WUE·NYC｜A Chinese Doctor，“We've tested over 100 COVID-19 cases”

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The Editor’s Notes

The COVID-19 has continuously broken out over the globe, and New York in the United States has still been “a place with serious pandemic”. By April 10, the confirmed cases of the COVID-19 have reached over 1,570 thousand, more than 460 thousand in the United States, and more than 160 thousand in New York.

On April 8, local time (EDT), the New York Times published a long report on “How Delays and Unheeded Warnings Hindered New York’s Virus Fight” (with English), reflecting and reviewing on the prevention and control of the COVID-19 in New York. Every New Yorker, including the mayor and the governor of New York, was hardly to imagine that “the mighty New York” would suffer a lot in the panemic. After all, this is a city with a perfect health care system, and experiences of facing difficulties: the Ebola virus, the Zika virus, the H1N1 virus, and even the Sept. 11 terrorist attacks. However, the pandemic still broke out.

The pandemic is still spreading. At the same time of reviewing and examining the reaction in the pandemic, it is particularly important for those in power to make timely and correct decisions to control the pandemic and protect everyone’s life. It is also what all the medical staff want to appeal loudly in the pandemic.

JIN ZHANG is a Chinese doctor in New York. She holds a Master Degree of Medicine from Columbia University and a MD from the medical college of Polytechnic Institute of New York University. She has also another identity——she is the granddaughter of Zhang Henshui, a master of modern Chinese literature. After nearly 20 years of medical practice in the United States, Dr. Zhang has learned the response herself of the health care system in New York in extreme cases of this pandemic.As an attending doctor of an urgent care in New York’s largest Chinese community, JIN ZHANG has tested more than 100 COVID-19 patients with her team since March 24, and they together have distinguished those patients who were critically ill and needed to be sent to the emergency rooms.

In fact, since the outbreak of the pandemic, many clinics in New York had no choice but to close down and implement telemedicine diagnosis. However, JIN ZHANG has still been fighting in the front-line, and she said “if we close down, patient will flock to the emergency rooms, and the health care system in New York will carry heavier burden than before.” A week ago, Dr. Zhang made some records about the prevention of the pandemic in New York under the appointment of “WUE2020”. Even today, the pandemic in New York is still severe, and the government has begun to review the response of the pandemic, but Dr. Zhang still holds confidence. She said, “it feels like the turning point is coming soon!”

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Before the article, we want to share a video with you to taste the warmth and strength evoked by medical staff around the world, and the gratitude and encouragement people give to medical staff.

Since the end of March, various cities in different countries have spontaneously organized an activity —— "Clap for Doctors" . Standing on the balcony, at the roadside, and on the top of the mountains, people cheer for all medical stuff. Souse: Twitter Editor: @WUE

It has seemed to be a catastrophe since the outbreak of the COVID-19 in the United States: the metropolis has shut down, stocks have taken a big drop, and social life has been seriously affected. In the eyes of some netizens, it looks like the end of the United States.

Taking New York as an example, some reports on the continuing outbreaks of the COVID-19 and rescue works cannot be published at once, making some people doubt whether the patient treatment could be carried out effectively in New York or even in the United States. It is anxious and sorry to see such a situation.

On the morning of January 29, the Wall Street Journal reported the progress of the Coronavirus overseas. At that time, the New Yorkers hadn't realized that it would happen in NYC. photo from：Ohia

As a doctor, I would like to say that we should enhance mutual trust between each other. We should cooperate and support each other while overseeing and reviewing our actions in the pandemic. Although viruses know nothing about borders, we should seize the time to make right decisions and implement them.

I have been living in the United States for nearly 30 years, and I hope we can promote mutual understandings and help each other in facing all these difficulties. As a practitioner, I would like to record and share with you the situation of the medical aid in New York.

On March 19th, the content of JIN ZHANG's WeChat Moments. Since the outbreak, JIN ZHANG and colleagues have been working in the clinic. photo from: JIN ZHANG

First, I would like to talk about the difference of the health care system between the United States and China. In the American health care system, in addition to the major hospitals, there are emergency rooms, urgent cares, and doctor’s clinics. Most Americans have their own family doctors.

Before the outbreak, Dr. JIN ZHANG and his colleagues in the clinic. photo from: JIN ZHANG

Taking New York as an example, private policlinics and specialist clinics spread over the communities in New York; moreover, there are hundreds of urgent cares in each block. Urgent cares play a role as a bridge between family doctors and emergency rooms, especially in such an extreme case of pandemic, the urgent care will decide whether the patients should be sent to the emergency room or the hospital according to their conditions. It prevents people from flocking to the emergency room in times of panic and is very helpful in alleviating the shortage of medical resources.

In short, in the United States, it is these large number of small medical institutions and major public and private hospitals that work together to build the health care system (PCMH Patient-Centered Medical Home) of each city.

When the COVID-19 first broke out in the United States, CDC virus testing techniques and test kits were temporarily unable to be delivered to grass-roots medical institutions. At the same time, the sudden increase in confirmed cases also caused panic among the public. For a while, the emergency departments of many hospitals were overwhelmed, especially in New York, and it felt like the health care system could not bear the burden anymore. Someone even asserted that, with the sharp increase of the people seeing doctor in New York, it would eventually destroy the health care system of this city.

However, within just one week, the health care system gradually changed from the initial disorder to order. At present, virus testing are constantly carried out in many policlinics, urgent cares, and large chain pharmacies like CVS. Large supermarkets such as Wal-Mart have also begun to set up driving monitoring stations to help people Drive-Through. This testing method is safer, and people can be tested without getting off the car. Within a week or two, there was a rapid increase in the number of people tested in New York, which was a basic guarantee that the pandemic would be brought under control.

After the outbreak, the number of patients visiting the clinic increased. Receptionists and doctors have all put on basic protective clothing. photo from: JINZHANG

In addition, due to the intervention of private doctors and convenient emergency services in various communities, patients with mild symptoms can go to the clinics and family doctors nearby without swarming to the emergency department of the hospital. It will release the burden of the hospital, and let the doctors concentrate on treating critically ill patients, especially those who are seriously ill and those who need to use ventilators. In the outbreak period of the pandemic, this is particularly important to avoid the dilemma of cross-infection when people crowded into the hospital. The cooperation of family doctors, urgent cares, emergency rooms and large hospitals is equivalent to two medical echelons in the pandemic, supporting each other in their efforts to keep the health care system functioning.

Taking our urgent care as an example, since March 24, we have already tested more than 100 COVID-19 patients. Patients with mild symptoms were all isolated in their homes and took the common therapeutic drugs according to the basic treatment of CDC, to enhance immunity. In the observation, if there was a tendency of the mild symptoms turning into the serious symptoms, we had to send the patient to the emergency room. During this period of time, the number of patients with fever was more than the one in previous years. However, many people come to the clinic only to get a comfort from the professional doctors, and make sure that they are fine after the doctor’s observation and diagnosis. There are many patients who suspect themselves to be sick because of psychological panic, and we need to reassure them through basic diagnosis and prevent everyone from rushing into the emergency rooms, which is more risky.

Then I would like to talk about the “challenge of hospital beds”.

Under the situation, each country and city needs to consider the issue of “whether there is a shortage of hospital beds”, and New York is also facing such a challenge.

On March 27th, New York Governor Como opened a press conference at the temporary hospital converted from the Javits Center. photo from: pscp.tv

Therefore, Andrew Cuomo, the Governor of New York announced at a press conference on March 27 that the Javits Center, New York’s largest convention center, would be converted into a temporary hospital. This “temporary hospital” was rebuilt by the US National Guard and the US Army Corps of Engineering within a week. It contained 1,000 beds and was officially put into service last Monday (March 31). It was believed that it could help alleviate the shortage of the hospital beds in New York. Governor Cuomo made a speech more than 4 minutes that day at the Javits Center, and it might become history. “We are going to do this, and we are going to do this together.” These words have given confidence to the New Yorkers.

At the same time, medical warship “USNS Comfort” finally docked in New York Harbor on March 30. There were also 1,000 beds, 12 operating rooms, laboratories, pharmacies and oxygen production rooms on board. In Central Park, an emergency field hospital was quickly built, with nearly one hundred beds and ICU wards. These beds were prepared for the non-COVID-19 patients who needed medical treatment, and it could ensure that they could be treated without being infected by the COVID-19 patients.

I would also like to talk about the “strength of the medical staff”.

Dr. JIN ZHANG and medical colleagues. After the outbreak, their urgent care of the New York Chinese community quickly joined the diagnosis and treatment of many mild patients which relieve the pressure for the emergency department of the hospital. photo from: JIN ZHANG

In addition to hospital beds, the shortage of front-line medical staff was also once on the governor’s table. To this end, Governor Cuomo previously issued a rally order, calling on the health care volunteers in the United States to actively participate in the medical aid. With this order, 10,000 people signed up in just one day, including students in the medical schools and retired medical staff. In just one week, another anti-pandemic army composed of doctors, nurses and respiratory therapists was quickly founded. The number of this army has been refreshed repeatedly in the past few days, and up to April 8, more than 90,000 volunteers has responded, including 25,000 volunteers from other states. What’s more, 10,099 psychotherapy volunteers have also joined the team several days ago.

photo from：Insider

What impressed me most was that among these volunteers, there was an 80-year-old citizen who wrote down a will, saying that in case he/she was infected, he/she did not need a ventilator and would give the hope of life to the younger patients. It reminded me of a priest in Italy, who recently gave his ventilator to a young stranger. It was adorable for his devotion, but we should make effort and pray to get the pandemic under control as soon as possible, so that people do not have to make choice on the ventilator.

Many airlines have joined to carry medical volunteers for free. On a flight of Southwest, medical volunteers smiled at the camera.

From March 25, JetBlue Airlines began to transport medical volunteers to New York free of charge; Hertz car rental company also provided local commuter vehicles for medical staff free of charge; and a number of hotels in New York have made it clear that they would provide free accommodation for volunteers. All of these good deeds were warming and inspiring the New Yorkers.

Chinese American Independence Practice Medical Association (CAIPA) donate medical supplies to local hospitals in New York. photo from: CAIPA

I would like to talk about the story of the Chinese around me in this pandemic. Some time ago, medical supplies in New York hospitals, especially protective equipment for medical personnel, were in an emergency. Many front-line doctors did not have adequate protective suits or protective masks. Including our urgent care, although the state government has delivered N95 masks and isolation gowns to us, we tried not to use head-to-toe isolation gowns and saved them for the medical staff in emergency rooms and ICUs. Then due to the shortage of the medical resources, the Chinese community in New York actively organized medical supplies for hospitals, and also various Chinese associations, including the Chinese American Independence Practice Medical Association (CAIPA) where I work, have taken the lead in launching donation activities.

Moreover, the donations launched by these Chinese were donated not only to the hospitals, but also to the New York City Police Department, the post offices, and the public transportation, demonstrating the great love of Chinese for American society. Recently, the federal government has also launched a wartime mechanism to increase the production capacity of protective equipment. Medical supplies such as masks, gloves and protective suits are being delivered to hospitals in New York and to the front-line medical staff. The shortage of medical supplies is being solved step by step.

New York Chinese Lawyer Sun Lantao (Dr. JIN ZHANG 's husban) donated medical supplies to Elmhursty Hospital——the COVID-19 Epicenter of New York on behalf of The Beijing Association of NYC. photo from CAIPA

Talking about the police station, I would like to say that the police in New York are not living an easy life. To maintain the operation of the city in such a difficult time, they have always been on the front line, sticking to their responsibilities and taking risks. One day morning, I was going to work in the emergency clinic. However, I was stopped by a policeman on our way. Because at this time, New York has strictly enforced the “Social Distancing”, which required people “not to go out if necessary”, “there should be a distance of six feet between two people”, and “there would be a fine of 400 dollars per person for driving without reason” etc. When the policeman asked why I was driving and then learned who I was, he let me go immediately, saying that “the green light must be given to the medical staff.”

It touched me deeply. According to the news, many police in New York have been infected, and I hope they can protect themselves well.

NYPD on the Times Square. Amid the pandemic, the New York police are still guaranteeing the safe of the city, and their health are also being challenged. photo from: Ohia

In recent days, I often think of the speech delivered by Governor Cuomo out of his personal feelings (the speech on a press conference at the Javits Center on March 27). He remarked that “remember today, and ten years from now, you will be talking about today to your children or grandchildren, and you will shed tears. Because you will remember the lives lost, and you will remember their faces.”

He said: “we will overcome the situation, and that is New York.”

On the Hudson River, a seagull flew in the sun. The picture was taken in January, when New York was still in peace, people did not realize that a disaster was gradually approaching. But in the end, people will definitely get through the difficulties. photo from：Ohia

The governor’s speech also represents the American spirit, which is a spirit that will not be knocked down and is not afraid of being scolded. To borrow the words of an author : “the brilliance of the human nature of calm, gratitude, and protection that flashes everywhere in times of crisis is precisely the founding and governing spirit of this great country.”

——END——

JIN ZHANG, a Chinese doctor in New York，the conceptual citizen of the Earth. She holds a Master Degree of Medicine from Columbia University and a MD from the medical college of Polytechnic Institute of New York University. She has also another identity——she is the granddaughter of Zhang Henshui, a master of modern Chinese literature. After nearly 20 years of medical practice in the United States, Dr. Zhang has learned the response herself of the health care system in New York in extreme cases of this pandemic.