Inside China’s covid-ravaged hospitals

By Hao Yu

Ding felt herself getting weaker as she performed chest compressions on an 81-year-old man with covid-19 whose heart had stopped beating. “One, two, one, two,” the nurse counted to herself as she tried to keep him alive. Then, suddenly, she fainted. In retrospect, this wasn’t much of a surprise. She herself was ill from the virus.

Ding’s supervisors in the hospital in Beijing knew she was sick – she had been diagnosed a few days earlier. The emergency department’s head nurse called her the next morning and asked how she was feeling. Before Ding could even answer, her boss continued: “If it’s at all possible, please come to the hospital this afternoon.” There were simply too many covid patients in need of treatment for Ding to take time off work.

In early December, China abruptly abandoned its zero-covid policy, in which it had sought to contain the virus through testing, quarantines and draconian lockdowns. Reliable information about the subsequent wave of infection is hard to come by. The government admits to a significant increase in cases but official statistics are widely thought to understate the severity of the outbreak. The picture is all too clear in big-city hospitals, however. One doctor says his wards are so overcrowded that he has had to perform emergency intubations in the corridor in full view of other covid patients. In one case, blood clots started emerging from one man’s trachea as staff forced the tube in. A bystander exclaimed “My God!” and covered his mouth, running away.

As China managed to suppress the virus until recently, doctors and nurses there have little experience of treating covid. Many are in no fit state to learn: new cases have proliferated so rapidly that many medical staff like Ding are being forced to work while infected themselves. Three of them shared their stories with 1843 magazine. Their names have been changed to protect them from reprisals.

Ding had a fever and joint pain when she came back to work; she felt like she was dragging her legs as she walked through the entrance to the emergency department. When she got there she quickly realised that many of her colleagues had the virus too. There was no time to settle back in. Immediately, a young man grabbed her arm. “Are you a nurse? Please, we tested my father’s oxygen level at home, and it was low. Can you please ask a doctor to see him?” As she was about to console him, another man standing nearby shouted, his voice cracking, “Hey! We are also waiting here. Please let’s take turns.”

Ding and her colleagues have had to turn many patients away since the current covid surge began in December. The unit has a capacity of more than 100 beds, but has frequently been overwhelmed. Ding’s ears ring with the exclamations of doctors trying to perform emergency procedures, the incessant beeping of life-support machines and, most haunting, the cries of bereaved relatives. When recounting her experience to me over the phone, Ding broke down in tears. “I’m so tired and hopeless,” she sobbed. “But that’s what we medics are here for.”

The patient she was trying to resuscitate when she fainted didn’t make it. In the four days following her return to work after getting covid, she witnessed more than ten deaths from the virus. The official death count from covid across all of China over that period, from December 13th-17th, was zero.

Yang, a kidney doctor in Sichuan, paused at the door of the dialysis room. When he was diagnosed with covid in mid-December, the department’s head doctor told him categorically that he was to come back to work the following day. He thought about the patients inside, all suffering from kidney failure. The prospect of infecting them with covid was alarming. It might even kill them.

But the department needed him. Yang reassured himself with the thought that 50 out of the 70-odd dialysis patients had already tested positive for the virus. He swallowed an ibuprofen, bolted down a mouthful of warm water, put on a respirator mask over his surgical one, and went to see his patients.

The dialysis room is normally a quiet place, but that day it was filled with coughs and groans of discomfort. Stretchers rolled in and out of the room carrying patients who were, at times, gasping for air. An air of panic was setting in.

Yang gathered colleagues for a meeting in his office, and realised that many of them also had the virus. One doctor assiduously typing up case notes was wearing an antipyretic plaster on her forehead to bring down her fever. “Hang in there,” Yang said, patting her on the shoulder. Shortly afterwards a nurse burst in and told them that a patient’s oxygen levels had become dangerously low. Yang had little idea what he ought to do – he hadn’t had much experience of treating covid before. He called a colleague in the pulmonary department in the hope of arranging a transfer, but they were overwhelmed. He eventually managed to secure the patient a place in a specialist intensive-care ward. The man, he later learned, died.

The patients’ fear was palpable. “Doctor, I am very scared. I heard some people have already died, but I don’t want to die!” said one as Yang carried out a routine check. “Don’t worry, we will take care of you,” Yang responded brightly. He wasn’t sure if it was true.

As a pulmonary specialist in a large hospital in Wuhan province, where the novel coronavirus emerged, Qin was one of the first doctors to treat covid. He witnessed the very first wave of cases three years ago. Being familiar with the virus, however, hasn’t made the current wave any less alarming. “In 2020 it was the mystery that terrified us, but this time it’s the huge number of patients,” Qin said. “Every hospital is running short on staff and capacity.”

When he contracted the virus himself in mid-December, Qin felt awful. His body hurt so much from fever and joint pain that he took to bed. But colleagues called him non-stop, exhausted, needing his help, so he returned to work the next day, his fever having abated only slightly.

When he got to the ward he saw two nurses, both infected with the virus, hooked up to IVs while they sorted out prescriptions for patients. Disheartened, Qin asked them how things were going. “Do you see the people sleeping by the elevator door?” one nurse asked, pointing at the lift area, which was normally empty but now packed with bodies. “We can squeeze three extra beds in there only because three others just died yesterday.”

Patients who should have been in pulmonary and intensive-care wards were being distributed across the hospital campus wherever a bed was available. Over the following days Qin raced with aching limbs from ward to ward to try to help them. His phone rang constantly with requests to respond to emergencies, often interrupting him while he was trying to save another patient’s life.

When I spoke to him in his hospital office at the end of December he sounded exhausted. But he didn’t see any end in sight. “We would of course love to rest because all of us are running fevers and having body aches, but we are so short-staffed for such a high number of patients,” he said. “We’re not optimistic about this winter.” ■

Hao Yu is a pseudonym for a Chinese journalist based outside mainland China

ILLUSTRATIONS: NOMA BAR