to the police and to a local government hotline went nowhere.
It has been nearly two weeks since Mr. Liao first sought help from doctors. With each passing day, his vision had become increasingly blurred, said his girlfriend, Liang Wanying.It has been nearly two weeks since Mr. Liao first sought help from doctors. With each passing day, his vision had become increasingly blurred, said his girlfriend, Liang Wanying.
“We are so lost,” Ms. Liang said. “There are just no resources left for patients who don’t have the coronavirus.”“We are so lost,” Ms. Liang said. “There are just no resources left for patients who don’t have the coronavirus.”
In recent weeks, networks of volunteers within China and abroad have emerged in response to the many non-coronavirus patients pleading for help online.In recent weeks, networks of volunteers within China and abroad have emerged in response to the many non-coronavirus patients pleading for help online.
In self-organized groups on WeChat, a popular messaging platform, the volunteers work together to gather information about patients and hospitals. Some reach out to community workers, local government offices and hospitals on behalf of patients; others serve as liaisons between families and reporters.In self-organized groups on WeChat, a popular messaging platform, the volunteers work together to gather information about patients and hospitals. Some reach out to community workers, local government offices and hospitals on behalf of patients; others serve as liaisons between families and reporters.
“Sometimes we can’t help as much as we would like,” said Pu Yan, a writer who has been volunteering from her home in California. “A lot of patients weren’t able to get admitted to hospitals in a timely manner, so the optimal window for treatment had already passed.”“Sometimes we can’t help as much as we would like,” said Pu Yan, a writer who has been volunteering from her home in California. “A lot of patients weren’t able to get admitted to hospitals in a timely manner, so the optimal window for treatment had already passed.”
The sick and their relatives often speak with a tone of resignation that comes from the knowledge that their suffering is not unique — that even those with the coronavirus have had difficulty getting treatment at hospitals.The sick and their relatives often speak with a tone of resignation that comes from the knowledge that their suffering is not unique — that even those with the coronavirus have had difficulty getting treatment at hospitals.
Stuck in Wuhan, Fu Haoran, the 3-year-old leukemia patient, could only rely on a fast-dwindling supply of oral medicine.Stuck in Wuhan, Fu Haoran, the 3-year-old leukemia patient, could only rely on a fast-dwindling supply of oral medicine.
Two weeks ago, the family was relieved to hear that the hospital could take him for another round of chemotherapy. Two days later, the family was back in their rented apartment, wondering when the next opportunity for treatment would come along.Two weeks ago, the family was relieved to hear that the hospital could take him for another round of chemotherapy. Two days later, the family was back in their rented apartment, wondering when the next opportunity for treatment would come along.
“Right now, all I’m worried about is whether the cancer will come back,” said Fu Hetian, the boy’s father. “If it does, I really don’t know what I’ll do. Maybe I’ll just give up.”“Right now, all I’m worried about is whether the cancer will come back,” said Fu Hetian, the boy’s father. “If it does, I really don’t know what I’ll do. Maybe I’ll just give up.”
Zoe Mou contributed research from Beijing.Zoe Mou contributed research from Beijing.