"Sharp Knives" Encounter New Crown Virus

On the morning of April 16, 2020, people waiting for rehabilitation or normal medical needs were collected from nasopharyngeal swabs in Wuhan Union Hospital infection department. On the same day, from 8:00 a.m. to 8:30 pm, Wang Weixian and nurses collected more than 600 nasopharyngeal swabs samples. After 76 days of pressing the pause button and restarting the city of Wuhan in the eyes of the new crown pneumonia epidemic eye, they need to go through the physical examination results with negative nucleic acid tests before they can participate in the resumption of work or leave the Han Dynasty. As of April 15th, the medical staff of Wuhan Union Hospital had collected tens of thousands of samples.

Wang Weixian is head nurse of infectious diseases department of Wuhan Union Hospital. After three consecutive months of undertaking the new high intensity pneumonia treatment, the infectious disease department once again assumed the new task of the asymptomatic infection screening and the non new crown pneumonia inpatient buffer room. In the new phase of preventing the outbreak of new crown pneumonia and restoring the same industry, they will also fight more.

"There are infectious disease team members in the new infectious disease area, the managed hospital, or the shelter hospital. In April 17th, Zheng Xin, director of the Department, recalled the fight against the epidemic. From the outbreak of the outbreak, team members took the lead and rushed to the forefront. "Under the impact of the outbreak, it highlights the importance of infectious diseases. In the future planning, infectious diseases will be given more responsibilities and pressures, including many large hospitals including Concord Hospital, which have embarked on a new plan for the development of infectious diseases.

"Sharp knives" encounter new crown virus

Before 2013, the Department of infectious diseases of Xiehe Hospital mainly treated all kinds of non respiratory infectious diseases including viral hepatitis, cirrhosis, bacillary dysentery, typhoid fever, septicemia, hemorrhagic fever with renal syndrome, fever with thrombocytopenia syndrome, and schistosomiasis. Zheng Xin, who returned from studying in the United States in 2012, joined the infectious disease department and began working with his colleagues to transform the infectious disease department.

"It is mainly to expand infectious diseases in narrow sense into a more mainstream infectious disease department in the world". Zheng Xin explained that they chose the most difficult fever of unknown origin in clinical practice as a breakthrough point. The departments regularly carry out a series of training and business improvement plans. Whenever there are difficult cases, the Department will organize Kone or hospital multidisciplinary consultation in time. Over the past few years, the number of patients with fever of unknown origin in the infectious diseases department has reached about 50%, which has accumulated rich experience in dealing with various kinds of difficult diseases, including many patients with rapid progression and multiple organ failure.

This kind of daily accumulation has made the new health care workers quickly respond to the call of the hospital and take the lead in the beginning of the new crown pneumonia. But the intensity of initial work has brought about tremendous changes in the pace of work.

In December 31, 2019, the Department of infectious diseases should start a fever clinic for 24 hours on duty and set up a new crown pneumonia isolation ward. As the first group of experts in the clinical treatment of new crown pneumonia in Xiehe Hospital, Zheng Xin also took the lead and other members of the expert group in the hospital quickly formulated the diagnosis and treatment plan of the new crown pneumonia in the isolation ward.

At that time, the five wards of the infectious disease department were gradually converted into isolation wards in three weeks. Critically ill patients living in the general ward of infectious diseases are constantly being transferred to other floors.

"Basically, it was the day vacant ward, and the day was full of patients. In just 20 days, there are as many as 5 scenes of "moving" scenes, and 6 times were moved by the largest number of patients. Wang Weixian remembered that a large patient who had been transported over the four floor could only be pushed over by a flat car. But when he was in the ward, he was jammed by the doorway. "We asked four nurses to lift a corner and bring him in. After entering the ward, there was a new change in his physical condition. We immediately started the rescue and was very nervous. Nurses are not adequately staffed. Nurses who rest at home take the initiative to help. No matter how late they are, they always wait for ward work to finish.

After moving to other wards in the later stage, they also encountered patients who could not rescue them. "The patients held our hands and the pain was revealed in their eyes." Zhang Li, the head nurse, said that at that time, weakness and frustration were coming in all of a sudden. Tears, nightmares and waking up had become a common occurrence. Zhang Li has not yet dared to touch the memory again.

Most medical staff in the infectious disease department had the same experience and similar emotional dike. "In the evening of February 6th, when I came home from work, I saw the group of friends and acquaintances in my circle of friends, WeChat group. They were expressing various anxieties. Self recognition is always calm, but sometimes tears flow down. Li Wei, deputy chief physician of infectious disease department, recalled.

The "kindling" scattered in the red area of the first line

Different from other departments, the experience gained from the early and new crown competitions, together with the special protection consciousness of infectious diseases doctors, and the infection of medical and health care departments in the ward, is the "fixing sea god needle" for other health care workers who have never worked in an infected environment.

Later, along with the progress of the epidemic, the medical and nursing departments of the infectious diseases were dispersed, and each group of doctors needed to manage at least one ward alone. Many people rushed to the next battlefield after being busy here. As a "fire" scattered around the Red areas of the first line, they formed a new team under the unified operation of the hospital and doctors from other departments, and continued to carry out treatment.

In January 14th, deputy chief physician Yi Jianhua took over an isolated ward on the first floor and never left the red area again. In January 23rd, twenty-nine in the new year, 6 second tier doctors in the infectious disease department, Wang Baoju, Zhou Ruxia, Guo Chunxia, Zhou Helong, Ye Pian and Chen Xiliu, with simple luggage, were stationed in the Honghui Hospital of Wuhan. They took the treatment plan and management mode of the concordance ward.

This is when the epidemic is most serious, Wuhan Union Hospital set up a transitional ward, A5 ward, to alleviate the hospitalization problem of confirmed patients in Jianghan shelter hospital and emergency department. In February 9th, Li Wei was appointed the responsible doctor in the new ward. She also went with Professor Wu Jun and Dr. Tian Jin and doctors from different specialties in the hospital.

A5 ward is transformed from Department of orthopedics ward, and can not be divided into three districts and two channels. Doctors offices and nursing station are all in the polluted area, requiring three level protection. Many patients are in critical condition, breathing machines, and combined with varying degrees of underlying diseases. Infectious diseases involve all organs of the body, and contact and deal with diseases of different specialties in the usual medical work. At the moment, the infectious diseases doctors control the advantages of diseases.

Almost at the same time, Zheng Xin took the 7 nurses, including Dr. Weng Zhihong, Dr. Zhu Bin and Kuang Zi Feng, together with other departments and doctors and nurses, and transferred to the Wuhan Union Hospital Tumor Institute. On the night of the ward, they stayed up all night and admitted 64 patients.

Department of infectious diseases in the post "new crown" era

From 0:00 on April 8, 2020, the Han channel was officially opened. Wuhan entered a new phase of epidemic prevention and rehabilitation. The isolation ward of the infectious disease department has been converted into a buffer zone for screening new crown pneumonia patients, and has once again become a firewall for combating new crown pneumonia. After fighting for more than three months, they continued to welcome the new task.

Nationwide, infectious diseases are relatively weak in the distribution of medical resources in the past.

Chen Guoqiang, Vice Chancellor of Shanghai Jiao Tong University and Dean of medical school, once pointed out in his article "thinking about the new coronavirus infection epidemic situation" that Wuhan's medical resources for infectious diseases are insufficient, Wuhan's household registration population and resident population are 14 million, while two special infectious diseases hospitals, the gold and silver hospital and lung hospital, have a total of 900 beds. 0.64 beds / 10000 people, far lower than the number of beds in infectious diseases hospitals in China, according to the standard set by urban non-agricultural population 1.2-1.5 bed / ten thousand people.

In twenty-first Century, according to the survey by the economic news reporter, in Wuhan, there are infectious diseases departments in general large tertiary hospitals, and the disposition power of departments is slightly different. Other small and medium-sized hospitals rarely set up infectious diseases.

Wuhan Union Hospital's infectious diseases department has 120 beds, and nearly 100 medical staff. Usually a bed is hard to find. The infectious disease department has its own Institute of infection and immunology and clinical laboratory. This comprehensive arrangement is in the forefront of the construction of major hospitals in Wuhan.

Reviewing the experience gained from the epidemic, both the public health system and major hospitals have further intensified their emphasis on infectious diseases. At present, Wuhan Union Hospital has planned to set up an infectious medicine center including medical centers and infectious disease medical laboratory and clinical research center. In accordance with national standards, a negative pressure isolation ward with three districts and two channels has been set up to achieve the purpose of combining medical treatment with prevention and combining peacetime and wartime.

"Infectious disease is an important and integral part of the hospital." Li Wei believes that as a modern comprehensive hospital, infectious diseases departments need to undertake the tasks of antibiotic management, early identification of new infectious diseases, treatment of severe infections, and the establishment of hospital sense control programs in collaboration with the hospital staff. Powerful large general hospitals also need two generation sequencing related equipment, capable of testing new pathogens and rare pathogens, improving the level of diagnosis and treatment of infectious diseases and reaching the leading international level. "In the future, as a clinical front line for prevention and control, comprehensive hospitals will be capable of doing two generation sequencing, timely issuing scientific and authoritative reports to assess the contagion and harmfulness of diseases, not only for better targeted treatment, but also for controlling the spread of diseases and protecting people's health."

The post "new crown" era will spawn a substantial leap in the infectious disease discipline.

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