The old man waits for the bed in the cold wind, the emergency room doctor collapses and tears, the mortuary is full... In the past two months, the scale of the fifth round of the epidemic in Hong Kong is unprecedented, with a cumulative report of 1.04 million infected people and more than 5,900 deaths. Under the vision of "dynamic zero clearance", Hong Kong has added more than 10,000 new products every day, and once tried to implement compulsory nucleic acid testing for the whole people.
After the chaos, the situation finally began to improve in mid-March, and the number of infected people decreased. On March 21, Hong Kong Chief Executive Carrie Lam Cheng Yuet-ngor announced the suspension of nucleic acid testing for all people, lifted the ban on nine countries from April 1, and maintained most social distancing measures until April 20, after which it was gradually relaxed in three stages, gradually resuming the evening market, fitness centers and other places.
Hong Kong is a mirror that reflects the present and future of China's local epidemic prevention and control. Starting from Hong Kong's experience, how will we adjust our prevention and control system and diagnosis and treatment strategy?
We have connected the stories of many ordinary people in Hong Kong, from panic and disorder to self-help, and their struggles are extremely realistic:
A local Public Welfare worker in Hong Kong traveled to Hong Kong Island for more than 20 days to deliver supplies to the confirmed family, and after helping many families, he was finally infected; a single mother did not want her child to be infected, and within three hours of getting a positive test result, she urgently decided to let her 15-year-old brother take her 7-year-old brother across Shenzhen Bay.
A family of five in two months, has experienced penny bay close quarantine isolation and confirmed home anti-epidemic, the hospital is full, so that the mother helplessly uses the "soil method" to treat the new crown for the three-year-old child. The family stood on the balcony, counting the clouds floating in the sky, the green clothes of the opposite building and the number of people getting on and off the elevator, and looking forward to a spring of cycling together.
But in the hospital, another narrative of joy and sorrow is playing out. One by one, real people, one by one, the infected people who unfortunately died were numbered, and everyone lined up to go to treatment, and then lined up to go to the funeral. Under the epidemic, hospitals and nursing homes are seriously understaffed, some people are facing seventeen or eight hours of ultra-long work, carrying bodies, cleaning the beds of discharge and death, using jokes to resist weakness, using "pig mouth" to resist the virus, under the burden, the truest idea is to hope to be infected, and then rest for 7 days.
Among all the ordinary people in Hong Kong, we finally decided to tell the story of Sun Kun (pseudonym). He was the steward of a public hospital in Hong Kong, responsible for cleaning and transporting the hospital, and every day, he could see all kinds of people coming to the hospital and sending away those who had unfortunately died. At four o'clock in the morning, the bauhinia flowers did not sleep, and after four interviews, Sun Kun finished telling his story:
Life and death have to queue up
At the end of the 20-hour work, I temporarily left my "battlefield".
I am a "porter" and the body, garbage, medical equipment, and high-risk patients all need to be transported through me to a designated place. On the taxi back, the driver looked at me with strange eyes, and I suddenly realized that due to the long work, my plainclothes had already emitted a putrid smell.
Those were 7 bodies left in various corners of the hospital, where they had been left for more than three weeks. My task was to temporarily transport them by float to the mortuary freezer, which has a low temperature of 2.5° C all year round, clean and comfortable.
The mortuary has been in a hurry for a long time. Even without the outbreak, hospital mortuarys are filled from time to time. Since March 5, there have been more than 200 new COVID-19 deaths in Hong Kong every day.
During these two days (March 8 and 9), we carried 40 or 50 bodies every day, most of them elderly. We transported the remains from the emergency room to the dissection room, from the ward to the freezer in the mortuary, from death to cremation, which needed to be transferred by multiple hands, and some FEHD staff, hearse drivers, and funeral home service personnel were recruited due to the spread of the epidemic, and all the processes were delayed again and again.
The negative pressure ward has been used up at the third and fourth days of the Chinese New Year, so the hospital management has placed a SERIES HIPER FIFTER blower that can pump out the new crown virus in the ordinary ward, and transformed the original six-person room into a five-person room for the new crown patients.
Emergency rooms are run heavily. In our hospital, many elderly people covered with aluminum paper in the cold wind waiting for the release of beds in the emergency room.
On February 18, public opinion surged and forced the hospital to take action. From 1 p.m. to 11 p.m., we moved all the patients in the open-air makeshift tent to the emergency room corridor on the first floor. The air system in the corridor is also maintained by an extractor, and the elderly, mostly from nursing homes, do not wear masks, do not drip, just lie down.
On the same day, both the Hong Kong Observatory and the Guangdong Meteorological Observatory reported cold wave weather, the wind blowing hard, and the mother with the baby could not find hot water. We stole some heaters and water dispensers from hospital staff quarters and office buildings. That day I dismantled three makeshift tents and moved 30 hospital beds. The whole process is like a war, chaotic, panicked, tired.
The reason for the chaos in Hong Kong is that the zero-zero policy was adhered to at the beginning, and a large number of mildly ill patients poured into public hospitals, and private hospitals could not undertake it. Patients with milder symptoms still have to wait in line for more than ten hours to see a doctor, and rounds are made after three days.
For more than a decade, no large hospitals have been completed in Hong Kong, and there have always been insufficient beds, and in the past, it took about four or five hours to queue up for public hospitals, and elective surgeries often required years of waiting. In addition to the public healthcare system, Hong Kong has 13 private hospitals and a certain number of private clinics, but they do not accept COVID-19 patients.
Local governments have yet to provide an effective mechanism for these hospitals to operate: is there a systematic treatment guidebook, whether employees need to be quarantined if they are infected, and who will bear the cost of isolation...
Hospitals began to gradually adapt to the rhythm of the epidemic. In the first month, the discharge standards of the hospital were still very high, so that those who needed to be admitted could not be admitted, and now they have been changed to two negative self-tests to discharge, and the CT value standard is also lowered because there are not enough beds. Like the body I was going to do, I said in the morning that I would put it in the mortuary, and in the morning I would not be notified to move to the ward that was still under renovation, because there were not enough morgues.
The double day of life and death, the living person waits for the bed in the emergency room to lie down, and the dead person sleeps on the bed and waits for the mortuary to be put away.
I also want to be infected for 7 days
Along with the patients, there are also people in various departments, some are isolated because of infection, some quit their jobs because they are afraid of infection, and some are tired because of the workload.
In my support services department, for example, there were originally 252 staff members, 151 of whom were listed as confirmed or close contacts because of social mobility, and needed to stay at home or in centralized isolation. My working hours have also doubled sharply from the original 8 hours, and I work two-person shifts by myself. The number of caregivers is also decreasing, with 3 nurses and 3 nurses caring for more than 80 patients, the same task is usually done by 8 nurses and 5 nurses.
I also want to be infected so that there is a legitimate reason to rest for 7 days.
I survive by drinking three cups of coffee and extra strong Pu'er tea every day, and the department hangs a couplet of "weak business". Crazy electric bells are always ringing in your ears. The constant influx of orders from departmental computers is overwhelming. Minor Clearance/Great Clearance, Blue Card/Red Card/High Risk, Post-Engineering Clean-up, Special Services (Transport of Remains)... The number of high-risk beds to clean is the most intuitive, last November, we only needed to clean more than 20 high-risk beds per shift, and in March this year the number exceeded 100.
Every time I clean up one ward after another in my blue isolation suit and N95 mask and face shield, I often hear patients wailing, coughing and the sound of various medical devices. "The doctor did me a favor to let me die early, I was in pain," but I knew that being able to feel the pain and make a sound represented hope.
We need to give strength to those who are silent. Once, I delivered an oxygen machine to an 85-year-old woman diagnosed with COVID-19, and she looked depressed. I asked my mother-in-law if she was still in good health? The mother-in-law said that she was very sad, and she came in at such an old age, and she was afraid that she would not be able to survive this pass. I comforted her and said, you can still speak very clearly, isn't it good to enjoy the benefits of the government now? Nurses and nurses are very good, what needs to press the clock, I also live in Kowloon, may have the fate to see you in the restaurant one day, the mother-in-law is very happy to listen.
There is too much demand and too little that can be done. Many times I would force myself to build an emotional barrier, pretend to be indifferent, and make some neurotic jokes to relax the atmosphere, "I like to move the body because I can spell, I let them give me a massage." 」 ”
All jokes are fragile in the face of life. I'm back to the busy, hard life I used to be. Don't let your own detailed emotions, hesitations, and feelings slow down the operation of the system, let those who are waiting for medical services enter the hospital for treatment earlier, and let the dead settle down earlier, which is my shame as a survivor for the unfortunate.
The dying, the dead. Lying people, sitting people. Screaming, crying, wailing. I often use the spirit of A Q to relieve myself of ridicule, "Ignite the fire, a loud noise the whole world is clean."
"Beep ————", the calm was interrupted by a strong noise of the BP machine (blood pressure monitoring instrument). "First aid," the nurse shouted. Another swarm of people rushed up, a slice of Bed 15 in Ward 9a. At that time, I was standing by the opposite bed to collect the body, ready to start carrying, and the doctor on the bed stopped me, "Master is sorry, there is another one here", no more than 5 minutes before and after.
The dead patient lay in his hospital bed as if asleep. I walked over, bowed to him slightly, and said, "Immortal friend, I'll help you, go all the way, what do you need to give me."
Sorrow and hope in the age of the pandemic
I joined the hospital as a steward in December 2019.
Before I joined, I needed to take an infection course online for training, including protective cleaning, how to wear pp clothing (isolation gown), personal protective equipment, etc. Before the outbreak of the epidemic, my job was mainly to deal with many cleaning orders, "Xiaoqing" is to change the bed cloth, and then use bleaching water to wipe all the places again, "Daqing" has one more procedure to change the bed curtain. Aside from the rest of the high-risk wards, our only piece of protective equipment is a surgical mask with first-class protection.
In hospitals, each item is labeled and colored differently, indicating a different level of risk. Red represents high risk, and recently we are generating more than 7 tons of medical waste every day. Silver gray represents infection, and COVID-19 deaths are often packed in such bags. Green and transparent represent safety and are used to hold ordinary deaths. Blue represents protection, and we wear blue straps to high-risk wards and transport bodies instead of white zippered suits. Although in my opinion, the latter has a higher level of protection.
Earlier, in 2003, I was a police officer who wore a "pig's mouth" (a gas mask that filters out gas and dust) during the SARS outbreak to enclose Amoy Garden, Block E, the hardest hit area.
I want to wear a "pig's mouth" because I think it has a higher level of safety and gives people a trustworthy and down-to-earth. When the epidemic first broke out the year before, I also put on a pig's mouth and came to the hospital. But the manager said don't wear this scare people to death, it will cause unnecessary panic. So, I took it off.
Now, I work 18 hours a day and then go back to my 18-square-meter house. I live alone and don't pass the virus on to my family, and I'm luckier than my colleagues, many of whom are infected.
I have also envied the closed-loop management of medical care in the mainland and can live in isolated hotels. But Hong Kong does not have so much land space, and many Hong Kong families live in conditions that are not suitable for home isolation.
A better family can also have a 40, 50 square meters of two bedrooms, a living room and a bathroom. Still others live in public and subdivided houses, some of which are crowded like small warehouses. Some infected colleagues rely on the help of neighbors and social workers to receive daily necessities and medicines, and without local isolation and cleaning guidelines, they can only rely on word of mouth and methods collected online: alcohol, disinfectant water, ultraviolet lamps, N95 masks...
I'm not afraid of infection, nor am I afraid of carrying, but I often ask when such a day is a head.
I haven't been home for almost three years, and although my family is in Hong Kong, round after round of epidemics has made it impossible for me to see them with confidence. My parents are in their sixties, my father has high blood pressure and heart disease, my mother has lupus erythematosus, her immune system is low, and my mother-in-law and grandmother are also eight or ninety years old. They had three shots of the vaccine, but they were all at high risk, and I didn't want to pass on the risk of infection to them.
Before the pandemic, my work was running smoothly, I was well staffed, and the patients' faces were the same as the time and date, nothing special. He works eight hours and forty-eight minutes a day, and he gets eight days off every month. If I take one day off I go to bed; if I take two days off, I sleep, exercise, and study orthopedic classes; if I take three days off, it's a pleasure, and I'll say to the master of the pain clinic, "Hey! I'm here again", and then the whole day was spent on the internship. However, since the 18th of last month, I have not taken a vacation.
Becoming a Chiropractor has been my wish for many years, and I have completed 2 subjects before this round of the epidemic, and there are still 6 waiting to be completed. I heard that a Chinese medicine hospital will be built in Hong Kong in 2025, and I want to apply to become an orthopedic doctor.
Yan Shengnan | wrote
Chen Xin | Editor
This article was first published on the WeChat public account "Eight Points Health" (ID: HealthInsight)
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