Shanghai doctor's advice: 'Stay vigilant'
Dr Hu Bijie discusses CT scans with fellow doctors at his "headquarters" where he can monitor patients data and make remote video rounds at the Shanghai Public Health Clinical Center, the city's designated hospital for the disease.
The coronavirus outbreak in Shanghai is easing due to effective clinical treatment and control — but people should not drop their guard, says Hu Bijie, director of the infectious diseases and infection control departments of Zhongshan Hospital.
Hu told Shanghai Daily more attention should be paid to hospital-acquired infection.
As a member of the city’s coronavirus expert team at the Shanghai Public Health Clinical Center — the key virus healthcare center — the 58-year-old has been on the frontline since January 27.
Before joining the team, Hu had a chance to view a lung scan of a patient later confirmed as Shanghai’s first infection case.
“I was asked by the Shanghai Health Commission to verify the suspected patient in Tongren Hospital. From the scans, I could tell it was very likely the patient had been infected,” he said.
“Actually when I learned about cases of pneumonia in Wuhan, the hardedst-hit city in Hubei Province, from a friend on December 30, one day earlier than the announcement by Wuhan health authorities of 27 viral pneumonia cases, I started to keep a close eye on the virus.
“I had listed the outbreak as the 9th of the top 10 major events in infection control and prevention on the WeChat account of the Shanghai International Forum for Infection Control and Prevention, one of the most influential online platforms in the field.”
Before becoming an infectious diseases doctor five years ago, Hu had been a respiratory physician for 30 years, specializing in pulmonary infections. He is also a pioneer in hospital-acquired infections.
“People had paid little attention to nosocomial infection management which aims to ensure the safety of patients and medical staff,” he said.
The problem in nosocomial control was one factor causing over 1,000 medical workers were infected in Wuhan, said Hu, who was a member of a united work group to combat SARS (Severe Acute Respiratory Syndrome) 17 years ago.
Exposed in enclosed and limited spaces in hospitals, the virus can easily spread from COVID-19 patients to other patients and staff and on to people around them inside or outside hospital.
He said the coronavirus mortality rate was lower than SARS virus, but was more contagious, no specific medicine to treat it so far.
“So, if prevention and control measures are not in place, there could be an immediate and big effect: You may die.
“It’s unlike seasonal flu or tuberculosis. If one is in close contact with a TB patient, you may fall ill after 10 to 20 years. If one caught flu, you may recover by yourself gradually without seeing a doctor. And not everybody around you would be infected because some of them may have some immunity if they had previously got flu with another virus subtype.”
Hu said the prevention and control work in hospitals should follow the basic rules — controlling the transmission source, blocking infection chains and protecting vulnerable people. The key points include equipping doctors and nurses with the correct protective gear, retrofitting hardware and separating safety areas for fever outpatients.
Dr Hu Bijie, director of the infectious diseases and infection control departments at Zhongshan Hospital, at work.
Hu said that when he and fellow doctors in the Zhongshan Hospital braced for the infection emerging in Shanghai, they found the hospital didn’t have enough protective supplies in stock, not even surgical masks, let alone the N95 variety.
“Even the Shanghai Public Health Clinical Center faced a shortage of protective materials at first. The situation was relieved after the government’s efforts. Medical supplies basically meet our needs now,” he added.
The most important thing in curbing an outbreak is to identify pathogens and develop testing methods for diagnosing infections as soon as possible.
He said early and fast detection, early diagnosis, early quarantine and early treatment was vital.
“We may have taken many measures in epidemic prevention and control, but much less effective in identifying who is infected.
“There may be only one confirmed case in 100 people. If we can identify the infected one, we only need to quarantine that person, otherwise we have to put everyone suspected under quarantine.”
Hu said it is important that people have good hygiene habits, which will keep them in good health.
“We have been taught to wash our hands before eating and after going to the toilet since we were primary students, but few people in China know how to prevent the transmission of respiratory infectious diseases.
“If you cough or sneeze, do it into your upper sleeve, not your hands, or use a tissue. That’s called cough and sneeze etiquette,” he said.
