Via Caixin Global: Wuhan’s ICUs Tend to the Last Few Severely Ill Covid-19 Patients. Excerpt:
On April 7, just one severely ill patient was still hooked up to an extracorporeal membrane oxygenation (ECMO) machine in the ICU of Wuhan’s Leishenshan Hospital.
His face had a purplish hue and his mouth formed an “O” shape. Tubes of various sizes sprouted from both his head and body — his kidney function was being supported by dialysis and the ECMO machine was putting oxygen into his blood and pumping it around his body. Due to heart problems, his chest heaved violently.
In the early evening, the monitor in front of the patient’s bed flashed red and sounded an alarm. Doctors and nurses surrounded his bed in an attempt to keep him alive, adjusting his blood’s oxygen level and pressure. After 30 minutes of effort, the siren finally subsided.
The 68-year-old patient was not only one of the last remaining in Leishenshan, one of two emergency field hospitals built in Wuhan to treat Covid-19 patients, his stay was also one of the longest. The man developed symptoms on Feb. 1, his condition worsened nine days later and he was hospitalized with breathing difficulties, according to Peng Zhiyong, head of the intensive care units at Zhongnan Hospital of Wuhan University and Leishenshan Hospital.
Both ventilation and intubation were applied to the patient, but his condition showed little improvement. On March 3, he was hooked up to the ECMO machine, and was still plugged in as of April 7. As a result of long-term intubation, he had twice developed infections along witih liver, heart and kidney complications. Yet the doctors wanted to keep trying.
“The patient is tenacious and wants to live, so we aren’t giving up and want to bring him back,” one doctor said.
The bed across from the man was occupied by a middle-aged woman, whose face had regained its color. She was able to move about the bed and was preparing to be discharged from the hospital the next day.
“I think I was in the same shape as him,” she said, gesturing to her neighbor. The woman had developed symptoms in late January, and was in hospital for more than two months. At one point doctors also resorted to treating her with ECMO. She survived.
“I’m grateful to them from bringing me back from the brink of death,” she said, giving them a thumbs up.
According to Peng, on April 7, the two ICUs at Leishenshan still had 17 severely ill patients, who had all developed symptoms about two months earlier. In comparison, the average number of days a person takes to clear their body of the virus is 20. Among the 17 patients, about seven had acute illnesses, which doctors had deemed the biggest challenge.
According to Peng, the severely ill fell into two categories. Those in the first category had suffered severe lung damage and function would not return in the short term, meaning they require ECMO support to live – at that time, Leishenshan only had one patient in this category. Patients in the second category had already recovered from the virus, but were experiencing complications such as multiple organ failure, or had underlying conditions prior to contracting the coronavirus. Covid-19 therefore induced other severe conditions such as coronary heart disease, stroke, and tumors, Peng said.
Public statements from Hubei province’s health authorities showed that on April 14, 179 Covid-19 patients remained in Wuhan’s hospitals, 57 with acute illnesses and 33 who were critically ill. On Friday, the National Health Commission (NHC) announced that the situation had improved further: the number of patients with acute illnesses in Wuhan had fallen to zero, something perhaps unimaginable during the peak of China’s epidemic’s in mid-February, when nearly ten thousand were hospitalized.
To concentrate medical resources in recent weeks, Hubei’s coronavirus epidemic response task force decided on April 12 to consolidate patients into facilities including Wuhan’s Tongji and Jinyintan hospitals, depending on their condition.
On April 14, the last four severely ill patients at Leishenshan were transferred to Zhongnan Hospital. With it, the makeshift facility was retired, and Peng no longer had to go back and forth between the two locations.
Zhongnan Hospital’s ICU now had a total of 13 patients from both Leishenshan and Jinyintan. According to officials, since it opened on Feb. 8, Leishenshan had taken in 2,011 patients, ranging from infants to people over 100 years old. A total of more than 1,900 recovered and were discharged, or roughly 94% of patients.
The heads of ICUs that spoke to Caixin emphasized the importance of clinics that conduct screening and serve as gatekeepers. These, they say, are the real front line of the battle against Covid-19. As hospitals return to normal, they say, hospitals must make full use of their fever clinics and give full play to epidemiological investigations.