From rushing to aid Wuhan on New Year’s Eve in 2020, stationed in the intensive care unit of Wuhan Jinyintan Hospital, joining Shanghai’s normalized anti-epidemic team in 2021, and then participating in the defense of Greater Shanghai in 2022, moving to shelters and designated hospitals, in the past three years, Cha Qiongfang The doctor’s nervous and busy pace never stopped. On the occasion of the Spring Festival in 2023, she said with emotion: “This time, I can finally have a reunion dinner with my family with peace of mind!”
Cha Qiongfang had a reunion dinner with her family. The pictures in this article are provided by the interviewees
Cha Qiongfang, Deputy Chief Physician of the Respiratory Department of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, was one of the first medical team members in Shanghai to assist Wuhan. She wrote 67 diaries with a length of more than 100,000 words on the front line of fighting the epidemic in Wuhan. , published the book “Diary of Dr. Cha’s Aid to Hubei”, which became well known to the public.
In this special Spring Festival of the Year of the Rabbit, although Cha Qiongfang still has to work during the Spring Festival, she feels much more relaxed. After work, she starts the stay-at-home vacation mode and enjoys every bit of happiness in life.
“New Year’s Eve, first day, fourth day, sixth day, four-day ward rounds, outpatient visits on the eighth day, I didn’t have a good rest every weekend in December last year, this time I can relax!” Cha Qiongfang said.
On the morning of the fourth day of the Lunar New Year, Cha Qiongfang was on duty to make rounds.
What pleased her most was that just before the Spring Festival of the Year of the Rabbit, a large number of patients with new crowns were discharged from the hospital one after another. Most of the patients want to be discharged early and go home for the Spring Festival.”
The ward that Cha Qiongfang is currently in charge of is located in the South Hospital of Renji Hospital, Pujiang Town, Minhang District, Shanghai. On December 23, 2022, the hospital “opened” and officially admitted patients with new crowns, most of whom were severe patients with new crowns.
“At that time, it happened to be the peak of infection in Shanghai, and the number of patients in the emergency department and fever clinic surged. The emergency observation ward was ‘full’, and the patients were diverted to other departments one after another. There are a total of 29 beds in the ward for COVID-19 patients, and they were all filled in just 3 days.”
For Cha Qiongfang, not only the ward is new, but also the treatment team.
“This ward is located on the second floor of the infection building of the South Hospital. This is a newly built building. The ward has never treated patients before, and I also brought 4 doctors to form a new treatment team. These doctors are not from the respiratory system. They are composed of doctors from different departments such as urology, neurology, endocrinology, etc. Since many new crown patients have underlying diseases, during the treatment process, doctors also need to adapt a little bit, and continue to learn what is not their own field expertise, including understanding how to administer medications, and seeing chest CT scans, etc.”
Cha Qiongfang pats the back of a patient in the respiratory intensive care unit.
In the ward, there were two elderly people in their 80s who were seriously ill with the new crown, which impressed Cha Qiongfang the most. One of them was an old lady with chronic obstructive pulmonary disease and heart disease. She had a fever at home for several days. When she was sent to the hospital due to dizziness and brain swelling, she stopped taking her usual medicines for basic diseases. After antiviral treatment, hormone therapy, etc., after a week, there was still no improvement, and the oxygen saturation kept going down, and even nearly 70% of the white lung appeared. For this reason, Cha Qiongfang applied for a hospital-wide multidisciplinary discussion on the diagnosis and treatment of the old lady. On the basis of the original high-flow oxygen, anti-inflammatory storm drugs were added, and the dosage of hormones was also adjusted.
“Thank you very much for the cooperation of the patient and family members. We also gave the old man immune-boosting treatment, continued to carry out prone position ventilation, and the lung condition gradually improved. Until a few years ago, high-flow oxygen was replaced by a nasal cannula for oxygen inhalation. It took a full 4 weeks. , the old man finally ushered in the hope of being discharged from the hospital.” Before being discharged from the hospital, Cha Qiongfang confirmed that the old man’s oxygen saturation had returned to a state where he could be discharged from the hospital, and the patient’s home had also prepared an oxygen inhaler, so the old man was released from the hospital in the afternoon with confidence.
Another severely ill elderly man who impressed Cha Qiongfang the most was an old gentleman. When he was admitted to the hospital, he was found to have poor lung function and severe asthma. After antiviral and systemic hormone treatment, he has not improved. Finally, the macrogene monitoring of etiology was adopted, and it was accidentally discovered that one of the pathogens infected by the elderly was “Aspergillus fumigatus”.
“This is a kind of fungus, but the number of NGS sequencing sequences is not high. Whether antifungal treatment is necessary, we invited the intensive care medicine department for consultation, and finally used antifungal treatment for the elderly in a targeted manner. Slowly, the elderly’s Asthma gradually improved, and oxygen saturation gradually improved.” Cha Qiongfang said with emotion that the diagnosis and treatment of patients with new crowns is indeed not simple, and doctors in one department alone cannot solve all the problems in diagnosis and treatment. Only multidisciplinary can play a role. “Among the patients we treat , There are kidney transplant patients, cerebral infarction patients, hyperglycemia patients, etc., and even some patients with sleep disorders. Their diagnosis and treatment cannot be separated from the efforts of doctors in multiple departments. , learned a lot.”
Facing the treatment of COVID-19 patients, the cohesion and sense of responsibility of medical staff are particularly important. Cha Qiongfang was once moved by the behavior of members of the diagnosis and treatment team: “In our team, a doctor suffered from vertigo due to fatigue. Originally, this doctor was excluded. I was on duty during the New Year’s Eve, but I had to change shifts temporarily due to illness. I need to mention the shift schedule of another doctor. The doctor who was on duty was already on vacation at the time, but he didn’t say anything, and immediately took the high-speed rail It’s not easy for everyone to come back to work, let’s tide over the difficulties together.”
Cha Qiongfang said: “At present, there are 9 patients left in the 29 beds in the ward, and the pressure has been reduced a lot. These days, there are only a dozen patients in the fever clinic every day, which is indeed a lot less, and the number of emergency patients is also lower. It has dropped sharply and has returned to the previous winter visits. Another new crown ward opened by our respiratory department in early January has been closed a year ago. This wave of infection peaks has basically passed. In February, It is expected that doctors in our team will return to work in their own departments.”
But at the same time, Cha Qiongfang said frankly that this wave of epidemics left me with a lot of thinking, and there are still many follow-up work to be carried out for patients. “There are many important things we need to do in 2023. Many patients told me when they were discharged from the hospital, I will visit my clinic to follow up the changes in my lungs and possible sequelae, which will also help us clinicians to better understand Omicron virus.”
In addition, Dr. Cha Qiongfang also said that although the current epidemic prevention and control policy has been “relaxed”, it is still necessary to do a good job in epidemic prevention and control in the future, and to respond to new changes at any time.
“Compared to 2020, our understanding of the new crown has deepened, we will no longer be helpless, we will not be afraid of the virus, and the treatment is more experienced, but for every doctor, in the face of the treatment of the new crown, there is a lesson to learn There are too many, and at the same time, this disease has also brought a huge test to our discipline construction and infectious disease treatment capabilities. We need to think about the incompleteness of the future development direction of medicine, and how to make our diagnosis and treatment system better. Even more powerful, how to give full play to the best capabilities of our respiratory doctors to treat patients with new crowns will be a question we will continue to think about in the future.” Cha Qiongfang said.