Local Beijing Newspaper Interviews Dr. Roo Changizi

During the novel coronavirus (now called SARS-CoV-2 virus) outbreak, Beijing United Family Hospital (BJU)，as a private medical institution, was appointed as one of the designated fever clinics in Beijing. Doctors dedicate their time and energy to working during this time and play critical roles in ensuring the health and safety of their patients. To understand the doctors battling at the front line of the epidemic, demonstrate the caring nature of the medical staff, and to help boost the public’s confidence in fighting against COVID-19, local newspapers have interviewed some of our doctors at BJU to get their insights on the current situation. Below is one such interview with our Chair of the Center for Family Medicine and Integrative Health Care, Dr. Roo Changizi.  

The following article is adapted from the Beijing Youth Daily interview, 抗疫故事 | “救死扶伤是医者责任” 抗击疫情中在华外籍医生的坚守", available at https://app.bjtitle.com/8816/newshow.php?newsid=5560682&mood=wx&typeid=99&ntype=0

Since the novel coronavirus appeared and cases were identified in Wuhan, there has been an increasing number of suspected and confirmed cases in Beijing. What’s your understanding of the novel coronavirus outbreak, and what’s your personal experience during this epidemic?

What we know is that the Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). This current coronavirus probably originally emerged from an animal source, likely pangolins (though previous speculation was bats). This novel coronavirus is a new strain that has not been previously identified in humans and as such, we do not have immunity against it.

On February 11, 2020, the World Health Organization named the disease "coronavirus disease 2019" (abbreviated “COVID-19”). The epidemiolocal studies are underway and thus far, the transmission rate appears to be 1.5-2 times higher than the seasonal influenza (flu), but may fall with public health measures as is currently happening in China. About 20% of cases have required hospitalization and 0.1-4% of all confirmed cases have been fatal. A robust Chinese and global response have helped slow down the disease spread. It has certainly disturbed the rhythm of life for millions and is causing a huge burden on the infrastructure of the health system.

As a Family Medicine physician, what are your primary roles and responsibilities during this epidemic period? Are there patients, co-workers, or events that are quite memorable?  

As a commitment to the ongoing care of our patients, the Department of Family Medicine and Integrative Health Care is actively contributing to the Emergency Room fever clinic where the shifts are 7-12 hours per day, for 7 straight days. Once the shift is done, the physician quarantines themselves for 2 weeks before they take the next shift. Our colleagues at the local levels are working up to 12 hours a day for 14 days straight, then quarantining themselves for 2 weeks.

At Beijing United Family Hospital (BJU) we have created a call center where anyone can call in with questions and concerns. Also, we have coverage in the Department of Family Medicine and Integrative Health Care 7 days a week to address acute or chronic issues that are not respiratory related.

In accordance with the local health requirements, all patients with respiratory issues, cough, congestion, and runny nose are seen in the designated fever clinics where patients and staff are well protected.

My coworkers are human beings like any others, they have their families, their loved ones and find it very difficult to leave their loved ones behind and go to work.  But it is the “Oath” taken and they feel the social responsibility to give a lending hand to unburden the current situation.

We can certainly see the nobilities of human beings in time of crisis. I feel honored to be working along some of the most incredible and dedicated people. In times of difficulty, I often  reflect on this 19th century quote: “Anybody can be happy in the state of comfort, ease, health, success, pleasure and joy; but if one will be happy and contented in the time of trouble, hardship and prevailing disease, it is the proof of nobility.” In brief, I would say that the whole world is witnessing a nobility and a resolve of this nation as has never seen before.

It has been an honor and a privilege to be working alongside my Chinese and foreign co-workers. Many of my colleagues are braving the unknown despite its potential risks. They too have families and young ones. The world is recognizing more and more how interdependent we are and that as human beings we are part of one family…what afflicts one part of the world afflicts the rest of us.

Despite being in challenging times, it also gives us a unique opportunity to help out in what we have all been trained to do. Our sense of gratitude goes to all the health care workers and the front line staff and their families for their daily bravery and putting their lives at risk.

Some countries have evacuated their citizens from China. What is the reason that makes you, as a foreigner, decide to stay in China and work?

My family and I have been in China since 1999 and have seen many changes and challenges. And every challenge has shown itself as an opportunity for the whole country to change, improve, and become a world leader through example. So this present crisis, although unprecedented in its nature and magnitude, will certainly pass, the health system in China will become more robust, and the health care workers will find their voices heard much earlier rather than later.

Soon China will be one of the safest places to live and to work.

We learned that 17 years ago, you were involved in the battle against the SARS outbreak. What differences can you see, in terms of the epidemic, the hospital’s response, and the public’s response, compared to 17 years ago?

There are a lot of similarities and differences between this and the SARS-CoV.

• With this COVID-19, within a 5-week window, the total number of cases had already surpassed the total case counts for SARS-CoV (which occurred over 6-7 months) and MERS-CoV cases (which spanned years). Increased individual mobility with higher population density (relative to 2003) is likely to have contributed to its increase spread.

• Asymptomatic transmission might be possible, though this did not occur with SARS-CoV, and there is no confirmed evidence of airborne transmission to this date.

However today is very different than 17 years ago. There is a China Center for Disease Control (China CDC) that did not exist prior to 2003. The healthcare system has significantly improved in China since SARS, with increases in public funding for health, improved access to healthcare, and modernization of the healthcare infrastructure.

Improvements in genome sequencing assets have enabled rapid characterization of the virus (e.g., identifying and quarantining the origin and tracking genetic changes during the epidemic). Currently more than 180 research and clinical trails are being conducted (the majority in China) to find a cure or vaccines to stop this virus in its tracks.

How do you keep your work-life balance during this epidemic period? What measures have you taken to keep yourself and your family healthy and safe? What was your family's attitude towards your work during the outbreak? Did they encourage you, or did they also express worries and concerns?

I read that people are often comparing this to a war zone, and I feel sorry for people who have been through war zones and other natural calamities. This in comparison is different and you still have much control over the course of what you do and how as an individual you can help to stop this epidemic.

My family has learned to be vigilant about hand washing, avoiding public spaces, and wearing a mask whenever we are outdoors. We are vigilant of public surfaces and try to wash our hands often. This is a fragile virus, but research is showing that it could live from minutes to days on different surfaces. We open the windows when the air quality is good and we have a routine of 45 minutes of exercise at home with exercise balls, resistance bands, and water bottles.

I have tried to keep a sense of normalcy with my 11 year old son at home and my wife who is a math teacher. They are both engaged with distance learning.

We know that this is a temporary situation and this too shall pass.

It is said an Eastern monarch once charged his wise men to invent him a sentence, to be ever in view, and which should be true and appropriate in all times and situations. They presented him the words: "And this, too, shall pass. How much it expresses! How chastening in the hour of pride! How consoling in the depth of affliction! Sorrow not if, in these days and on this earthly plane, things contrary to your wishes have been ordained and manifested, for days of blissful joy, of heavenly delight, are assuredly in store for you.”

As the outbreak evolves, what do you see or plan for your next move in your work? What advice do you have for the patient who may have medical concerns? For example, what patients can wait and should avoid going to the hospital now, and what patients still need to see a doctor as soon as possible?

It is my hope that sooner than later we will all go back to normal. However, if this endemic changes to pandemic (where the whole world is involved) then we will be entering a new normal.

My advice to whoever is reading this is to keep a positive attitude, smile, laugh, and bring joy to others. Reach out to others with a phone call or WeChat video, you’ll be surprised how much reaching out would help you and others. Be a source of courage and joy to others. Keep physically active, eat wholesome food, get enough rest, and sleep at least 8 hours a night, and reach out. And to finish this off, call us before coming to see us, we would be happy to address your concerns and questions.

Advice on cleaning surfaces:

1. As the virus can survive on surfaces of different materials for at least 2 to 3 days, surfaces potentially contaminated with novel coronavirus should be sanitized.

2. An appropriate disinfectant with indication of effectiveness against coronaviruses can be used. Disinfectants should be prepared and applied in accordance with the manufacturer's recommendation. Ensure appropriate contact time is given before removing any disinfected materials. Please refer to the "Interim List of Household Products and Active Ingredients for Disinfection of COVID-19" for a list of disinfectants that can be used.

3. Bleach can be used as a disinfectant for cleaning and disinfecting (dilute 1 part bleach in 49 parts water, 1000 ppm or according to manufacturer's instructions). Bleach solutions should be prepared fresh. Leaving the bleach solution for a contact time of at least 10 minutes is recommended.

4. Alcohol can be used to wipe down surfaces where the use of bleach is not suitable, e.g. metal.

Useful Links:

1. https://www.nea.gov.sg/our-services/public-cleanliness/environmental-cleaning-guidelines/guidelines-for-environmental-cleaning-and-disinfection

2. https://www.nea.gov.sg/our-services/public-cleanliness/environmental-cleaning-guidelines/guidelines/interim-list-of-household-products-and-active-ingredients-for-disinfection-of-covid-19

3. https://www.infectioncontroltoday.com/environmental-services/best-approach-disinfecting-surfaces-amid-novel-coronavirus-outbreak

As Chair of Beijing United Family Hospital’s Center for Family Medicine and Integrative Health Care, Dr. Roo Changizi continues to make a difference in people’s lives every day. If you have any health concerns you wish to discuss with him or any of BJU’s experienced doctors, please do not hesitate to schedule an appointment via our 24-hour hotline at 4008-919191.