District hospitals, community centers combine to combat COVID-19 pandemic
Medical institutions in suburban Jiading District are doing their best to prevent severe illness and treat COVID-19 patients with better equipped hospitals and community health centers. Doctors and nurses are using targeted and the latest expertise to treat patients, particularly those with severe COVID-induced conditions, in a bid to protect the health of the people to the greatest extent possible.
Chen Erzhen, vice president of Ruijin Hospital affiliated to School of Medicine, Shanghai Jiao Tong University, came to the Jinsha Xincheng Community Health Service Center and Yingyuan Hospital in Jiangqiao Town on January 9 to learn about the treatment of patients and give on-site guidance on treatment and medication.
At the community health service center of Jinsha Xincheng, Chen inspected the infusion areas, wards and consulting rooms to ask about the patients' admission status, treatment process and supporting resources.
A resident surnamed Jiang, aged 70-plus, was diagnosed as COVID-19 positive at the end of last month, which developed into pneumonia. After a period of treatment, his condition improved though he was still undergoing infusion. However, he was worried about the sudden edema of his legs and feet.
"Swelling in the legs and feet is generally an indication of heart failure," Chen said after seeing the patient's bulging feet. He asked the hospital to do further tests to help manage symptoms.
In the ward, Chen carefully inquired about patients' conditions and answered questions, comforting and reassuring many of them.
Chen Erzhen, vice president of Ruijin Hospital and member of Shanghai's COVID-19 expert advisory panel, talks with a patient in the ward.
Another resident surnamed He, 78, developed cough, expectoration and asthma after testing positive for COVID-19. Having received treatment, his condition improved. He was transferred to the community hospital for further hospitalization on January 6.
At He's bedside, Chen learned about his treatment process and recovery in detail, and looked up his medical records and examination results.
"Do you still have phlegm? And breathlessness?" Chen asked.
"It's much better now. I don't feel stuffy or uncomfortable without oxygen," He answered.
"That shouldn't be a problem. You can stay for another day or two and go home," Chen said.
Chen also communicated with community doctors and answered questions.
Regarding the principles and indications of drug use, Chen said: "The first principle is to use the drugs as early as possible, and the second is sticking to the courses of treatment. Do not lapse in the middle."
Chen also reminded the grassroots medical staff to go over the 10th version of COVID-19 diagnosis and treatment plan and master the core issues, such as how to diagnose diseases and how to classify and stratify patients.
Infusion and oxygen therapies
Jiading has achieved full coverage of infusion rooms in community health service centers as well as the wide use of equipment such as oxygen cylinders and drugs like Pfizer's COVID-19 treatment pills.
On January 3, at the community health service center in Anting Town, the infusion room was full of patients. A middle-aged woman surnamed Han had a fever for more than 20 days, accompanied by cough, asthma and other symptoms, and was diagnosed with pneumonia by the district hospital.
Due to the long waiting time at the hospital, she came to the community health service center in Anting Town for further treatment, and the doctor gave her infusion and oxygen therapy.
"It takes six or seven hours to get infusion at the district hospital. I was already suffering from pneumonia and couldn't wait. But there is no need to wait here. It will be my turn immediately," Han said.
Patients receive intravenous therapy at the infusion room of the Huangdu Community Health Service Center.
Another patient, surnamed Xiang, also came to the community health service center after waiting in line for several hours in a top-tier hospital.
"I had to wait for more than two hours in that hospital just to register. There were too many people. The community health service center was much better, and the waiting time for seeing a doctor and getting infusion was relatively short," Xiang said.
Shen Zhiping, director of the Anting Town Community Health Service Center, said that they managed to expand the mobile infusion rack by using the corridor space in the waiting area of the laboratory and the ultrasound room next to the infusion room, and added 20 infusion chairs, which now can guarantee 50 people to receive infusion at the same time.
"In terms of oxygen therapy, we purchased oxygen cylinders and oxygen bags, and opened an oxygen therapy area. We also purchased new CT scanners, so that patients can get diagnosed in the community health service center and receive the treatment in need," Shen added.
In addition to the Anting Town Community Health Service Center, the Huangdu Community Health Service Center has also increased its treatment capacity by expanding the outpatient infusion room.
So far, all the 13 community health service centers in Jiading have opened their infusion rooms with 685 infusion seats and 228 oxygen therapy seats available. The opening time of fever clinics and infusion room has been extended to 9pm, and the infusion service is now available on weekends.
A patient gets a CT test at the Waigang Town Community Health Service Center.
New CT scanners
At present, eight community health service centers in Jiading have purchased new computed tomography (CT) scanners for fast and accurate diagnosis of COVID-19 patients with critical conditions.
As an efficient and accurate imaging device, CT is of great help in finding and diagnosing pneumonia.
On January 5, Yu Hongliang, a radiologist at the Waigang Community Health Service Center, found the image of a 73-year-old patient showed up a large white spot on lungs, commonly known as "white lung."
He then contacted the radiologist of the Jiading District Imaging Center and asked for a consultation report.
"We uploaded the image as soon as possible when we encountered the critical condition, and we received feedback within 15 minutes," said Yu.
The chest CT used by the Waigang Town Community Health Service Center is equipped with remote consultation system and voice function, so that medical staff do not contact the patients during the whole process to avoid cross infection.
A radiologist at the Jiading District Imaging Center peruses an image sent by the community health service center.
Wei Jiafen, deputy director of the Waigang Town Community Health Service Center, said that the average number of daily outpatient requests for radiology consultations was nearly 80. The center also has an oxygen therapy area, which can supply 150 people with oxygen for 24 hours.
Chang Wei, director of the center, said that the use of CT was very helpful for the identification of mild and severe COVID-19 cases and the referral of critical patients.
TCM for post-COVID-19 recovery
Since many recovered people still suffer cough, fatigue, shortness of breath, insomnia and other problems, some medical institutions in Jiading have set up COVID-19 TCM rehabilitation clinics.
"Recently, I have been coughing all the time. Sometimes I have chest pain, my body is weak and my legs are heavy," said a woman surnamed Zhang, who visited the COVID-19 Rehabilitation Clinic of Traditional Chinese Medicine on the first day when the Nanxiang Town Community Health Service Center launched the service.
Ge Lingyu, head of the center's TCM department, said that in general, it takes about two to three weeks for the body to recover.
"At this stage, TCM intervention can be used to give full play to the roles of TCM in preventing disease," Ge said.
"At present, we have launched two TCM rehabilitation formulas: one is mainly for cough and expectoration symptoms, and the other targets pulmonary infection.
"If some patients suffer from loss of appetite, we add Chinese herbs, such as Chinese mint, Pei Lan (herba eupatorii) and Adlay millet, which have the function of invigorating the spleen and removing dampness."
Herbal remedies for loss of appetite
A mild leg exercise is helpful in improving the cardiopulmonary function of people after recovering from COVID-19.
In addition to TCM, physical therapy is also helpful for improving the cardiopulmonary function.
At the suggestion of the doctor, Zhang came to the rehabilitation clinic for aerobic training to improve her cardiorespiratory endurance through moderate leg exercises.
Zhu Mengjie, chief physician of the rehabilitation department of the center, said that through a series of rehabilitation treatment such as respiratory therapy, ultrashort-wave therapy and aerobic training, the oxygen content in the lungs can be increased, and the symptoms of inflammation, cough and expectoration can be alleviated.
"Moderate exercise will make people feel more comfortable, and long-term training can effectively improve their cardiopulmonary fitness," said Zhu.
