Europe’s Doctors Repeating Wuhan Errors: Experts

As Europe’s daily new cases of the coronavirus now eclipse China’s at the peak of its epidemic, doctors in Wuhan — the city in central China where the pathogen first emerged — are seeing worrying signs of similar mistakes unfolding.

Key among them is inadequate protection for medical workers, leading to a high infection rate among doctors and nurses. In Wuhan, a lack of understanding of the disease and a shortage of protective equipment in the early weeks of the outbreak in January led to thousands of health-care workers being infected while treating patients. At least 46 have died.

“Our European colleagues are contracting the disease in their daily practice, and the proportion is quite similar to the earlier situation in Wuhan,” said Wu Dong, a gastro-enterology professor at the Peking Union Medical College Hospital. Wu spoke from Wuhan with journalists in Beijing on Monday, alongside three other top Chinese doctors. “We need to protect our medical staff.”

The toll on medical workers is an emerging crisis faced by major western countries where the virus has now taken hold. From Italy to the US, countries are reporting a shortage of protective medical supplies like masks in hospitals, while the rapidly growing patient load is overwhelming doctors and nurses. The highly-contagious nature of the virus means that it has shown signs of being transmitted in unusual ways, like through the eyes.

In Wuhan, ear, nose and throat (ENT) and eye doctors were infected at higher rates than colleagues in the same hospitals, Du Bin, director of the intensive care unit at Peking Union Medical College Hospital, said at the same briefing.

“My personal interpretation is these doctors have very close contact with the patients, that’s the major reason that they got easily infected,” he said. “It’s important to get doctors educated and trained on how to protect themselves.”

The epidemic has now sickened over 170,000 globally and killed over 7,000. While it’s slowed in China — only 21 new domestic cases of infection were reported on Tuesday — it’s accelerating in Europe and the US, cutting a particularly deadly swathe in countries like Italy, where the reported mortality rate is currently almost twice that of China’s.

In China, where the population is cautiously resuming their daily activities, the death of prominent doctors during the course of the crisis has been a lightning rod for public anger over the government’s handling of the outbreak. The death of Li Wenliang, a 34-year-old doctor who was one of the first whistle-blowers about the disease in December and was sanctioned by local authorities, ignited a wave of rare public fury against the Communist Party.

The Chinese doctors at Monday’s briefing had other insights into treating the disease:

Prioritize Testing

Unlike previous pandemics like the 2003 one caused by SARS, the coronavirus causes only mild or even no symptoms in some infected people at first, which means they’re unknowingly spreading the virus to others. Administering nucleic acid tests, which identify the virus’ genetic sequence in patient samples, is essential, said the doctors.

“Test, test, test,” said Du. “Apart from testing, I just have no idea how you can identify the suspected cases, and how to quarantine the close contacts.”

Testing has become a barometer of competence for the world’s governments and health-care systems. The U.S. government is facing widespread public anger for the slow roll-out of tests, while nations from Indonesia to India are being criticized for not testing much at all. South Korea, which had the second-biggest number of cases in Asia, has gotten its epidemic under control largely through testing tens of thousands of people daily.

Adults, Kids

While the population most at risk is over 60, children can be infected by Covid-19 and some cases have been fatal, the head of the World Health Organization said at a briefing on Monday.

Adults are 2.7 times more likely to get the disease than children, according to a study published in the Nature Medicine journal on Monday of 745 children and 3,174 adults. Most of the infected kids had close contact with confirmed patients or were part of family clusters.

Du said the majority of children infected have only mild symptoms, and all have survived so far. In the Journal of the American Medical Association, another study showed that among nine infants, none required intensive care or had severe complications.

Traditional Chinese Medicine

While no drugs have yet been approved to treat the virus, there’s been a lot of attention within China on the use of Traditional Chinese medicine, or TCM, by patients. The herb-based treatments are being used in some 87% of cases in the country, the official Xinhua News Agency reported on Feb. 17.

“TCM works quite well in patients with mild diseases, and in those who have recovered from their critical illness,” said Du. But it’s hard to judge the efficacy of the treatment from a western medical point of view. The evaluation system for the TCM could be “futile or invalid”, because it has a different philosophy or evaluation system for efficacy from western medicine, he added.

China’s Approach

The doctors said that it seemed to them that China’s domestic outbreak has come to an end, but that the country still needs to be vigilant.

“Even in Wuhan, we should remain alert, we should prepare for future sporadic cases and future imported cases,” said Du.

China is now providing assistance to other affected countries. Last week, a Chinese plane carrying medical professionals and about 30 tons of medical supplies landed in Italy.

“Every nation has its own COVID-19 situation. We are not saying this is China’s example and you should follow, we totally respect that you take your own actions,” said Wu, “But everyone of us should take it seriously, take necessary actions, change your behavior, and be responsible.”