February 27, 2020

Even as cases of the novel coronavirus appear to level off in China, Chinese health care workers, particularly those at the center of the outbreak in Wuhan, face crowded hospitals, extremely long hours, and a shortage of protective gear and protocol, leaving them more susceptible to the new virus.

Our analysis: The 'recurring themes' of disease outbreaks

Background

Reports of the new coronavirus first surfaced in early December 2019 in Wuhan, in China's Hubei province. According to the World Health Organization (WHO), the main symptoms of the virus are fever and lesions in both lungs. Some patients also have reported difficulty breathing, WHO said. Health officials named the disease the virus causes COVID-19.

As of Thursday, officials reported more than 82,400 cases of the virus globally, with most of those cases occurring in mainland China. Officials said as of Thursday there had been more than 2,800 deaths linked to the virus, and all but 60 of the deaths occurred in mainland China.

3.3K+ health workers infected

As of Monday, Chinese health officials and WHO said 3,387 health care workers in China had been infected with COVID-19. Of those workers, 90% worked in Hubei province.  

According to the Los Angeles Times, the infection rate among medical staff is in part the result of the delayed response to the outbreak. Now, in Wuhan and the surrounding areas, medical workers face shortages of protective suits and masks, an "overwhelming number of patients," and understaffed hospitals, leaving them "underprotected, overworked, and increasingly vulnerable," the LA Times reports.

In a letter to The Lancet on Monday, Wuhan health workers described working conditions as "more difficult and extreme than we could have ever imagined."

Workers die from exhaustion

Amid these obstacles, health care workers continue to treat patients.

One doctor in Wuhan told the LA Times in late January that 12 out of 59 doctors in his hospital showed symptoms of the virus, but continued to treat patients—even while wearing insufficient protective gear.

The pressure to treat patients can lead to exhaustion, overwork, and even death. As of Monday, the LA Times had tallied 18 deaths among medical workers on the front lines of the COVID-19 response. That number includes not only deaths from the virus itself but also deaths related cardiac arrest and other potential work-related stressors.

For instance, Song Yingjie, was the only pharmacist managing his hospital's medicine prescriptions. After checking temperatures at a highway stop in the cold for 10 consecutive days, the 28-year-old died. According to the LA Times, the cause was cardiac arrest due to exhaustion. Similarly, 51-year-old Xu Hui, leader of her hospital's virus control group, "lay down and never got up," after working for 18 consecutive days, according to Chinese state media.

Another health worker died after being hit by a car while taking patients' temperatures on a highway, the LA Times reports.

Issues that make health care workers more susceptible to infection and death include a lack of training and expertise on the virus, according to the LA Times.

During the SARS outbreak, many of the medical workers asked to join the frontlines weren't trained to work with high-risk, infectious diseases, according to John Nicholls, a pathologist at Hong Kong University. As a result, several medics without proper training became infected with the virus and spread it to others.

Now, Nicholls sees hospitals are facing a similar issue with COVID-19. "There has to be a sense that only the people trained ... should be allowed to have access, not to allow any people who are willing but maybe not properly trained with the skills," he said.

Nurses wear adult diapers for menstruation

For 27-year-old Zhang Wendan, a nurse in Hubei, the most challenging moment was when she and other female workers had to discuss with their supervisors how to handle menstruation.

In Hubei, supplies have to go through authorities to get into the city, meaning menstrual products, such as tampons and pads, were scarce and difficult to obtain. When her superiors at the hospital, who were predominantly men, found out that Zhang and other female medical workers were asking for help to get the products, they told the women they "lacked the spirit of devotion." Zhang said she felt her spirit was "breaking down slowly."

Eventually, a group of volunteers sent around 2,000 adult diapers to the hospital for the 500 female medical workers on staff.

In addition, for hygienic reasons, Zhang and other female medical workers had to cut their hair short when they worked in the hospital's quarantine zone.

Zhang's assignment is over, and now she's completing a 14-day quarantine in a hotel before she can return home. Still, Zhang said, "I worry about being infected, I miss home" (Stevenson, New York Times, 2/26; Su, Los Angeles Times, 2/25).

Just released: Your top resources for coronavirus readiness

You're no doubt being inundated with a ton of information on how to prepare for possible patients with the Novel Coronavirus (nCoV). To help you ensure the safety of your staff and patients, we pulled together the available resources on how to safely manage and prevent the spread of nCoV.

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