As of April 29, the number of patients in the isolation ward has dropped to more than 50, and some wards have been temporarily closed.
Text | Huang Qi
The Omikejung mutant strain is a great threat to the elderly and children.
On April 28, the Shanghai Municipal Health Commission announced the situation of positive infected children in Shanghai.
Since the current round of the epidemic, Shanghai has reported a total of 12,707 cases of positive infection among children under 6 years of age, accounting for about 2.4% of the total number of infected people; the cumulative number of discharged and released from centralized medical observation is 7,480. They are mainly admitted to designated hospitals such as the Municipal Public Health Clinical Center, and some asymptomatic children are accompanied by guardians and admitted to the Fang Cabin Hospital.
In addition to designated hospitals and cabin hospitals, some children with other serious diseases are infected with new crown, such as children with tumors, children with serious heart diseases, children with blood diseases, and children after organ transplantation, who are found to be infected with new crown in children's specialist hospitals, and will receive treatment in children's specialist hospitals for a period of time and then transfer them to designated hospitals or cabin hospitals.
More than 5,000 loaves of bread came to the children with the help of the Pudong Public Welfare Promotion Association and the district-level transportation department
Since April 1, the Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine has received and treated more than 600 children infected with COVID-19, of which more than 60 are positive children with underlying diseases. The hospital urgently set up isolation wards and formed a medical team, including surgeons, to ensure a smooth transition of these children in the isolation wards.
Give a seriously ill positive child a safe island
On the evening of April 21, in the isolation ward of Shanghai Children's Medical Center, a child with cirrhosis and severe ascites suddenly became serious, and after the first active treatment, the child turned the corner. This child is not a COVID-19 positive child, but because he has been exposed to other positive children before, he was judged to be a close contact.
"This child is close contact, what if it is a positive seriously ill child who needs surgery?" What should I do if I need first aid? Cao Qing, director of the Department of Internal Medicine of Shanghai Children's Medical Center, told reporters that at the beginning of this round of the epidemic, the hospital made the decision to expand the isolation ward, which was to consider the safety of these special children in the epidemic.
A young doctor invited Miao to work in the isolation ward
In mid-March, there was an outbreak in Pudong, and the Shanghai Children's Medical Center also closed-loop management for a short time, when some seriously ill children had difficulty seeking medical treatment. Summarizing the lessons learned from the previous epidemic, the hospital merged the wards of other specialties at the beginning of this round of epidemics, freed up a whole building as an isolation ward, and admitted and treated the new crown positive children with underlying diseases, as well as the new crown positive children with more severe symptoms, and then transferred to the designated medical institutions or cabin hospitals after the symptoms of these children were controlled.
From April 1 to April 29, about 10 percent of the more than 600 children admitted to the isolation ward were themselves suffering from underlying medical conditions, and other children's symptoms included fever, high fever convulsions, severe diarrhea, and so on.
From the beginning to the middle of April, when the epidemic was the worst, more than 200 beds in the isolation ward were fully filled, and in recent days, as the epidemic situation in Shanghai has improved, the beds have gradually been vacated.
Because many positive children with serious illnesses have been admitted, in addition to infectious diseases and respiratory doctors, doctors from hematology, neurology, endocrinology, and surgeons from thoracic surgery and neurosurgery have also been added to the medical staff of the isolation ward. There are also operating rooms and intensive care units in the isolation wards. "Doctors join a multidisciplinary team to keep these children safe."
Cardiothoracic surgeon Dong Wei signed up to support the isolation ward at the beginning of the epidemic, but because of the infection in his own building, he joined the medical team of the isolation ward after meeting the conditions on April 9. He introduced that several positive children with heart disease who had undergone surgery in the ward, as well as children who had undergone tracheal surgery, all belonged to the category of cardiothoracic surgery. One of the more concerned children had previously been treated by ECMO and later contracted COVID-19.
These children are very weak in resistance, and the likelihood of developing severe illness after contracting the new crown virus will be greatly increased. "Our isolation ward is also a parent-child ward, allowing parents to accompany them, and parents will be more at ease when they see surgeons and hematologists." Dong Wei said.
Isolation ward care is assembled before the ward opens
Li Xin of the Department of Endocrinology entered the isolation ward on April 7, responsible for the seventh ward of the isolation ward, and she managed 30 beds with three doctors. In Dr. Li Xin's ward, there have been many hairy heads under the age of 1, because the baby has not been injected with the new crown vaccine, the child is diagnosed with the new crown after fever, parents will be particularly nervous and anxious; children under the age of 2 account for about half.
Dr. Li Xin was also impressed by two children.
One is a child with a tumor who is infected with the new crown virus during chemotherapy, "this kind of child has low white blood cells itself, low immunity, and it is very dangerous to have symptoms of infection." Another child suffered from a malignant tumor, which was combined with the new crown again, and had difficulty breathing, and his condition was more critical. In the end, both children stabilized after treatment and were discharged from the hospital.
Dr. Li Xin laughed and said that the team of doctors in the isolation ward is a "special force", which is urgently formed by various children's sub-specialists, but it is precisely because of multidisciplinary cooperation that these special children who are vulnerable have the most complete life and health protection.
Li Xin still remembers a child who came to Shanghai to see a doctor, the child suffered from mediastinal tumors, and the father was illiterate, not to mention that the treatment plan was not very understandable, and even in Shanghai it was difficult to stay and eat. The social work department of the hospital helped the father throughout the process, arranging for him to live in a public welfare free dormitory, and the hospital also paid special attention to these two fathers and sons after the infection with the new crown.
Li Xin introduced that the 30 beds in the ward in the most serious stage of the epidemic were all full, and due to the shortage of square cabin beds at that time, it was relatively slow for stable children to be transferred out. In recent days, the transfer has become faster and faster, the number of children admitted has slowly decreased, and the beds have begun to be vacated.
The paramedics put the baby out of the hospital to the car
Director Cao Qing introduced that as of April 29, the number of patients in the isolation ward in the hospital dropped to more than 50, and some wards have been temporarily closed.
Children who will also be retrograde in Shanghai during the epidemic
The "last stop" in the isolation ward is the fever clinic.
In children's specialized hospitals, fever is the majority of outpatient symptoms, in order to protect more children, the hospital set up ordinary fever clinics to receive fever children in the ordinary community, if it is a risk group of children to go to fever isolation clinics.
During the epidemic period, more than 30 doctors from the general fever clinic and isolation clinic of Shanghai Children's Medical Center entered the closed-loop work, and the earliest batch worked from March 18 to the present, and later successively reinforced medical care.
Dr. Shen Nan of the Department of Infectious Diseases first went to reinforce the emergency department, and began to enter the closed-loop work of the fever clinic on March 28, and was one of the 15 "pioneers" who had been stationed in the fever clinic for more than a month.
Shen Nan remembers that one day, the laboratory sent a message to the fever clinic, and more than ten positive cases appeared in a batch of test reports. "I remember it very clearly, and it was a bit of a breakdown in an instant." More than a dozen positive children plus parents, medical staff must immediately isolate them, protect other negative children and parents from infection, medical staff also have to comfort positive families to avoid panic.
Although isolation rooms are prepared for fever clinics, it is clear that it is not enough to isolate more than a dozen families. The paramedics let the clinic out for the positive patients to isolate, and the doctors moved to the nurses' pre-screening desk to continue serving the other children.
The fever-stricken health care workers persisted for twelve or three hours that day until the positive infected person was settled into a ward or transferred to another hospital. "Although it was very tiring during that time, there was a lot of unity between colleagues and there was a feeling of fighting together."
In the epidemic, the fever clinic that is still open is sometimes the lifeline of the child. Shen Nan remembered a child she received who had been suffering from a fever for more than ten consecutive days. The child suffers from congenital immunodeficiency and lives in Jiaxing, Zhejiang. Previously, the child had been treated at the Shanghai Children's Medical Center, and was a patient of Dr. Shen Nan, but due to the special disease, there were no good treatment conditions in the local area.
During the epidemic, the mother of the child resolutely took the child to shanghai again on the high-speed train, and in addition to her and the child, almost all the medical staff supporting Shanghai in Zhejiang were on the train. Someone asked her why the epidemic was so serious and she had to take her child to Shanghai, and the mother replied: "If you don't go to Shanghai, your child's illness will not be cured." ”
The staff of the high-speed rail station learned about the child's special situation, and after getting off the bus, they called a 120 ambulance for the child and sent it directly to the hospital. "When the child's mother saw me, I said, 'I feel hopeful when I come to you."' Shen Nan said.
In addition to this child with a serious illness, there are many urgent situations in the fever clinic. Within a month, Shen Nan himself experienced two first aides, both of which were high fever convulsions in children. There was a child with fever and cramps, the nucleic acid test was positive, and the neurology department that supported the fever clinic conducted a preliminary assessment of the condition, carried out timely treatment after CT examination, and later the child's condition was smoothly transferred to the cabin hospital.
There was also a feverish child, whose cause was sudden encephalitis, who was sent to the fever clinic by 120 when his breathing was already urgent, and his blood oxygen saturation dropped to a dangerous level.
"We have a 120 system in the hospital, as long as this phone is called, the rescue team including anesthesiologists, critical care doctors, etc. will come to support, and generally a few big whites will appear neatly in the fever clinic in 5-10 minutes." Later, after resuscitation, the child was in stable condition and transferred to the neurology ward of the hospital, and has now been discharged.
Dr. Shen said that the fever clinic of Shanghai Children's Medical Center has not been closed in the past month, and only after the emergence of positive infections will sanitize be suspended. "When sanitize, our medical staff did not leave, and when the sanitize was over, we continued to receive patients. This temporary closure is also to protect the children who come to see the sick later. ”
Fever clinic with small clothes for diaper powder
As the only children's specialized hospital in Pudong, Shanghai Children's Medical Center usually has a very large outpatient volume, and during the epidemic period, it has become the only channel for feverish children in Shanghai's most populous district to see a doctor. Wu Yufen, deputy director of the outpatient emergency department of Shanghai Children's Medical Center, said that in the first two weeks of April, the epidemic situation was the most severe, the probability of positive cases in isolated outpatient clinics was as high as 80%, and the highest positive rate of ordinary fever clinics was also 70%. The biggest pressure on medical staff is to protect children who are not infected while arranging timely referral of positive children.
Once tested positive for COVID-19, both the child and the parent must be isolated at the first time, which often makes the parents very nervous. In order to solve the most practical difficulties of parents, a batch of "forever in stock" baby food and supplies was placed in the fever clinic.
"At the beginning of the epidemic, everyone had no experience, and the parents of the confirmed children did not bring anything, and the family may have to wait a long time to send something to the hospital." In the middle of March, everyone found this problem, so we prepared the baby milk powder, baby cookies, diapers, small blankets, and changes of clothes collected from various sources for these children who suddenly faced isolation in the outpatient clinic. Dr. Wu said.
In the process of waiting for the next step of the arrangement, children and parents cannot leave the isolation clinic, so they are all medical staff to deliver water and meals.
Wu Yufen remembers that in the early days of the epidemic, the fever clinic also encountered emotional outbreaks among parents, mainly because they did not believe that their children were infected, and at the same time, they were worried that the conditions of the Fang Cabin Hospital were not good. With the development of the epidemic, parents have also been more fully prepared. "In the later stage, some parents dragged their suitcases to the clinic, and he may have suspected that he was infected, so he was ready to be isolated."
Dr. Wu said that the team of doctors working in the closed fever clinic is mainly post-80s and post-90s, and many of them are mothers whose children are only two or three years old. Everyone stuck to their posts, gave up their small homes, and fought the epidemic for the more important city.
Dr. Shen Nan has three cats in her home, which were recently cared for by a colleague. "This colleague took care of several of our colleagues' cats at home." Dr. Shen said that sometimes in the dormitory, I heard colleagues talking to the young children in the family on the phone, and I could feel the concern of colleagues for the children. But white clothes, the medical staff chose to stick to it.
Director Cao Qing introduced that with the control of the epidemic, the number of beds in the hospital's current isolation wards is constantly shrinking, but as a children's specialized hospital, it is necessary to make long-term preparations for the sporadic outbreaks that may occur in the future.