2020.2.3 The 12th day of Wuhan quarantine 日记原文于下
My cough has improved significantly in the past two days. Although I am still coughing a little, it is much better. My mother was having a fever the previous days, and she is normal now. At special times, slight changes cause amplified panic.
My aunt has been hospitalized. I heard that the fever has been under control for the past two days.
Colleagues who are isolated at home are also improving, fever is under control, coughing is decreasing, and appetite is improving.
Recently, I increasingly feel that the problems with nucleic acid detection kits are huge and the risks are many. First of all, there is a shortage of kits (don’t know the reason). If the situation is relatively smooth, you must queue for two or three days. If a critically ill patient dies in the process of waiting in line, then it cannot be counted as either confirmed or suspected case. Second, the testing result is inaccurate. According to my doctor friend, it is with very low accuracy, much lower than I expected (because there is no other supporting evidence, I won’t mention specific values here). That is to say, many cases tested negative by the kit cannot completely exclude the possibility of infection. In fact, some cases can be seen from news reports recently. There are indeed many cases in which they resulted negative initially but then became positive finally.
This is very bad. Why?
First of all, in the current situation of extremely scarce hospital beds, the diagnosis of the kit is a necessary condition. If the kit is negative, from what I know now, it is difficult to arrange hospitalization, even if the patient is already very sick (unless there is other special means);
Second, according to the current policy, to get free treatment you have to be confirmed to be sick first. This may cause those “negative” cases who are actually infected to refuse treatment because of fear of the cost of treatment. This is not only fatal but also difficult to prevent the spread of the virus.
Third, if a person is actually infected but not quarantined because the test was negative, it will lead to a wider spread of the virus;
Thus, the official reported confirmed cases are greatly decreased because of this.
Hospital beds are the most critically short resource. You can’t get them simply by standing in line. Some people get a bed by “going through the back door”. Some people get a bed through a social media post – they are “going through the back door” that way. That means that someone else, who has no personal connections or who can’t make a social media posting, doesn’t get a bed. But in these times I can’t be criticizing people who “go through the back door” because if it were for a member of my own family I think I would do whatever it takes.
The day before yesterday one of my friends said that five members of one family were infected but there was only one hospital bed available for them. The parents gave the bed to the youngest child. That amounted to sacrificing their own chance to survive. I am not sure that particular story is true but what I am sure of is that there are true stories like that taking place these days. Some time ago I saw the movie “Sophie’s Choice”. I thought that story was incredibly cruel. I was relieved to think that stories happened in the past, that they belong to history, and could never happen in my neighborhood in the year 2020. History doesn’t belong only to the past.
The centralized quarantine of mild cases and of suspected cases began these past two days. I asked some friends who work for their community’s local authority about it. The community they live in has requisitioned some nearby hotels for the centralized quarantine of patients. There are mostly people who have been diagnosed as infected by CT scan, although not yet by the nucleic acid test so their diagnosis has not been confirmed. Now what I worried about is actually happening. There are not enough medical personnel and the community authority lacks sufficient staff. No expert personnel are caring for these people in quarantine. Each patient has different symptoms so it is very doubtful that they will get appropriate care.
There are also serious issues concerning those people who have “suspected cases” of coronavirus pneumonia. Some of them may have the flu or some other type of pneumonia since the symptoms as seen a CT scan closely resemble those of new type coronavirus pneumonia. If these people are quarantined together with people who actually do have coronavirus pneumonia, they may get infected. Moreover, some of the close contacts of people with suspected cases may be virus carriers. Shouldn’t they be quarantined as well?
My friend couldn’t give me a definite answer. They are overwhelmed. I can well understand the predicament that community grassroots workers like my friend are in. After all, they are not professional medical personnel, they do not have specialized medical knowledge, and they lack medical supplies. Most of the patients they face already have confirmed diagnoses of new type coronavirus pneumonia. They are afraid and even more important, they lack the authority to make decisions. Both beds and testing kits are in short supply. They can’t solve those problems. On top of that, they must confront the fears, criticisms and panic of all the residents in the community under their jurisdiction.
I cannot think of any words to comfort him but to repeatedly tell him to protect himself carefully, not to take direct conflict with the patients.
My other concern is that circumstances differ greatly regarding resources, management level, extent of execution and humanization. For example, In my friend's community, officials have been working overtime for days, following up residents door by door in their district. Let's put it in the cask effect perspective. This could result in severe consequence.
Plus, my family hasn't been reached by the community so far, which is not yet the worst case. Another friend of mine tried calling their community service only to find it a vacant number...
A friend from another city, who works as a journalist, told me she was planning on coming to Wuhan. I told her not to but I'm also aware that many decisions are not optional.
CCP has done quite a brilliant job on oppressing lawyers and journalists these years, so brilliant that I once believed that medias and journalists deserving to be called "professional" were extinct on mainland China. Surprised to find that the performance of many medias in this crisis proved me wrong. Even though I have not a clue how long this situation will last. Probably the words they wrote down risking their lives may get erased from the whole Chinese Internet tomorrow. Those words are worth remembering no matter what.
There are many people worrying about the medics but unfortunately very few focusing on the safety of the journalists. As far as I'm concerned, quite a few journalists on the front line have been infected. I pray for them to be seen, be remembered, not to be viciously slandered ever again.
2月3日 武汉封城第12天
这两天我的咳嗽情况明显好转了，虽然还有些咳，但已经好很多了。妈妈前两天感觉有点发热，现在也正常了。特殊时期，身体略微有些小恙，恐慌都容易放大。
姨妈已经住院，听说这两天发热已经控制住了。
在家隔离的同事也在好转，发热控制住了、咳嗽在减轻、食欲也有好转。
最近，关于核酸检测试剂盒，我越来越觉得问题很大、隐患很多。首先，缺，试剂盒奇缺（不知道原因），比较顺利的情况要排队两三天，如果有重症病人在这个排队确诊的过程中去世那就不能算进任何人数里了；其次，不准，从我的医生朋友那里了解的情况，准确率非常低，比我预想的还要低很多（由于没有其它佐证，这里就不提具体数值了）。也就是说，很多试剂盒检测呈阴性的病例，也不能完全排除感染的可能。事实上最近从新闻报道中也能看到一些病例，确实存在检测多次，前几次阴性，最后是阳性的情况。
这就非常糟糕了。为什么呢？
首先，在现在医院床位极度缺乏的情况下，试剂盒确诊是一个必要条件，如果试剂盒呈阴性，从我现在了解的情况是很难安排住院的，哪怕病人已经病得非常严重（除非有其它特别手段）；
第二，根据现在的政策，免费治疗的前提以试剂盒确诊为前提，这就可能会造成实际感染的未“确诊”者因为担心治疗费用而拒绝治疗的情况，不仅害人性命，也难以杜绝病毒传播；
第三，如果有人实际受到感染，却因为检测呈阴性而没有采取隔离，会造成更大范围的病毒传播；
当然了，官方通报人数却由此大大减少了。
“床位”作为现在最稀缺的资源，更不是靠正常“排队”可以获得。有的人靠关系“走后门”得到了床位，有的人发微博“走后门”得到了床位。这当然意味着没有关系、不会发微博的病人正在失去床位。
但是这个时候我没有办法去评价任何“走后门”的行为，因为如果换作是我的家人，我想我也会无所不用其极。
前天听一个朋友说起，一家五口三人感染，只有一个床位，父母让给了更年轻的儿子——这几乎相当于让出了“生”的机会。我不确定这个故事是不是真的，但我确定的相信这个故事正在真实发生。从前看《苏菲的选择》，我觉得那是太过残忍的故事，还曾庆幸那是过去、是历史。万万想不到在2020年，在我身边，又在发生。
历史从来不意味着“过去”。
这两天轻症和疑似患者的集中隔离已经开始了，问了问在社区工作的朋友，他们所在社区现在征用了周边酒店，安排疑似（主要是做了CT肺部有感染，还没做核酸检测，尚未确诊）患者集中隔离。但是如我此前担心的情况一样，医护人员不足、社区工作人员也不足，此部分隔离患者没有专门人员照顾，每个患者的症状程度也不同，是否都能得到妥善的照顾，恐怕是个问题。
而且这个“疑似”也是有漏洞的，一方面，可能存在流感、其它肺炎的患者，如果CT症状跟新型肺炎很相似，一起进行隔离的话有可能会被感染；另一方面，疑似病患的密切接触者可能也是病毒携带者，是否要一起进行隔离？
但是朋友没有办法给我很准确的回答，他们现在已经是焦头烂额了。其实我很能理解我朋友这样的社区基层工作者们的处境，他们毕竟不是医务专业人士，没有专业的医学知识，他们的医用物资也很缺乏，而他们正在面对的很多都是已确诊的患者，他们也会有恐惧，而且，更重要的，他们并没有很多处置的权限，医院床位稀缺、试剂盒稀缺，这些都不是他们能解决的问题，与此同时他们还要直面来自辖区住户的全部恐惧、指责和惊慌。
我找不到安慰他的语言，只能反复告诉他注意保护自己、不要跟病人发生正面冲突。
另外一点我很担心的是，不同社区的资源、管理水平、执行力度、人性化程度相差很大，比如朋友所在社区已经加班好多天了，社区的负责人每天会跟辖区内的住户挨家挨户排查跟进。按“短板效应”设想一下，很有可能就会造成很严重的后果。
而我们社区到现在都没有联系过我家……但我这还不算最糟糕的，我的另一个朋友联系他们社区服务站的定点电话，居然是空号……
有外地的朋友告诉我，她在准备来武汉。朋友的工作是记者。我嘱咐她不要来，但我也知道，很多事情都不是自己的选择。
CCP这几年在打击律师群体和媒体人上的成绩相当瞩目，我一度认为现在大陆已经没有能称得上“专业”的媒体和记者了，没有想到这次仍然有不少媒体的表现让我刮目相看。虽然我也不知道这个状况还能持续多久，也许明天他们以命相搏写下的文字就会被全网删了，但是仍然值得我记住。
关注医护人员的人很多很多，很可惜，并没有太多人关注记者的安危。就我所知，已经有不少一线的记者感染，我希望他们被人看到、被人记住，不要再被恶意抹黑。