Wuhan: Jiangcheng Recovery

China News Weekly reporter / Du Wei He Bin Liu Yuanhang Li Mingzi

Issued in 2020.4.6 issue 942 of "China News Weekly"

A bowl of steaming hot noodles, the shops on Chuhe Han Street and Jiefang Avenue are the eternal coordinates and destinations of Wuhan people's hearts. Wuhan is awake, people are beginning to rush to these goals, and they are also penetrating the scene from the winter solstice The haze of spring

"Wuhan, we are back", around 6 pm on March 30, in the middle of "Chuhan Street", one of the landmarks of Wuhan, a shop typed such words on the LED advertising screen. On this day, "Chuhe Han Street" resumed business. Wuhan International Plaza Shopping Center, located on the Jiefang Avenue in Wuhan's golden business district, also opened its doors to customers.

Walking on the southern section of "Chuhe Han Street", a bunch of delicate yellow lights gathered into a light curtain, and the lights flowed to the ground. Pedestrians walked under the light beam, raised their cameras and took pictures.

Now walking on Wuhan Street, we can already see the residents waiting for the bus under the bus stop, students who are riding out on shared bicycles, and take-away brothers who are busy delivering goods. The traffic flow is also increasing. In recent days, some sections of the urban area have become congested. On March 25, 117 bus lines in Wuhan resumed operation, and on the 28th, six rail transit lines began to operate.

Wuhan is restarting. The city's epidemic-free communities accounted for more than 90%, and more than 60 medical institutions for non-crown patients were opened. More and more residents are walking out of the community, heading for the park, and going to the open square for fitness.

The city and the people in the city are emerging from the closure of more than two months, and are penetrating the haze from winter to spring.

Hot dry noodles, vegetable basket, health code

Holding the still hot packaging box, I can't wait to pour sesame sauce into the noodles and stir it. This is the bowl of hot dry noodles that awakens the hearts of Wuhan people. At 9 am on March 29th, at Jiqing Street, where Wuhan's food and folk culture meet, the take-away rider at the entrance of Cai Linji Hot Noodle Shop has long been waiting.

The store resumed business on March 24, and orders are getting more and more every day. It was raining on the 29th, and the shop was steaming. The customers' order boxes were filled with the entire long table. Within half an hour, there were almost 10 takeaway brothers. Another Cai Linji on Linjiang Avenue opened for business on the 28th, and there were more than 50 takeaways in the early morning of the 29th, basically returning to the pre-epidemic business volume.

Takeaway rider was the best witness of Wuhan's change throughout the epidemic. Are you hungry? Rider Zhou Kai told China News Weekly that there are still a few take-out orders on the third day of the new year. As more and more restaurants are closed, orders are getting fewer and fewer. Only supermarkets, convenience stores and drug stores are still open. Later, for a period of time, I basically ran errands for users. I could receive 30 orders a day, and the amount of orders received was less than half before the epidemic. Fortunately, the company has subsidies for the epidemic situation. One hundred yuan a day is subsidized, and the income is almost the same as before. Until recently, restaurants have started to deliver online, and take-out orders have increased again. "No more, I have three more orders, and I'm about to run out of time." He raised his cell phone and rode away.

In addition to delivery, express delivery is slowly recovering. During the epidemic, only a few companies in Wuhan, such as EMS, SF, JD.com, provided courier and distribution services. Community control and insufficient transportation capacity backloged a large amount of goods. On March 25, 12 express delivery companies in Wuhan resumed their work. According to the data of Cainiao Network, 780 Cainiao Post Stations opened and more than 2,000 Cainiao Wrapped Couriers went online.

This will greatly ease the shopping difficulties of Wuhan citizens. Because of community control and insufficient capacity, the people of Wuhan spent the most embarrassing and helpless two months. On the day of the closure of the city on January 23, the panicked citizens of Wuhan almost evacuated major supermarkets. As the time of the closure of the city has been repeatedly extended, it is especially important to follow up with the supply.

At first, everyone could go to the supermarket to purchase. By the middle and late February, with the daily increase in the number of newly diagnosed diagnoses, Wuhan began to adopt community control measures. Commercial districts in all districts and counties have stopped supplying to individuals and replaced them with unified community purchases. . Due to the small number of group purchases and insufficient staffing in the community, the personalized needs of residents cannot be met.

"From lack of vegetables, to wanting to eat meat, to hot dry noodles, to fish, the demand is increasing. Fortunately, the types of materials are constantly increasing, and the prices have slowly come down." On the day of dinner, Wuhan citizen Liu Yaping planned to give The family made a prawn with oil, and the crayfish was ordered the day before, and it was delivered the next morning. "The hardest day has finally passed."

Between the demand of residents and the supply of businesses is the embarrassment of insufficient capacity. Hema Xiansheng has 18 stores in Wuhan. From the beginning of the epidemic to the present, it has not been closed and closed. "Because Chinese people are accustomed to stocking New Year's goods before the Spring Festival, retail sales during the Spring Festival will decrease, so only a small number of people remain during the Spring Festival. In Wuhan, there was no expectation that the city would be closed due to the epidemic and orders soared, "said Li Nan, head of public relations at Hema Xiansheng in Wuhan, Changsha and Xi'an, and told China News Weekly.

According to the normal online order, a delivery person delivers 3 to 5 orders at a time, and under normal circumstances, everyone buys at most three days. But during the outbreak, many people bought items for a week or more at a time. With less capacity and large orders, all employees in Wuhan at that time were dispatched, and even the delivery by private car was difficult to complete.

Because of this, Hema Xiansheng began to switch to community group purchases in early February to alleviate the shortage of capacity. After the introduction of community control measures in Wuhan, Hema Xiansheng suspended offline retail and mainly provided community group purchases. Wuhan City Bureau of Commerce also provided for Hema To provide support, each store is equipped with a bus for community group purchase transportation.

On March 21, the Wuhan Supermarket started to open to individuals, and Hema Xiansheng gradually resumed offline operations. At present, the daily passenger flow of each store ranges from 200 to 500 people. Supermarkets such as Zhongbai and Wushang and some convenience stores have also resumed personal retail on the basis of current restrictions. Just show the Hubei health code and test that the body temperature is normal before entering the store for shopping. The same is true when taking public transportation. When entering a subway station or during security check, scan the health code and scan the code again before getting off.

In this outbreak, contactless payment methods and various online shopping and social software have played a huge role, but for the elderly who are not good at these operations, it means being marginalized. Although community volunteers can provide procurement and distribution services for the elderly in the area, even if Wuhan is unsealed, I am still in a state of epidemic prevention for a long time. Whether shopping or traveling, there is no health code and contactless payment, or it will be very difficult.

Liu Yaping, who had been working in Guangzhou before, only returned to Wuhan last year. She was very fortunate to stay with her parents over the age of 70 when they closed the city. Otherwise, the elderly may even have problems eating. "Fortunately, everything has passed!" She sighed.

Hospital: Freshmen, normal outpatients, rehabilitation patients

From the fever pre-test triage, to the obstetric outpatient nurses' guide, to the outpatient doctors, if not all medical staff are wearing protective clothing, facing the crowds of people in the Maternal and Child Health Hospital of Hubei Province, you would never think of this epidemic. Just passed by. Women and children in Hubei Province were designated medical institutions for non-new crown pneumonia pregnant women in Wuhan during the epidemic. Since March 16th, since the restoration of normal medical treatment order, the number of outpatient clinics in this hospital has ranked first in the province for 14 consecutive days. By 12:00 on the 30th, there were 2,732 outpatient visits in a day.

The accumulated demand for checkups during the epidemic is an important factor in driving up the number of outpatients. Liu Na, 30, who lives in the Xudong area of ​​Wuchang, was accompanied by her husband to the hospital at 7:30 in the morning on March 28. The doctor's consultation number was 114, the 114th patient in the morning of the maternity clinic. She is a expectant mother at 29 weeks of gestation. Considering that the epidemic situation is relatively stable, she came to the hospital for an ultrasound examination of small abnormalities. She told reporters that in the past two months, many pregnant women around her had postponed the examination. According to the pregnancy cycle, she was supposed to come to the hospital for a major breast cancer checkup on February 14, but because of the epidemic, she had to complete the checkup at a private maternity hospital with more than a dozen people until March 1.

At more than 1 noon, the display screen outside the maternity clinic of the Maternal and Child Health Hospital indicated that the number of the day had reached more than 500 people. This number has been maintained in the impression of Deputy Chief Physician Tang Zenan for three weeks. Tang Zenan told China News Weekly that the increase in the number of outpatients and inpatients has also brought challenges to hospital prevention and control. In order to avoid the potential risk of nosocomial infections caused by the increase in the number of consultations and asymptomatic infections, according to the requirements of the epidemic prevention and control headquarters, the hospital requires all pregnant women and accompanying families to undergo a "dual examination" of nucleic acid and CT. For those who come out, they can also enter the buffer ward first according to the degree of emergency. More than 800 new lives have been born here from March 17th to 29th.

After the epidemic was stable, the normal order of outpatient clinics in major hospitals in Wuhan began to recover. From 12:00 on March 29 to 12:00 on March 30, the total number of outpatients exceeded 24,000. In the Fifth Hospital of Wuhan City, in order to reduce the concentration of patients, an appointment system is implemented. If admission is required, nucleic acid needs to be checked in the buffer ward. The Fifth Hospital is also the designated hospital where Xinguan was discharged from the hospital during the rehabilitation period with patients with basic diseases. For patients who have basic diseases within 14 days after discharge, they can go to the hospital for treatment.

In order to provide the hospital with new crown patients who have completed 14 days of observation at the isolation point to provide review and rehabilitation treatment, the Guanggu District of Hubei Provincial Hospital of Traditional Chinese Medicine opened the first rehabilitation clinic in the province from March 5.

Yang Qi had symptoms around January 27 this year. She was admitted to the Guanggu District of the Third Hospital of Wuhan. Her husband, children, husband's sister, and brother, a total of 6 people, became infected around this time. On February 29, she was discharged from the Third Hospital, and on March 15, she returned home from the isolation point of Hubei University. Yang Qi said that she was "severely ill" and after returning home from the isolation point, she developed shortness of breath and poor breathing. She came to the rehabilitation clinic that day, and performed nucleic acid, CT, and liver function tests. Wang Li, 46, came to the rehabilitation clinic at 9 am on the 30th. She was diagnosed at the People's Hospital of Wuhan University on January 20. Before that, she had a fever in the unit. On February 6, she was admitted to Wuchang's cabin. 2 He was discharged on March 26, and returned home from Wusoft Quarantine on March 13. During her first four days at home, she felt extremely tight in her chest. "Breathing hard to get oxygen in and out." On March 16, she went to Tianyou Hospital of Wuhan University of Science and Technology for CT and nucleic acid tests. The nucleic acid was negative and she wanted to inhale oxygen. The doctor said she was not qualified. In these two days, her chest tightness was not so severe. From March 16th, it has been 14 days since she came to the rehabilitation clinic for a review.

Xiao Mingzhong, deputy chief physician of the Department of Infectious Diseases, Hubei Provincial Hospital of Traditional Chinese Medicine, is the head of the rehabilitation clinic. In an interview with China News Weekly on March 30, he said that the earliest outpatient clinics accepted telephone appointments, with a limit of 30 people per day. In the past few days, with the convenience of staff mobility and the increase in patient needs, rehabilitation The number of outpatient clinics is gradually liberalized, and a total of 1,000 patients have come to the clinic. Outpatient consultation is divided into cough, chest tightness, shortness of breath, sweating, insomnia and other symptoms; pulmonary imaging examination is not completely absorbed, manifested as pulmonary fibrosis; the three types of patients come to review on 14 and 28 days after isolation , Each accounting for about a third.

Xiao Mingzhong found in the consultation that among the patients with neonatal pneumonia recovered from the consultation, he found that the virus may damage the patient's heart, liver, and kidney functions, and also affect blood sugar. He admitted to a 70-year-old male rehabilitation patient. Lung imaging showed that 10% to 20% of the inflammation was not absorbed, and the lungs showed fibrosis. At the same time, the postprandial blood glucose was significantly higher than the normal value after meals. . The condition of several other rehabilitation patients also showed that in the past, one or two drugs could be used to control blood sugar, but now three or four drugs are not ideally controlled. However, Xiao Mingzhong said that the specific mechanism of this phenomenon is not clear.

In the Xiao Mingzhong team's observation of nearly a thousand rehabilitation patients, the percentage of these patients in recovery is not high. There are three or four people, and they have not shown any clinical symptoms. The liver and kidney function, blood routine and CT are all good. "Eat, drink, and sleep". However, he also found that after experiencing new coronary pneumonia, the clinical symptoms and imaging performance of many rehabilitation patients were not synchronized. "Many people have mild symptoms, feel good, and can exercise for half an hour at home", but imaging still shows There are ground glass-like and fiber-line-like shadows in the lungs that have not been completely absorbed. In Xiao Mingzhong's opinion, this also reminds patients to check regularly and follow up.

"This is a brand new disease. Everyone's understanding of the disease is not complete. Whether the imaging performance can be completely absorbed, whether the patient can recover after getting sick, and how much the impact on the body requires long-term observation." Xiao Mingzhong also It is said that in addition to the physical state, patients' mental health should be paid attention to, to give them greater social tolerance and acceptance, and to return to normal life as soon as possible.

Psychological barrier on the road to rehabilitation

On February 21, Wu Yi, director of Shanghai Yangpu District Mental Health Center, came to Wuhan as a member of the ninth batch of foreign medical teams. A total of 50 psychiatrists were divided into groups of 5 and entered different cabins and designated hospitals. Wu Yi and his team members are in Wuhan Red Cross Hospital. For those who come to the consultation, they are not called patients but called "visitors". The visitor may be a recovering new coronary pneumonia patient or a medical staff.

Since the outbreak, there have been about 300 psychiatrists in field medical teams. In addition to these professional psychiatrists, a large number of community hospitals also have to deal with psychological problems encountered by patients during the rehabilitation process. After being discharged from the hospital, the patient must enter the rehabilitation post for isolation for 14 days before returning to home.

Xiao Dong is the director of the public health department of Changshan Hospital in Hongshan District (under the Changdong Community Health Service Center) and has been dealing with patients for a long time. She witnessed the darkest part of the city. On January 23, Wuhan was taken down by the pause button. The sudden outbreak brought more than just the pain and stagnation of the disease, but also the inner separation and the rupture of relationships. The night of the city closure, leaving or staying, some couples were separated. Isolate each other or stay with me, and my family faces difficult choices.

New crown pneumonia once threw many patients to the border of life and death. After the life-saving barrier, psychotherapy was put on the agenda. During the most bleak times, the medical staff was under tremendous pressure in the face of the surgeons in the outpatient clinic, the protective supplies were tight, they could not be rotated for a long time, and they faced a large number of deaths every day. Especially the young nurse group is the first to bear the brunt, so there is a lot of need for psychotherapy.

This is the situation that Wu Yi saw when he first arrived in Wuhan, especially in early February. "Including nurses assisted in the field, there is a lot of heavy physical work every day, and there are relatively few things experienced. I rarely encounter frequent deaths in the intensive care unit. Today I am still feeding and I will come back the next day. , The patient is no longer there, "Wu Yi told China News Weekly.

Wu Yi once encountered a visiting nurse who was only 26 years old. He was originally working in a non-scheduled hospital in Wuhan. He was one of the first eight medical staff to apply to assist the Red Cross Hospital. During the care of the patients, He was also infected with new coronary pneumonia.

The nurse's symptoms are mild, but she also has an older sister, a nurse who is in the front line of the epidemic, and her parents live in the countryside. She is not anxious about her condition, but has always worried that her sister is also infected with the virus, causing a series of symptoms such as chest tightness and insomnia.

It is not always easy for these medical staff to show their hearts to the surrounding colleagues and family members. In this case, the psychologists from other provinces gave them a proper emotional outlet.

In Wu Yi's opinion, it is often that the cognitive has been biased, which leads to the emergence of emotional problems, and it is necessary to find a way to vent. "Some people can't find an outlet for venting. If social support is available, there will be fewer psychological problems for patients." Wu Yi told China News Weekly.

With the continuous reinforcement of foreign medical teams, the pressure on local medical personnel has been relieved, and the psychological needs of patients recovering have increased rapidly. Wu Yi once consulted an elderly man in his 70s who had just experienced life and death at that time. He changed from severe to mild and finally recovered. His wife has been gone for eight or nine years, leaving two daughters. He lives with his eldest daughter. After the illness, the family members were unable to accompany them to prevent transmission.

The old man was very contradictory. On the one hand, he was worried that his daughters might be infected, on the other hand, they felt that they did not visit themselves and no longer care about him. When his illness was better, what should he do after being discharged from the hospital? Burden, do you abandon yourself later, and so on.

After the isolation period of the rehabilitation station has expired, the patients who have recovered their health still need to face the reconstruction of social relations and the mind. Some people feel that they are not sick from beginning to end, and some people still feel physical problems after recovery, saying that the virus has spread to every organ in the body. In addition, some rehabilitation patients are worried that they will be discriminated against by residents in the community.

A friend who lives in the same community as Xiao Dong once consulted her and described her distress. The friend's mother-in-law was infected with new coronary pneumonia and has recovered and returned home. She walked in the neighborhood and saw the epidemic notice on the wall writing the building and unit she was in, and she felt a little uncomfortable. People you once met occasionally, whether intentional or unintentional, always feel that the other party is avoiding themselves.

For community hospitals like Changdong Center, there are only one medical staff dedicated to psychological consultation. In addition, the volunteers in the community are not professional. Recently, higher authorities required all community hospitals to report a quota as a psychological "specialist" and have the opportunity to receive centralized training. Xiao Dong feels that the psychological problems of rehabilitation patients are receiving outside attention, which will be of great help to Wuhan's true recovery.

(In the text, Zhou Kai, Liu Na, Li Ling, Yang Qi, and Wang Li are aliases.)

"China News Weekly" No. 12 of 2020

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