Medical workers in Beijing leave for Wuhan, Hubei province, on Jan 26 to fight against the pandemic. NIU HONGCHAO/FOR CHINA DAILY
Li Haichao, vice-president of Peking University First Hospital, and his team have kept their habit of meeting daily at 7 pm since returning from Wuhan, Hubei province, in April.
However, these days, instead of discussing COVID-19 treatments, they hold online singing parties through video chats.
Li, 51, led a 135-member team from the Beijing hospital that was dispatched in three groups to help patients at Tongji Hospital's Zhongfa Xincheng branch in Wuhan at the height of the outbreak in February. When the team left Wuhan on April 4, 100 of their 115 COVID-19 patients had been discharged.
"Our job of helping the patients recover was only a part of the whole medical-treatment system," Li tells China Daily, adding that the teamwork was not just among the medical workers but also residents of the city, such as bus drivers and hotel staff.
Li and his team arrived in Wuhan on Feb 7, and there was only one day left for them to prepare to take over the west zone of the ninth floor of Building B in Tongji Hospital, which was originally designated for tumor patients.
Turning regular wards into special ones, setting the course for patients and medical staff, training all members on prevention and control of infection and arranging protective equipment－all these tasks had to be done within 24 hours.
On the night of Feb 8, 10 patients were transferred to the wards. Two days later, all 50 beds were filled.
The seriousness of the COVID-19 patients and the limitation of medical resources were the next challenges Li and his team faced.
Ventilators were significant in treating serious cases but there were only three for medical treatment and five home ventilators. Sometimes Li and his team had to borrow ventilators from other departments of the hospital or other hospitals in the city.
"We used oxygen carriers to fill the gap, and our rule was to maximize the use of resources to treat patients," Li says.
There was limited protective equipment. At first, they could only be assured of access to such protective equipment as facemasks and suits the night before they'd be used.
Peking University First Hospital's team returns to Beijing after completing its mission in Wuhan on April 6. [Photo/Xinhua]
Maximizing resources
Li took part in the fight against the SARS outbreak in China 17 years ago. He says COVID-19 has some similarities and differences with SARS.
"The duration of the severe illness was long and there were many details that we needed to pay attention to. So we were vigilant all day," Li says.
Some COVID-19 patients' conditions suddenly got serious after seven or 10 days without any early symptoms, so the team enhanced monitoring of patients.
"For some patients who get hypoxemia, they may not feel it and can still do some physical activities or take phone calls, but their oxygen levels drop sharply, which is very dangerous and needs special monitoring," he says.
One morning on the way from his hotel to the hospital, Li almost cried when hearing the message that one of his patients' oxygen saturation had returned to over 90 percent－it was a good sign, though it only lasted for a moment.
In a Chinese journal, Li writes: "We tried our best and kept an eye on all health parameters to avoid drops in the oxygen levels because of any short-time mask removal from the patient. The patient's will power made us believe that she would make it through."
Among the 31 doctors in the team, seven were respiratory experts, three worked in critical care and the others specialized in cardiology, gastroenterology, endocrinology, hematology, nephrology, and rheumatology and infectious diseases. Li arranged the shifts for the doctors.
"It is not a simple treatment of pneumonia, as the virus infects many systems in the body. Sometimes the therapeutic schedule might be a double-edged sword. For example, the measures to control the pneumonia might damage the immune system, and there is also potential infection," Li explains.
"We needed to discuss with doctors from different hospitals to give patients an effective treatment."
Li gave two endocrinology experts in his team a special task. When they were on duty, they needed to check all patients whose blood glucose levels were abnormal and based treatments on whether or not to use insulin and what dose.
Li also gave two doctors whose hometown is Wuhan an extra task－they took turns talking to patients in the local dialect every day.
"Our nurses were so nice to the patients that they always smiled. That gave the patients comfort."
Li's colleagues in Beijing assisted the team remotely.
There was one patient who got rashes. Li's team took photos and asked dermatologists in Beijing for advice.
Besides the day shift, Li had two other daily routines－joining discussions about treatments for difficult and complicated diseases with colleagues from Peking University's two other hospitals at 4 pm and meeting with medical groups, care groups and logistical groups at 7 pm.
A consultation center was built in Tongji Hospital, where doctors gathered every day to discuss seriously ill patients' cases.
Li Haichao leads the hospital's team in Wuhan. [Photo provided to China Daily]
Joint efforts
"Because it was a new disease, nearly every discussion brought a collision of ideas, and new problems tested our experience and knowledge, and challenged our wisdom," Li says.
"Doctors of all specializations, and even nurses, joined the discussions, which helped us improve our knowledge and treatments."
Li says the doctors also read the latest papers about the virus from around the world and constantly exchanged updates.
Sun Lu, one of the two administrative staffers in the team, says Li was like a "head butler".
"When a new patient was transferred to our ward, Li would lead the team to develop a treatment plan," Sun says.
"He designed a system called 'long day shift'－each doctor was doing three consecutive day shifts so that the treatment for each patient was sequential."
Sun says Li was also in charge of deciding when a patient could be discharged, which was tricky because they needed to make sure the patient had fully recovered and ensure they didn't stay in the hospital for too long.
Li also cared about medical workers' mental health.
When the work was not that intense in late March, he arranged some small activities for medical workers and hotel staff to relax a bit, such as making dumplings together, Sun recalls.
Li has been a doctor for 40 years. To be a medical expert, one has to also be a collaborator, communicator, professional, leader, health advocate and scholar, he says.
"Now, we view the pandemic as suffering and hardship. But if we analyze and research the outbreak, our healthcare system will improve," Li says.
"Scientific literacy, the spirit of professionalism, doctor-patient relationships, and life and death in extreme situations are important components of medical education. This experience of fighting COVID-19 has led me to engage these more deeply."
