(Authorized to publish) Report on the investigation of the situation reported by the masses involving Dr. Li Wenliang

Xinhua News Agency, Beijing, March 19th, a report on the investigation by the public concerning the situation involving Dr. Li Wenliang

On February 7, 2020, the State Supervision Commission set up an investigation team to conduct an investigation according to law on the situation reported by the masses involving Dr. Li Wenliang. The investigation is notified as follows.

I. Basic information of Dr. Li Wenliang and the background and process of reposting and publishing information about WeChat

Li Wenliang, male, Manchu, born in October 1985, Jinzhou, Liaoning Province, member of the Communist Party of China, died of pneumonia due to infection with a new coronavirus on February 7, 2020. He was an ophthalmologist at Wuhan Central Hospital before his death.

In December 2019, Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan Central Hospital Houhu District, Wuhan Red Cross Hospital and other hospitals successively treated some patients with unexplained pneumonia. On December 27, Zhang Jixian, the director of the Department of Respiratory and Critical Care Medicine, Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, reported to the hospital the situation of 3 patients with unexplained pneumonia, and the hospital reported the situation to the Jianghan CDC in Wuhan. On the same day, the Wuhan City Center for Disease Control and Prevention arranged an epidemiological investigation and test for these three patients. On December 29, Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine reported another four cases of unexplained pneumonia from the South China Seafood Market. The Wuhan Municipal Health and Health Committee organized a team of experts to conduct an investigation, and the relevant patients were referred to the Wuhan Jinyintan Hospital that night. Taking into account that similar cases were found in many hospitals in the city, the Wuhan Municipal Health Commission issued departmental documents "Emergency Notice on Reporting the Treatment of Unexplained Pneumonia" in the system at 15:10 and 18:50 on December 30, respectively. The "Urgent Notice on Doing a Good Job in the Treatment of Unknown Causes of Pneumonia" requires that we do a good job in the treatment of unexplained pneumonia and conduct a comprehensive search and retrospective investigation of pneumonia cases in the South China Seafood Market. The two notices were uploaded to the Internet at 15:22 and 19:30 on the same day.

At around 17:30 on December 30, 2019, Dr. Li Wenliang received a message from a colleague. At 17:43, Dr. Li Wenliang reposted in WeChat group “Wuhan University Clinical Level 04” under the nickname “Li Wenliang Wuhan Ophthalmology”, Published clinical information such as “7 cases of SARS confirmed in the South China Fruit and Seafood Market”, “Isolated in the Emergency Department of Houhu Hospital of our hospital”, and a clinical report with the words “positive indicators for detection of SARS coronavirus (high confidence)” Pictures of pathogen screening results, a lung CT video of 11 seconds. At 18:42, the group also released "The latest news is that the coronavirus infection is confirmed and the virus is being typed." "Everyone should not spread the word and let family members and relatives pay attention to prevention." At the same time, similar information also appeared in other WeChat groups. The two departmental documents of the Wuhan Municipal Health and Health Commission that were uploaded to the Internet, and the information forwarded and published by Dr. Li Wenliang and others aroused attention and discussion.

Dr. Li Wenliang's Acceptance of Interviews, Admonitions, and Hospital Interviews by Public Security Organs

At 13:38 on December 31, 2019, the Wuhan Municipal Health Commission issued the "Circular on the Current Situation of the Pneumonia Epidemic in Our City", saying that "27 cases have been found" and "the above cases are viral pneumonia", and said "to Investigations so far have not revealed any apparent human-to-human transmission or infection by medical staff. " Several media have reported on this. In accordance with Wuhan ’s work arrangements for the prevention and control of pneumonia of unknown cause, Wuhan ’s public security organs reposted and published SARS and other infectious disease information on the Internet in accordance with laws and regulations on the prevention and control of infectious diseases and public security management, as well as the notification by the Municipal Health and Health Commission. The situation was investigated and disposed of. At around 13:30 on January 3, 2020, after contacting Dr. Li Wenliang with the police station of Zhongnan Road, Wuchang Branch of Wuhan Public Security Bureau, Dr. Li Wenliang was accompanied by his colleagues to the police station. Deputy Chief of the Police Station Yang Mou arranged a police officer in charge of internal affairs to talk to Dr. Li Wenliang. After the interview was verified, the interviewer produced a transcript on the spot. Dr. Li Wenliang said that it was incorrect to send information about SARS in the WeChat group. He will pay attention to this later. The interviewer produced a disciplinary book for Dr. Li Wenliang. Dr. Li Wenliang also held a disciplinary book and left the police station at 14:30. The interviewers were Hu Mou, an internal police officer, and an auxiliary policeman. Hu Mou signed his name on the disciplinary book and Xu Mou, the police officer on duty that day. In fact, Xu did not participate in the conversation.

Earlier, on the morning of December 31, 2019, the leaders of Wuhan Central Hospital had a conversation with Dr. Li Wenliang after the information sent by Dr. Li Wenliang in WeChat group was reposted on the Internet. Dr. Li Wenliang said in the conversation that he forwarded unverified SARS and other information to the group of students in order to remind the students in the group to take precautions. The hospital asked Dr. Li Wenliang to write an awareness sheet. Until Dr. Li Wenliang was sick and hospitalized, he had been working as an ophthalmologist in the hospital.

Third, Dr. Li Wenliang's illness, treatment and rescue

On January 10, 2020, Dr. Li Wenliang developed fever. He was admitted to the Ophthalmology Ward of Wuhan Central Hospital on January 12 and was transferred to the three wards of the Department of Respiratory and Critical Care Medicine on January 14. The intensive care unit of the medical department died on February 7.

On December 9, 2019, Dr. Li Wenliang was transferred from the ophthalmology clinic to the ophthalmology ward. On January 6, 2020, Dr. Li Wenliang admitted an 82-year-old eye patient. The patient developed fever on January 7 and was later diagnosed with New Crown Virus. He died on January 23. On January 10, Dr. Li Wenliang began to have fever and went to the Wuhan Central Hospital for a fever clinic.

On January 12, Dr. Li Wenliang was hospitalized in the Second Division of Ophthalmology, Wuhan Central Hospital. He was diagnosed with acute conjunctivitis and pulmonary infection in the right eye. On January 14, Dr. Li Wenliang's lung infection worsened, and he was transferred to the third ward of the ward. The three areas of breathing are arranged by Dr. Li Wenliang to live in a single room, and special staff are arranged to work shifts to monitor blood oxygen saturation, heart rate, blood pressure, and provide respiratory support and symptomatic supportive treatments such as anti-virus, anti-infection, sputum, and stomach protection. Hormones and gamma globulin. From January 15 to January 18, according to Dr. Li Wenliang's condition, the attending doctor adjusted the relevant drugs and treatment methods in a timely manner.

On January 19, Dr. Li Wenliang had intermittent fever. In the afternoon, the chief physician of the Department of Respiratory and Critical Care Medicine of the hospital and the leader of the medical treatment expert team in the New Crown Pneumonia Hospital reviewed Dr. Li Wenliang's condition and put forward treatment advice. That night, the hospital invited the Professor of Respiratory and Critical Care Medicine of Tongji Hospital of Huazhong University of Science and Technology and the leader of Wuhan New Crown Pneumonia Expert Team to consult with Dr. Li Wenliang.

From January 20 to 22, Dr. Li Wenliang did not have fever, but his asthma symptoms were still severe. On January 15th, 19th, 20th, and 21st, experts in the medical treatment team of the New Coronary Pneumonia Hospital, such as the team leader and deputy team leader, repeatedly checked Dr. Li Wenliang's condition and put forward his diagnosis and treatment opinions.

At 23:50 on January 22, Dr. Li Wenliang developed symptoms of wheezing and dyspnea after going to the toilet. His blood oxygen saturation dropped to 88%, and his symptoms eased slightly after treatment. The attending doctor informed him that his condition was serious. After obtaining his consent, he transferred Dr. Li Wenliang to the intensive care unit at 3:30 am on January 23.

Prior to January 27, most hospitals in Wuhan, including the Central Hospital, did not have the qualifications and qualifications for nucleic acid testing. After the upgrading and upgrading of the facilities, on January 27, Wuhan Central Hospital started trial operation of nucleic acid testing. On January 28 and January 31, the hospital conducted a nucleic acid test on Dr. Li Wenliang twice. The first test was negative and the second test was positive. On January 31, Dr. Li Wenliang was diagnosed with new crown virus.

From January 31 to February 3, Dr. Li Wenliang had no fever and had some relief from shortness of breath, but his spirit and appetite were poor. At noon on February 4, she had vomiting, frequent coughing, and exacerbation of wheezing, and her symptoms eased after treatment. On February 5th, Dr. Li Wenliang had no fever, but still wheezing and shortness of breath in the resting state, and a chest radiograph on the bed indicated an increase in right pneumonia. On February 6, Dr. Li Wenliang had severe lung disease and was at risk of further deterioration. After consultation with the expert group in the hospital, it is recommended to transfer to the more professional Houhu hospital district. After obtaining the consent of Dr. Li Wenliang and his family, at 18:20, the attending doctor and two nurses will accompany Dr. Li Wenliang to the hospital. . At 18:55, arrived at the Houhu District of Wuhan Central Hospital.

At 19:20 on February 6, Dr. Li Wenliang appeared confused, heart rate and blood pressure decreased progressively. He immediately injected injecting epinephrine to strengthen the heart and opened blood vessel channels to actively replenish fluid volume and increase blood pressure. At the same time, tracheal intubation was performed, and the invasive ventilator maintained breathing and continued chest compressions. At 21:30, the upper cardiopulmonary resuscitation instrument assisted the continuous chest and chest compressions, continued the cardiopulmonary resuscitation rescue, and was given active drug resuscitation. At 22:40, Dr. Li Wenliang was treated with ECMO (Extracorporeal Pulmonary Oxygenator, commonly known as "artificial lung") borrowed by the hospital from Wuhan Yaxin Hospital. Coordinated by the Wuhan Municipal Health Committee, experts from the Peking Union Medical College Hospital arrived at the rescue site. At 2.58 am on February 7, Dr. Li Wenliang's electrocardiogram showed a linear response, declaring clinical death. At 3:48, the hospital released the news of Dr. Li Wenliang's death.

The doctor who organized the rescue said that Dr. Li Wenliang is our colleague, and he is very young. We do n’t want him to leave. We do n’t want to give up as long as there is a little hope. At that time, we did n’t think of any other factors, that is, we wanted to save him. For a long time. Dr. Li Wenliang's attending doctor said that although he could not save Dr. Li Wenliang's life, his treatment was standardized and the rescue was timely. Everyone did his best. According to the out-of-hospital experts who consulted Dr. Li Wenliang, from the medical record of Dr. Li Wenliang, the hospital's treatment is more standardized, and drugs and measures can be adjusted according to the condition. The important medical measures recommended and actually taken by the hospital were all consulted by Dr. Li Wenliang or his family.

4. Dr. Wenliang Li's care and aftercare

After the unfortunate death of Dr. Li Wenliang, a special working class was established in Wuhan Central Hospital, which is responsible for all aspects of care and rehabilitation. On the afternoon of February 7, the leaders of the central hospital visited and visited Dr. Li Wenliang's parents, wife and children. At the request of Dr. Li Wenliang's wife, she and her child were arranged for recuperation in the relevant hospital.

With the application of Wuhan Central Hospital, Wuhan Human Resources and Social Security Bureau has identified Dr. Li Wenliang as a work-related injury. According to relevant regulations, the work death allowance has been fully paid and the funeral allowance has been issued. The insurance company has paid a donation insurance to Dr Li Wenliang's family members (for frontline health care workers fighting the new coronavirus infection pneumonia). The Workers' Union of Wuhan Central Hospital called on employees to make a donation for Dr. Li Wenliang and his family members. The Wuhan Red Cross Society received a targeted donation. On March 4, the National Health and Medical Commission and other departments issued a decision praising advanced individuals in the prevention and control of the new crown pneumonia epidemic in the national health system, including Dr. Li Wenliang.

V. Work suggestions

Due to improper instructions issued by Zhongnan Road Police Station and improper law enforcement procedures, the investigation team has recommended that the Wuhan Municipal Supervisory Authority in Hubei Province supervise and rectify the matter, urge the public security organ to revoke the instructions and hold the relevant personnel responsible, and promptly announce the results of the treatment to the society.

State Supervision Commission Investigation Team

March 19, 2020