Dehao Fu, Yu He, and Yuanyuan Guo report back from Wuhan, China, on how the city is dealing with covid-19 and how best to navigate a lockdown.
At the start of the year, covid-19 swept through Wuhan. Wuhan, a metropolitan city with more than 10 million people, was put into lockdown.
The declaration of lockdown was unprecedented. Insufficient and hasty preparation for the lockdown resulted in certain tensions and even panic among the general public. In the wake of an outbreak like this, a moderate panic may be beneficial so the public can become aware of the situation and seek self-protection, helping to contain the virus. However, excessive panic is not only harmful to both physical and mental health, but it can also cause adverse consequences in society. In this case, panic caused unreasonable hoarding of living and medical materials among the public, resulting in material shortage. Also, panic increased the spread of unverified information and rumors, propagated through social media and mobile devices. Moreover, the panic also caused a huge influx of patients in every hospital. Some of these patients presented with very mild upper respiratory symptoms that were not caused by the novel coronavirus. The influx of patients not only severely burdened the hospitals, but also increased the risk of nosocomial infections.
Quarantine of primary infected areas is an ancient, but direct and effective way to control an epidemic, however, it carries risks and challenges. Here are some tips that we have learned so far on how to deal with the challenges that have risen during the lockdown.
Firstly, efforts should be made to guarantee adequate medical supplies to the hospitals, especially the supplies needed for epidemic prevention and control.
Second, early psychological intervention including psychological counselling should be considered in order to reduce panic and avoid confusion among the people that are directly impacted by the covid-19.
Third, better triaging of patients is necessary to efficiently divert the patient load and to treat the patients in critical condition. From our experience, dealing with extreme numbers of patients daily during the lockdown period, patients should be triaged to four types. Confirmed cases that are in critical condition should be treated intensively; suspected cases should be strictly isolated; general fever, cough patients and asymptomatic patients that had direct contact with confirmed cases, should be quarantined and observed to avoid spreading the infection.
Fourth, measures should be taken to ensure health care providers’ health and safety. We implemented a rotating schedule in order to maintain adequate staff and to prevent burnout. Special funds should be set up to compensate the staff that are on the front line fighting the epidemic. In addition, timely and adequate information regarding the epidemic should be disclosed by the government to increase transparency and public trust.
Finally, the government should ensure the proper functioning of society, which includes maintaining essential travel needs and emergency access to medical care, so that patients with a heart attack and expectant mothers can receive timely and proper care. Methods to prevent illegal occupation or destruction of public facilities caused by panic should also be considered.
With the methods described above, it is our belief that during the period of home quarantine, the general public in the affected area can remain in a good physical and mental state; remaining optimistic, keeping a balanced diet, getting enough rest, and conducting regular self-screening.
Given a reasonable amount of time, with the cooperation of the government, society, and medical staff, we are hopeful that this epidemic will be defeated.
Dehao Fu, Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology (HUST), Wuhan, P.R. China
Yu He, Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology (HUST), Wuhan, P.R. China
Yuanyuan Guo, Department of Pharmacy, Liyuan Hospital, Tongji Medical College, Huazhong University of Science & Technology (HUST), Wuhan, P.R. China
Competing interests: none declared.
References:
- WHO. Novel coronavirus – China. Jan 12, 2020. http://www.who. int/csr/don/12-january-2020-novel-coronavirus-china/en/ (accessed Jan 19, 2020).
- Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020; (Published online Jan 29. DOI:10.1056/NEJMoa2001316)
- Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. J Med Virol. 2020; (published online ahead of print, 2020 Jan 29. DOI:10.1002/jmv.25689)
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