Face to face with covid-19 on Hong Kong’s dirty team

A doctor from Hong Kong describes what it is like to work in a hospital managing the coronavirus outbreak

It’s 10am on a Hong Kong winter morning, and I’ve just finished my 16 hour night shift, but I’m not heading home. Instead, I’m going back to the hotel near the hospital, where, like the rest of my hospital’s “dirty team”, I’m staying for the next four weeks. 

The dirty team, comprising around a dozen junior and three senior doctors from across all specialties in each rotation, cares for the confirmed and suspected cases of 2019-nCOV virus infection (recently renamed covid-19 by the World Health Organization). At my hospital there have been four confirmed cases so far, out of 56 in Hong Kong as a whole, and we’re monitoring countless suspected ones. 

Members of the dirty team have to be extra careful when we touch patients. We’re in full personal protective equipment (PPE), N95 masks, visors, and we’re extremely conscious about infection control measures like hand hygiene. We have a separate office and showers, away from the rest of the team. We don’t eat in the staff canteen. After work, we basically detach ourselves from the outside world and try to avoid physical contact with anyone. We stay away from crowded places, and when we go out, we wear a surgical mask at all times. 

The hospital management drew lots to see who would join the dirty team and when. There are a few exemptions: pregnant staff, for example, those with medical conditions that put them at increased risk. I have psoriasis, and for that I was on long term methotrexate. It’s an immunosuppressant, so theoretically, I am weaker against germs than others. But it’s not a strong reason, so instead of being exempted, I opted to stop the drug for a couple of weeks before. My psoriasis might flare up, especially during these stressful times. But that’s nothing compared to the risk of being infected. 

I volunteered, as I’d rather do it now, than do it later. My wife is due to deliver our first child in April. The thing is, in the end, if this battle carries on until mid-2020, it’s likely that I will need to go back again later, but we’ll cross that bridge when we come to it. 

In the days running up to joining the team, I prepared myself and my family as best I could. All I could do really is ask my parents and friends to take care of my pregnant wife. There is nothing much to prepare, apart from psychologically. You can imagine this is super difficult for everyone, especially my loved ones, given that the hospital where I work is where Joanna Tse Yuen-man died in 2003. 

I think everyone in Hong Kong knows Dr Tse’s name, and that at the start of the SARS outbreak, she volunteered to work on the SARS ward. She was one of six healthcare workers who died here as a result of SARS that year. I was still a medical student at the time, so I was too young to be drafted into the dirty team then, but the stories I heard from my colleagues were scary. The memories of SARS are painful for all of us Hong Kongers: 299 deaths, 800 people infected, a city shut down, living in fear for weeks on end. 

Last week, I tried to prepare myself. I went to the barber’s and got a buzz-cut. I booked a hotel where I will self-quarantine for two weeks after I leave the dirty team. I would say this is something you can never really be ready for. The last night before I joined the dirty team, when I touched my daughter through my wife’s tummy, I could not hold back my tears. 

I felt anxious, scared, frustrated. Anxious for the uncertainty, because you never know which of the suspected cases would turn out to be the next confirmed case. And rumour has it that our protective gear is going to run out soon. And this is still a disease without well-proven treatment. 

Scared, for this is a potentially deadly disease. And there is no sign of this epidemic ending anytime soon. I am the bread winner for my whole extended family. It’s unthinkable that anything should happen to me. 

Frustratingly this whole catastrophe was potentially preventable. If the government had listened to the people and to the experts earlier, we could have avoided the vast majority of the cases in the past few weeks, which were imported cases. If the government had closed the border earlier on, perhaps we wouldn’t have a community outbreak now, and wouldn’t be panicking about running out of personal protective equipment, or beds, like we do now. They act too slow, and they never listen. Even now, they are still pushing for the anti-mask wearing law they tried to pass because of political protests. 

Now the media is full of commentaries comparing this disease to others: the 2018 Spanish flu, SARS, MERS, seasonal influenzas, the common cold. But the reality is, this is a new disease, a new virus. We don’t know too much about it. All we know is that it transmitted by droplets and contact, as with all other coronaviruses. But the degree of infectiousness, and the way of transmission are two different topics. Even if this disease causes only 1% of mortality, we are facing a pandemic with a death toll of 14,000, only in Hong Kong. All people here, including us as healthcare professionals, are in a dangerous position now, but we have to fight this battle.

This opinion was told to Jane Parry, a public health writer in Hong Kong, who wrote up the piece.

Jane Parry is a public health writer and researcher from Hong Kong. She is currently a PhD candidate at McMaster University, Hamilton, Canada.