Since China issued “ten new rules” on December 7, small, understaffed hospitals are seeing Covid patients 24 hours nonstop at fever clinics. Many doctors are working while sick.
The night view of Dazhou, Sichuan Province. Photo from CFP
By ZHAO Meng
The photo making its rounds on the internet showed a dozen masked men sitting shoulder to shoulder on hospital benches, IV bags hanging above their heads. Some were dozing off. All looked exhausted. The scene took place inside a clinic in Dazhou, Sichuan. Local bloggers said there were so many Covid patients in Dazhou that some had to receive IV treatment on the street.
As people watch Covid’s progress, anxiously awaiting their turn, Dazhou has become synonymous with overwhelmed hospitals. Dazhou’s healthcare resources were stretched to the limit, but public health officials say that the outbreak has peaked and life is returning to normal.
China issued “ten new rules” on December 7 to relax the Covid control measures. Before that, Dazhou, a city with a population of 5.9 million and a fifth of which are over 60, went into its biggest lockdown in three years in November for surging Covid cases.
HU Bo, a local blogger, said there were long lines at every PCR booth since negative tests were needed at all public venues. People spent entire days waiting in multiple lines.
Officially, daily new cases ranged from single digit to two dozen in the last two weeks of November. But by November 20, the comments section of the Dazhou government’s WeChat blog was flooded with complaints. For one thing, children had to queue for hours every day for nose swabs to be allowed into classes.
The reality was that many symptomatic patients simply recovered at home – without a negative test they couldn’t enter a hospital anyway. An official said the delays were partly due to the large workload, and partly due to “abnormal results.”
On November 28, the lockdown was lifted as inexplicably as it started. On November 30 – official case count 10 – the government issued an open letter warning residents that “the pandemic is not over yet.” Infections were still spreading wide and fast, and the city faced severe challenges.
When “ten new rules” were issued, hospitals were already overflowing. The fever clinic at Dazhou People’s Hospital, usually staffed with two physicians, saw three times as many patients as normal and had to borrow doctors and nurses from other departments.
Small, understaffed hospitals were more stretched. XU Hong, an obstetrician at Dazhou Southern Hospital, said doctors were seeing Covid patients 24 hours nonstop at the fever clinic. The rest of the hospital was so shorthanded that doctors with symptoms were called to work. Xu herself saw patients while having a fever and headache. In fact, almost every obstetrician in her hospital worked while sick.
Hu Bo’s family of four all contracted Covid around that time. He and his wife felt horrible, but the two children hardly showed any symptoms. He stocked up on pain and fever medicine before the outbreak, but most people were not so lucky. Long lines formed outside pharmacies. Where to find ibuprofen became the talk of the town.
Hospitals and clinics were running low on medicine. At least 30 clinics had to turn patients away because of the shortage. Then, in an unexpected turn of events, the “IV gathering” photo went viral. The local government, alarmed, banned injections and IV treatment altogether.
“Some patients came to us, delirious with 40-degree fever, and were told that no treatment was allowed,” LIU Xiaowang, a primary care doctor at a community clinic, told Jiemian News.
The ban was lifted on the same day as it was issued.
On December 11, the Dazhou Center of Disease Control issued a statement that ibuprofen and Covid antigen tests were in short supply nationwide and that the government and pharmacy chains had been in contact with drug companies to buy more. It promised to “monitor sales in real-time” and “make every effort to meet demand.”
Small hospitals and community clinics were having the hardest time. “No medicine, no people. Of the two, I would say the shortage of medicine is worse,” said TANG Hao, a primary care doctor at a community clinic. He ran out of fever medicine on December 14. Five days later, after numerous calls to suppliers, he was still waiting for a shipment.
The wave subsided almost as quickly as it hit. Hu Bo’s two children were back to school on December 15. “Every kid in their school got it,” he said. He is back to work. An official at the Dazhou Covid workforce said his entire department has recovered. “We’ve all had it. It’s like having a cold, no big deal,” he said. His son also contracted Covid but recovered in two days.
Several doctors have reported a significant drop in the number of patients. This is partly because of the mild symptoms and quick recovery of the Omicron variant. Another reason, they observed, is that people are more educated about home treatment. Instead of panicking and overwhelming hospitals upon the first appearance of any symptom, most people now know to just rest at home.
Liu Xiaowang, the primary care doctor, said he saw as many as 200 patients a day during the peak of the outbreak, four times his usual workload. Now, he sees about 100 on a bad day, and about the same as before the pandemic on a good one.
But he is worried that rural hospitals might have it worse during the upcoming Chinese New Year holidays when migrant workers travel back to their villages and infect old people. Rural facilities, understaffed and under-resourced to begin with, will not have the manpower and expertise to deal with the wave of patients, many with chronic conditions are at higher risk.
Although understaffing can be partially resolved by calling retired doctors back to work – which the government has been trying to do – changes need to be made in how they work. There are strict rules on which doctors can prescribe what medication. A primary care doctor, for example, would not have authority for cardiovascular drugs, even though they might save the life of a Covid patient suffering from hypertension. Such red tape has to go.