Asia Pacific / Science & Health

Overwhelmed Chinese hospitals turn away patients without virus

Bloomberg

Liu Zi’ao was awaiting surgery in a Wuhan hospital to treat the tumor pressing on his spinal cord when, suddenly, he was told to leave. The novel coronavirus had plunged the central Chinese city’s health care system into crisis, and all resources were being diverted to contain it.

In the month since, the 25-year-old former acupuncturist has been turned away from hospital after hospital as he seeks treatment. Because his right leg has atrophied, he will need an ambulance to pick him up if one agrees to admit him. But there are few spare ambulances, hospital beds or doctors at the epicenter of the outbreak, which has infected over 75,000 people.

He has been downing Oxycontin — an addictive, powerful opioid — to manage his excruciating chronic pain, but the pills are running out. “I don’t know what I will do,” said Liu.

Liu is one of a growing number of Chinese patients with urgent medical conditions unrelated to the coronavirus epidemic who have become collateral damage as China struggles to gain control of an outbreak that has now claimed over 2,100 lives.

In Hubei, the province of 60 million whose capital is Wuhan, medical facilities are still facing severe shortages in dealing with the surge in virus patients. Almost all medical personnel, equipment and resources have been channeled into fighting the outbreak, leaving other patients in limbo.

Chris Wang’s 56-year-old father has kidney failure and requires dialysis twice a week. But his usual sessions at the Third People’s Hospital of Hubei have been canceled because the hospital, and its rooms equipped with dialysis machines have been commandeered by government officials in charge of the outbreak response, he said.

“It’s understandable that the government needs the hospital beds for virus patients, but it doesn’t make sense to take the dialysis rooms because these patients can die if they don’t get dialysis on time,” said Wang.

A woman who answered the hospital’s hotline said it can’t admit dialysis patients at the moment because the hospital has been taken over for coronavirus treatment.

While most marked in Hubei, a shortage of nonvirus medical care is also emerging across China — even in its most prosperous cities.

This crisis puts a spotlight on a health care system that was already uneven, with care in rural areas lagging that of big cities like Beijing and Shanghai. In recent years, China has embarked on an ambitious overhaul of its medical system in a bid to drag down drug costs and waiting times, but the current epidemic brings those persistent inequalities into sharp relief.

Over 23,000 doctors and nurses have been sent from hospitals around the country to Hubei to shore up the virus response at the epicenter, leaving some hospitals with fewer medical staffers in provinces like Guangdong and Jiangsu.

And a fear of exposing medical staffers to the highly infectious pathogen is causing some hospitals to turn away all new patients in major cities like Beijing and Shanghai, even if those patients need urgent care for cancer or renal failure.

There is no comprehensive data on how many patients are in this quandary, and it is difficult to estimate how many preventable deaths have resulted from the abrupt withdrawal of nonvirus medical care since the disease’s spread began.

Still, interviews with doctors, patients and social media discussion point to an emerging crisis that could leave a deadly trail even after the outbreak ebbs.

Posts from desperate patients begging for help and accounts of citizens taking their own lives because they could not get medical care are trending on social media in China, where anger is already simmering over the government’s slow initial response to the outbreak.

On Sunday, Wuhan designated six hospitals for patients in critical condition unrelated to the virus, and another 15 hospitals that can take emergency nonvirus cases. In the city of 11 million people, 46 hospitals with nearly 19,000 beds are devoted to virus care, with converted stadiums, office buildings and schools also providing thousands more beds for infected patients.

National health officials have also publicly urged local hospitals throughout the country not to neglect patients unrelated to the outbreak.

But resources, especially in Hubei, are stretched thin.

Wuhan Union, where Liu Zi’ao was hospitalized before the outbreak, is one of the six that are supposed to be taking critical patients unrelated to the virus, but a doctor there says the hospital is already overwhelmed and does not have enough physicians.

All junior doctors in his department have been sent to the front line to treat infected patients, and he is also on call for virus work.

“It’s impossible to care fully for patients in need now. Those with milder symptoms can talk to doctors online, but critical cases that need surgery — there’s really no way out,” said the doctor. “What can we do?”

A deep exhaustion has taken hold among medical professionals on the ground, hundreds of whom have been infected themselves while caring for patients. A shortage of medical equipment and protective gear has meant that many work without adequate safeguards.

The death of Li Wenliang, one of the doctors in Wuhan who was censured by officials after raising an early warning on the virus, ignited a wave of grief and anger across China earlier this month.

One doctor in Wuhan who specializes in treating diabetes patients became infected with the virus in January. She believes she contracted it after treating diabetes patients who work at the market where the pathogen is suspected to have originated.

“Sacrificing nonvirus care for the moment is the only option in a situation where there are no good options,” she said. “Wuhan is losing a pawn to save a castle — and that’s the only thing that’s feasible, because the virus is just too infectious.”

Outside of Hubei, fear of the virus’s spread has meant that some top-tier public hospitals in other parts of China are turning patients away. In some hospitals, most nonurgent surgeries have been postponed, according to doctors.

There has also been a drop in patients themselves going to hospitals, even in parts of China where there aren’t widespread infections, according to doctors working in cities like Shenzhen and Zhongshan. The new coronavirus is seemingly more infectious than SARS, which claimed almost 800 lives globally 17 years ago.

In Shanghai, a 75 year-old man who gave his surname as Zhong is suffering from a tumor in his abdomen and multiple cysts in his liver. His feet are too swollen to fit into his shoes, he has no appetite, and he needs to go to the toilet dozens of times a day. While a doctor that saw him on Feb. 7 suggested immediate surgery, five top-tier hospitals in the city have since refused to take him out of fear of the virus’s spread.

“We’ve tried everything that ordinary people can possibly do but still he cannot be admitted to a hospital,” said Zhong’s daughter, who declined to give her name out of fear of reprisal. “Seeing my father suffer at home makes my heart ache.”

Some hospitals are now trying to expand the use of online platforms to help nonvirus patients. Beijing’s municipal health committee on Saturday ordered all patients, except for emergency cases or those with fevers, to register online and secure appointment slots before visiting hospitals in person.

Wuhan Tongji hospital has developed an app that is available on Android smartphones through which doctors can advise patients and suggest drugs they should buy from online pharmacies.

For those with conditions beyond the remit of online consultations, there are few options besides hoping that the outbreak comes under control and medical resources can be freed up again. While additional cases of new infections in Hubei seem to be on a downward trajectory, and Chinese Premier Li Keqiang was cited by state TV has saying that the epidemic is on a “positive trend,” it is unclear if a turning point in the outbreak has been reached.

For Liu Zi’ao, there is nothing to do but wait.

“No hospital will take me although I have been calling different hospitals for weeks,” he said. “For now, I can only stay at home and wait. But I don’t even know what I am waiting for.”

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