Goldbank Englisch

Links to the other parts:《金銀潭》Goldbank_Englisch Part 1, Goldbank_Englisch_1 Part 2, Goldbank_Englisch_3 Full

Part 1

金银潭医院——刺破新冠病毒阴霾的那道亮光 金银潭医院是武汉地区唯一一家具有近百年历史的公共卫生医疗救治基地，也是湖北和武汉的传染病专科医院。 2019年末，新冠肺炎疫情突如其来地在武汉暴发，疫情发展之快，前所未见。这场新冠肺炎疫情，金银潭医院首当其冲，从12月29日收治9例患者到21个病区800多张床位全开，只经过了20多天的时间。 武汉作为核心重灾区，于历史上首次封城，全国4万余名医护人员紧急驰援武汉、湖北，打响了武汉保卫战、湖北保卫战。 “武汉胜则湖北胜，湖北胜则全国胜。” 全国看湖北，湖北看武汉，而武汉则看金银潭。 金银潭医院是重症患者定点救治医院，疫情期间收治的全部为新型冠状病毒感染的肺炎确诊患者。从最早收治确诊患者、查找病毒来源、研究治疗方案，金银潭医院始终走在疫情阻击战的最前沿，成为疫情中的“风暴眼”。包括医生、护士在内的金银潭医院每一位员工，以及各地驰援而来的白衣战士们，以勇者无畏的先锋队姿态奋战在一线中的火线，坚守着脚下的阵地，以大无畏的崇高职业道德守护着身后的武汉人民。在被新冠病毒阴霾笼罩的武汉，似一道亮光破空而出，带来希望与曙光。 一部金银潭抗疫纪事，反映的是武汉人民、湖北人民、全国人民万众一心、众志成城抗击疫情的信心和能力，展示的是中华儿女心往一处想、劲往一处使抗击一切灾难的强大力量。

目录 CONTENTS

金银潭医院 ——刺破新冠病毒阴霾的那道亮光 1

第一章 金银潭——抗疫一线的火线 1

悄然拉开的序幕 2 老传染病医院碰上了新病毒 4 感染人数上升 6 发布试行诊疗方案 8 逐步揭开新冠病毒神秘面纱 10 首例死亡病例出现 13 新冠肺炎存在“人传人”现象 14 孤岛求生，与“疫魔”展开“肉搏战” 16 封城，救治力量和医疗物资均告急 21 竭尽全力，应收尽收 23 不是一个人在战斗 26 快半拍的重要性 31

第二章 救治与研究同步开展 33

克力芝用于临床研究 34 瑞德西韦临床试验启动 36 探索利用康复期血浆“免疫性治疗” 39 首例遗体解剖完成并送检 42 中医武汉抗疫临床发挥重要作用 44 中西医协同作战成效显著 47 延伸阅读：一位医生的确诊和治疗康复之路 52

第三章 坚守阵地的金银潭战士们 55

拼渐冻生命 与疫魔竞速 ——记疫情“风暴眼”中武汉金银潭医院院长张定宇 56 老搭档眼中的张定宇 67 一个人的多身份战“疫”历程 70 为省10分钟，夫妻俩“以车为家” 75 风暴中心的药师们 79 庚子春疫情中的“120部队” 84 医院南二病区的他们 89 后勤，一群不回家的人 92

“暴风之眼”中的医院GCP 97

医院检验科的坚守 104

第四章 “小人物”的“大故事” 107

于无声处听惊雷 108 军功章上有你的一半，也有我的一半 110 不能守护的家人 112 那个蹒跚的身影 114 哪有什么生而勇敢，只是因为选择了无畏 117 累，但是值得！ 121 一名医者的担当 123 “一点都不害怕那是假话，但也容不得我们害怕” 125 不只是在疫情中才是战士 129 宁愿穿纸尿裤干活，也不愿离岗的大男人 132 背后的她 134 小小身体里的巨大能量 136 新冠肺炎疫情下的耐药之战 138 一名护士长的抗疫实录 140 金银潭白衣战士群像 148

第五章 并肩战斗 153

我们要更加坚定要竭尽所能 ——一位重症医学医师的“武汉六日记” 154 战“疫”前线的医生心声：前线保住了，后方才安全 159 “等疫情结束后，我娶你” 161 “为了节约防护服同事穿上了纸尿裤” ——湖南支援武汉金银潭医院护士的一线日记 163 这件白大褂其实很沉 165 那些发出的感谢信 168

第六章 金银潭医院之外 171

社区工作的重中之重：确保900万居家市民生活 173 社区书记：我恨不得变成孙悟空 180 拉网式大排查 184 社区“守门员”的感悟 189 “老武汉”的家国情怀 191 最可靠的警务力量 193 “我的责任要求我这么做” 196 承父志，奋战在疫情防控一线 199 “疫情不退，绝不休兵！” 202 “国难当头，必须全力配合” 204

战斗到最终胜利的那一刻 206

附录：中国发布新冠肺炎疫情信息、 推进疫情防控国际合作纪事 208

Jinyintan Hospital --The light that pierces through the haze of COVID-19

Jinyintan Hospital is the only public health medical treatment base in Wuhan that enjoys a history of almomst one hundred years. It is also a specialized hospital for infectious diseases in Hubei and Wuhan. At the end of 2019, the novel coronavirus suddenly broke out in Wuhan, with unprecedentedly rapid spread. Jinyintan Hospital stood in the breach of the COVID-19 outbreak. It only took 20 days from a mere admission of nine patients on December 29, to availibility of more than 800 beds in 21 wards. Wuhan, the core of the severly afflicted areas, was locked down for the first time in history. More than 40,000 medical workers from all over the country rushed to Wuhan and Hubei to join the rescue, launching the battle of Wuhan and Hubei. "If Wuhan wins, Hubei wins, and if Hubei wins, the whole country wins.” The whole country counts on Hubei, and Hubei counts on Wuhan, while Wuhan counts on Jinyintan. Jinyintan Hospital was the designated treatment hospital for critically ill patients, and all patients admitted during the outbreak were confirmed patients with COVID-19. From the earliest admissions, to finding the source of the virus, to researching treatment options, Jinyintan Hospital was always at the forefront of the pandemic and became the "eye of the storm" during the pandemic. Every staff member of Jinyintan Hospital, including doctors and nurses, as well as the white-coated soldiers who came from all over the world, fought as a brave vanguard in the front line of the fire, holding the ground under their feet and guarding the people of Wuhan behind them with a fearless and noble work ethic. In Wuhan, a city shrouded in the gloom of the COVID-19, a bright light came out of the sky, bringing hope and dawn. A chronicle of the fight against the pandemic in Jinyintan reflects the confidence and ability of the people of Wuhan, Hubei and the whole country to fight the pandemic with one heart and one mind, and demonstrates the strong power of the Chinese people to fight all disasters with one mind and one strength.

Contents

Jinyintan Hospital --The light that pierces through the haze of COVID-19 1

Chapter 1 Jinyintan -- The front line of the war against the COVID-19 pandemic 1

The prelude quietly kicked off 2 The old infectious disease hospital encountered a new virus 4 The number of infected people increased 6 A trial diagnosis and treatment plan was released 8 The mystery of the COVID-19 has been gradually unravelled 10 The first death case appeared 13 There is a phenomenon of "human-to-human" transmission of COVID-19 14 Survival on an isolated island, "hand-to-hand combat" with the "pandemic" 16 The city was in lock-down, the rescue force and medical supplies were urgent 21 Do our best to ensure all patients in necessary conditions were admitted 23 Not fighting alone 26 The importance of taking a proactive approach 31

Chapter 2 Simultaneous development of treatment and research 33

Kaletra used in clinical research 34 Remdesivir clinical trials started 36 Exploring the use of convalescent plasma "immunity therapy" 39 The first autopsy was completed and sent for inspection 42 Traditional Chinese medicine in Wuhan played an important role in the anti-pandemic clinic 44 The coordinated operation of traditional Chinese and Western medicine achieved remarkable results 47 Extended reading: A doctor's diagnosis and treatment road to recovery 52

Chapter 3 Jinyintan, where firm soldiers stand 55

Frozen life and the race against the pandemic -- Record Zhang Dingyu, director of Wuhan Jinyintan Hospital in the "eye of the storm" of the pandemic 56 Zhang Dingyu in the eyes of his old partner 67 A person's multi-identity battle against the "pandemic" 70 To save 10 minutes, the couple "take the car as their home" 75 The pharmacists in the storm center 79 The "120 troops" in the pandemic in Gengzichun 84 "They" in the South Second Ward of the hospital 89 Logistics, a group of people who don't go home 92 The GCP group in hospital who bear the most pressure 97 Perseverance of the Laboratory Department of the Hospital 104

Chapter 4 Extraordinary stories of ordinary people 107

Where silence reigns, listen for a startling thunderclap 108 The credit shall go to both you and me 110 The families that cannot be guarded 112 The tottering figure 114 Bravery is not inborn; it's a choice 117 Tired, but worth it! 121 A doctor’s responsibility 123 "It's a lie not to be afraid at all, but we can't be afraid" 125 Be a soldier, not just in the pandemic 129 A man who would rather wear diapers to continue working than leave the position 132 The woman behind 134 Huge energy in her tiny body 136 The battle against drug resistance under the COVID-19 pandemic 138 The memoir of a head nurse's fight against the epidemic 140 A group portrait of "soldiers in white" in Jinyintan Hospital 148

Chapter 5 Fighting side by side 153

We must be more determined and do our best "Six Days in Wuhan" by intensive care physicians 154 The voice of doctors on the front line of the "war" against the pandemic: only if the front line is preserved, the home front can be safe 159 "Marry me, after the epidemic." 161 "In order to save protective clothing, my colleagues put on diapers" -- Diary of Hunan's nurses who have come to Wuhan's Jinyintan Hospital to help 163 The white coat is actually very heavy 165 Those thank-you letters sent 168

Chapter 6 Beyond Jinyintan Hospital 171

The top priority of community work: ensuring the lives of 9 million citizens under home quarantine 173 Community Party Branch Secretary: I wish I could become Sun Wukong 180 Sweeping investigation is carried out 184 The reflection of a "gatekeeper" of community 189 Wuhan locals' deep attachment to home and country 191 The most reliable police force 193 "It's my duty's call" 196 Do what my father has wished: fighting on the front line of the war against the pandemic 199 "As long as the pandemic is not over, the army will not retreat!" 202 "National crisis has happened; we must fully cooperate" 204 Fight until we win 206

Appendix: China publishes Timeline: China's International COVID-19 Cooperation 208

Part 2

金银潭——抗疫一线的火线

金银潭医院是这次新冠肺炎疫情阻击战最先打响之地。早在2019年12月29日，金银潭医院就开始收治第一批患者。面对未知的病毒，金银潭人以高度的责任感和使命感，冒着生命危险奋战在一线，全力抢救患者，并配合各地专家和科研机构，一步步揭开了新冠病毒神秘的面纱。 疫情期间，金银潭医院收治的全部为新型冠状病毒感染的肺炎确诊患者。武汉封城后，全国各地医疗队紧急驰援。最早收治确诊患者，且收治危重症患者最多的金银潭医院迅速成为了抗疫一线中的火线。

悄然拉开的序幕

2019年12月29日，农历腊月初四。 深夜的江城，寒气逼人。 坐落在武汉西北地带的金银潭医院，灯火通明。这一天，医院里突然收治了9例特殊的肺炎患者。 这9例患者中有6例与武汉华南海鲜批发市场有关，症状同是发烧、咳嗽、呼吸有点困难…… 两天前，也就是12月27日晚，金银潭医院副院长黄朝林接到了一个来自武汉同济医院的电话，对方请求将一名冠状病毒肺炎患者转至金银潭医院。第三方基因检测公司已在这名患者的病例样本中检测出冠状病毒RNA，但这个结论并未在检测报告中被正式提及。 金银潭医院院长张定宇正在与黄朝林讨论工作，凭借职业敏感，他立即拨通了北京地坛医院的电话，地坛医院的专家建议接收患者，并立即展开调查和研究。张定宇当晚就找到了这家第三方检测公司，通过沟通协调，由对方将相关基因检测数据发送给医院的合作单位——中科院武汉病毒研究所。 初步基因比对的结果显示，这是一种“蝙蝠来源的SARS样冠状病毒”。

2020年1月26日晚，金银潭医院病房灯火通明。（新华社记者 肖艺九 摄）（图）

12月29日，黄朝林通过电话向张定宇和武汉市卫生健康委做了汇报，调来了负压救护车，将湖北省中西医结合医院的9例患者全部转运至金银潭医院南七楼重症病区。这次转运一 直持续到深夜。作为一家传染病医院，医护人员有很强的职业警惕性，此次转运患者，所有工作人员都采取了严格防护措施。 收治这些患者后，刚刚应对完12月初武汉暴发的冬季甲流的金银潭医院，迅速启动预案，开辟了专门的病区。 谁也没有想到，一场震惊全国、震撼世界的“武汉保卫战”就此悄然拉开了序幕。

老传染病医院碰上了新病毒

拥有近百年历史的金银潭医院是湖北省与武汉市共建的一座公共卫生医疗救治基地。 然而，面对冠状病毒他们也并无良策。好在冠状病毒只是一种病毒，而病毒性肺炎多为自限性疾病。所谓自限性疾病，就是在发展到一定程度后能自动停止，并逐渐靠自身免疫痊愈的疾病。 金银潭医院的医生们抱着新冠肺炎也是一种自限性疾病的侥幸，在没有任何特效药的情况下，迎难而上，对患者进行对症治疗和支持治疗，医生们尝试了多种抗病毒药物，然而收效甚微。 病原不明，无药可用，还可能具有很强的传染性，金银潭这座老牌的传染病医院，陷入了束手无策的境地。 做肺部CT后，金银潭的医生发现，与以往不同，此次患者的感染，是先到肺底，从肺的末端感染，然后是肺泡里面的感染，感染的病毒足够多以后才会到上呼吸道，到咽部，是自下而上的顺序，而非常规的从上往下。 武汉同济医院赵建平教授提及，他看放射片子的时候，发现早期这些患者，只是在肺底上面有一颗一颗的几个病毒，成毛玻璃样的改变，到后来就一片一片地往上面再感染，而后逐渐成为“白肺”。 这种白肺现象不同于以往的一些渗出性改变，主要是一些间质性改变。没有合并细菌感染的时候，患者全部是干咳，没有痰，也咳不出痰。白肺改变主要是间质的一些纤维渗出导致的一个实变的过程。 12月30日上午，患者咽拭子检测结果出来了，但全部是阴性，与基因测序的结果并不一致。张定宇跟黄朝林说：“不行，我们得把所有的患者做肺泡灌洗，先进行支气管内镜检查，之后再做肺泡灌洗。” 当天，金银潭医院采集了9名患者中7名患者的肺泡灌洗液标本（因为检查是有创检查，9名患者里有2名拒绝签知情同意），并将每名患者的样本分为4份，2份分别提供给疾控部门、中科院武汉病毒研究所，2份冻存以备后续研究。这些样本为后来确定病原提供了重要基础。 金银潭医院送检的样本很快得到武汉病毒研究所的确认，诱发这种肺炎的确实是一种冠状病毒，但似乎发生了变异，是一种新型冠状病毒，而且其中4人确诊为这种新型冠状病毒感染的肺炎。 同一天，武汉市中心医院也拿到了一份不明原因肺炎病例的样本检测报告，第三方基因检测公司直接给出了SARS冠状病毒阳性的检测结果。该院医生李文亮将这一消息发到了微信群，由此开始引起了公众的注意。

感染人数上升

这种新型冠状病毒的传播速度比金银潭医院料想的要快很多。 自12月30日开始，从武汉市其他医院转诊的不明原因肺炎患者的人数开始增多，医护人员的压力日渐加大。

金银潭医院隔离病房，护士为患者换药。（新华社记者 肖艺九 摄）（图）

12月31日，救护车一辆接着一辆呼啸着驶入金银潭医院，送来有着相似症状的患者。这些患者来自武汉同济医院、武汉协和医院、武汉市中心医院、武汉市红十字会医院……金银潭医院启用了另外一层楼开始集中收治患者。 这一天，国家卫生健康委先后派出工作组、专家组赶赴武汉。在与湖北省、武汉市对接后，他们赶到金银潭医院和武汉华南海鲜批发市场实地走访。在金银潭医院ICU病区认真查看了患者的临床表现后，专家得出了结论——这是一种典型的病毒性肺炎。 当夜，武汉市卫生健康委的一间会议室几乎彻夜灯火通明，专家组向国家卫生健康委派驻武汉市工作组汇报临床观察意见。这次会议明确了一个最为紧要的任务：针对这种新发疾病尽快制订诊疗方案。

发布试行诊疗方案

2020年1月1日，国家专家组与武汉当地专家再次聚集，由国家第一批专家组成员、中日友好医院副院长、呼吸与危重症医学专家曹彬教授执笔，开始起草第一版诊疗方案。 同一天，武汉华南海鲜批发市场休市整治。 1月3日凌晨，《武汉不明原因的病毒性肺炎诊疗方案（试行）》最终定稿，由专家组交给武汉市发布。

2020年1月29日，市民经过已经被封闭的武汉华南海鲜批发市场。（新华社记者 熊琦 摄）（图）

这两天内，金银潭医院的患者不断增多，已由开始的9人增加到四五十人。金银潭医院开始紧急采购呼吸机、监护仪、 输液泵、体外的除颤设备还有心肺复苏设备等等。每个楼面大致按照25台呼吸机、25个输液泵这样来准备。张定宇心里有些打鼓：是不是开口开太大了？准备这么多，万一没用上呢？实际上到了十几号以后，所有的呼吸机都用上去了，连 ECMO （体外膜氧合设备）也上了。

逐步揭开新冠病毒神秘面纱

武汉病毒研究所收到金银潭医院12月30日送来的冠状病毒肺炎样本后，经过连续72小时攻关，于1月2日确定了新冠病毒的全基因组序列。 1月3日，国家卫健委组织中国疾控中心、中国医学科学院、中科院武汉病毒所、军事医学科学院4家科研单位对病例样本进行实验室平行检测。经过紧急科研攻关，专家评估判定新冠病毒为武汉不明原因病毒性肺炎病原体，疫情真凶开始露出真容。 同一天，金银潭医院取消了周末休息，组织了大量人力物力开展临床资料整理工作。因为面对一个新的病种，要全面搜集资料，给专家提供研究基础。通过资料整理工作，金银潭医院的医护人员也对这个新病毒有了充分认识。 1月5日，武汉市卫健委向社会通报，截至5日8时，全市共报告符合不明原因的病毒性肺炎诊断患者59例，其中重症患者7例。当日，武汉病毒研究所成功分离得到新冠病毒毒株。 1月8日，武汉市卫健委晚间通报，武汉8名不明原因病毒性肺炎患者当日治愈出院。 据通报，8名患者之前在武汉相关医院诊治，后集中收治在金银潭医院。经救治，已连续多日无发热、肺炎等临床表现。临床专家诊断后，认为符合出院标准，可以出院。 1月9日，武汉病毒研究所完成国家病毒资源库入库及标准化保藏。 1月10日，紧急研发的PCR核酸检测试剂运抵武汉，用于现有患者的检测确诊。两天后，这种疾病被正式命名为“新型冠状病毒感染的肺炎”。 这种病毒的传染性很强，除了前面说过的对症治疗和辅助治疗，患者必须隔离治疗。 因为具有传染性，患者没有义工，也不能有家属陪伴，一切医疗护理和生活护理，都要靠医院。金银潭医护人员的工作量一下子增加到平时的5倍。

金银潭医院，护士穿好防护服准备进病房。（新华社记者 肖艺九 摄）（图）

金银潭医院北楼5楼隔离病区潜在污染区，医护人员准备把患者的晚餐送进病房（新华社记者 肖艺九 摄）（图）

首例死亡病例出现

1月6日，武汉小雨，天气湿冷，第一个死亡病例出现。 “我们迫切地想要了解患者的病理生理特点和疾病规律，只有在科学的指导下，才能更有效地救治患者。”在ICU病房外，国家第一批专家组成员、中日友好医院副院长、呼吸与危重症医学专家曹彬教授和金银潭医院副院长黄朝林、金银潭医院ICU主任吴文娟，与死亡患者家属沟通了近一个小时，想说服家属同意对逝者尸体进行解剖用以研究，但患者家属最终没有同意。 1月11日，金银潭医院向世界卫生组织提交了新冠病毒的病毒序列。 武汉卫健委当日发布通报：初步诊断有新型冠状病毒感染的肺炎病例41例，其中已出院2例，重症7例，死亡1例，其余患者病情稳定。 从这天开始，随着患者不断增加，病区不断增加，金银潭医院的医护人员排班已经排不过来了，几乎全天无休，疲惫不堪。 至1月中旬，金银潭医院已经收治了100多名新冠肺炎患者，有14张床位的ICU病区已无法满足危重症患者的救治需求。 前来支援的专家告诉张定宇，后续可能会有更多的重症患者转过来，要做好增设临时ICU的准备。

新冠肺炎存在“人传人”现象

1月20日下午，国家卫健委召开高级别专家组记者会，组长钟南山等专家明确表示，新冠肺炎存在“人传人”现象。 同一天，武汉市公布了61家设置发热门诊的医疗机构名单，其中武汉市金银潭医院、武汉市肺科医院、武汉市汉口医院作为中心城区新冠肺炎定点医疗机构。

金银潭医院隔离病区走廊，护士在喷消毒液。（新华社记者 肖艺九 摄）（图）

3家定点医院共设置800张床位用于患者救治，其他市属医疗机构将腾出1200张床位收治患者。当日，武汉市公布的累计报告新冠肺炎确诊病例为258例。 金银潭医院之外，新冠肺炎作为一种新发传染病得到确认后的一段时间内，武汉市每天都有数千名患者涌入各医疗机构的发热门诊，让武汉市的不少医院几近崩溃。 在人们对新冠肺炎逐渐增加认识的过程中，这种极具传染性的病毒已经在武汉市悄无声息地快速传播，制造了大量病毒携带者。

Chapter 1 Jinyintan -- The front line of the war against the COVID-19 pandemic

Jinyintan Hospital was the first place to start the fight against the COVID-19. As early as December 29, 2019, Jinyintan Hospital began to treat the first batch of patients. In the face of unknown viruses, the medical staff of Jinyintan Hospital, with a high sense of responsibility and mission, braved the risk of life on the front line, spared no effort to rescue patients, and cooperated with experts and scientific research institutions around the world, step by step to unveil the mystery of COVID-19. During the pandemic, all the patients admitted to Jinyintan Hospital were diagnosed with COVID-19. After the lockdowm of Wuhan, medical teams all over the country rushed to the rescue. Jinyintan Hospital, which was the first to receive the confirmed patients and the most critically ill patients, quickly became the front line of the pandemic.

The prelude quietly kicked off

December 29th, 2019, the fourth day of the twelfth lunar month. The river city was cold and chilly at night. The Jinyintan Hospital, located in the northwestern area of Wuhan, was brightly lit. That day, the hospital suddenly admitted 9 special cases of pneumonia patients. 6 of the 9 cases have been linked to the Huanan Seafood Wholesale Market in Wuhan, with the same symptoms of fever, cough and breathing difficulties…… Two days ago, on the evening of December 27th, Huang Chaolin, vice president of Jinyintan Hospital, received a call from Tongji Hospital in Wuhan asking for a patient with coronavirus pneumonia to be transferred to Jinyintan Hospital. A third-party genetic testing company has detected coronavirus RNA in the patient's case sample, but this conclusion was not officially mentioned in the test report. Zhang Dingyu, president of Jinyintan Hospital, was discussing work with Huang Chaolin. With professional sensitivity, he immediately called Ditan Hospital in Beijing. The experts of Ditan Hospital suggested accepting the patients and conducting an immediate investigation and research. Zhang Dingyu found the third-party testing company that night. And through communication and coordination, the third-party company sent the relevant genetic test data to the hospital's partner, the Wuhan Institute of Virology of the Chinese Academy of Sciences. Preliminary genetic comparisons suggested that it was a "SARS-like coronavirus of bat origin".

On the evening of January 26, 2020, the lights in the ward of Jinyintan Hospital burned all night. (Photo by Xiao Yijiu/Xinhua News Agency)

On December 29, Huang Chaolin reported to Zhang Dingyu and the Wuhan Municipal Health Commission by phone, and a negative pressure ambulance was brought to transfer all 9 patients from Hubei Integrated Traditional Chinese and Western Medicine Hospital to the intensive care unit on the South Seventh Floor of Jinyintan Hospital. The transfer lasted until late at night. As an infectious disease hospital, the medical staff are very vigilant and strict protective measures were taken by all staff for this transfer. After admitting these patients, Jinyintan Hospital, which had just responded to the winter outbreak of influenza A in Wuhan in early December, quickly activated its contingency plan and opened up a special ward. No one had expected that "the battle against the COVID-19 and protecting the city of Wuhan" that shocked the whole country and the world would quietly be unfolding.

The old infectious disease hospital encountered a new virus

Jinyintan Hospital, which has a history of nearly 100 years, is a public health medical treatment base jointly built by Hubei Province and Wuhan City. However, they have no good plan for the COVID-19. Fortunately, coronavirus is only a virus, and viral pneumonia is mostly self-limiting disease. A self-limiting disease is one that stops automatically after a certain point and gradually heals by autoimmunity. The doctors at Jinyintan Hospital took the chance that COVID-19 was also a self-limiting disease and, in the absence of any specific drugs, faced up to the difficulties and treat patients with symptomatic and supportive ways. Doctors tried a variety of antiviral drugs, but with little effect. The pathogen is unknown, no drugs available and potentially highly contagious, Jinyintan, an old infectious disease hospital, was at its wits' end. After CT scans of the lungs, the doctors at Jinyintan Hospital found that, unlike in the past, the infection had reached the base of the lungs first, from the end of the lungs, then inside the alveoli, and only after enough virus had been infected did it reach the upper respiratory tract and the pharynx, in a bottom-up sequence, rather than the usual top-down one. Zhao Jianping, a professor at Tongji Hospital in Wuhan, said that when he looked at the radiography, he found that in the early days, these patients only had a few viruses, piling one by one on the bottom of the lungs, which changed like ground glass. Later, they were reinfected the lungs upward layer by layer until the lungs became "white lungs". Different from some exudative changes in the past, this white lung phenomenon is mainly some interstitial changes. When there is no co-bacterial infection, the patient is all dry cough but don't have phlegm, can't cough up phlegm either. The change of white lung is mainly a process of consolidation caused by exudation of some interstitial fibers. On the morning of December 30, the patient's throat swab results came out, but they were all negative, inconsistent with the results of genetic sequencing. Zhang Dingyu told Huang Chaolin, "No, we have to do alveolar lavage for all patients, Broncho endoscopy first, and then alveolar lavage." The hospital collected samples of alveolar lavage fluid from 7 out of the 9 patients (2 of the 9 refused to sign informed consent because the examination was invasive) and divided the samples from each patient into 4. 2 copies were given to the CDC and Wuhan Institute of Virology, Chinese Academy of Sciences respectively, and 2 copies were frozen for follow-up research. These samples laid an important foundation for later identification of the pathogen. The sample sent to Jinyintan Hospital for testing was swiftly confirmed by Wuhan Virus Institution. According to their research, this pneumonia is indeed triggered by a kind of coronavirus but it seems to have transmuted into a new type. Among them, 4 people have been infected with this new type coronavirus. On the same day, Wuhan Central Hospital issued a sample testing report on this unexplained pneumonia and the third-party gene detection company gave a direct testing result of positive SARS coronavirus. It was not until doctor Li Wenliang who worked in this hospital sent this message to WeChat that the public became alarmed.

The number of infected people increased

It proved that the spreading speed of the COVID-19 is far beyond the expectation of Jinyintan Hospital. Since December 13, the number of the patients diagnosed with unexplained pneumonia transferred from other hospitals in Wuhan started to rise, which made the pressure on the medical workers grow heavier day by day.

Nurses were changing medicines for patients in the isolation ward of Jinyintan Hospital. (Photo by Xiao Yijiu/Xinhua News Agency)

On December 13, one after another ambulance whined their way to Jinyintan Hospital. Patients with similar symptoms were sent here. They came from Wuhan Tongji Hospital, Wuhan Union Medical College Hospital, Wuhan Central Hospital and Wuhan Red Cross Hospital... Another floor of Jinyintan Hospital started to treat patients intensively. On this day, the National Health Commission dispatched a working group and an expert group to Wuhan. After connecting with Hubei Province and Wuhan, they rushed to Jinyintan Hospital and Wuhan Huanan Seafood Wholesale Market for field visits. After carefully examining the patient's clinical manifestations in the ICU ward of Jinyintan Hospital, experts concluded that this is typical viral pneumonia. A meeting room of the Wuhan Municipal Health Commission was brightly lit almost all night, and the expert team reported clinical observations to the National Health Commission's working group in Wuhan. In the meeting, one of the most urgent tasks was to formulate a diagnosis and treatment plan for this emerging disease as soon as possible.

A trial diagnosis and treatment plan was released

On January 1, 2020, the national expert group and local experts in Wuhan gathered again. One of the first batches of national expert group members, the vice president of the China-Japan Friendship Hospital, professor Cao Bin, an expert in respiratory and critical care medicine, drafted the first version of the diagnosis and treatment plan. On the same day, Wuhan Huanan Seafood Wholesale Market was closed for remediation. In the early hours of January 3, the "Wuhan Unexplained Viral Pneumonia Treatment Plan (Trial)" was finalized and handed over to Wuhan City by a panel of experts for release.

January 29, 2020, the public passed by the closed Wuhan Huanan Seafood Wholesale Market. (Photo by Xiong Qi/Xinhua News Agency)

In these two days, the number of patients in Jinyintan Hospital has been increasing, from 9 to 40-50 people. Jinyintan Hospital began emergency procurement of ventilators, monitors, infusion pumps, extracorporeal defibrillation equipment and CPR equipment. Each floor was prepared with roughly 25 ventilators and 25 infusion pumps. Some doubts rose in Zhang Dingyu's mind: Is the opening too big? We prepared so much, in case they are not used? In fact, after January 10, all the ventilators were used, even the ECMO (extracorporeal membrane oxygenation equipment) was also used.

The mystery of the COVID-19 has been gradually unravelled

After receiving the COVID-19 sample from Jinyintan Hospital on December 30, the Wuhan Institute of Virus Research determined the full genome sequence of the COVID-19 on January 2, after 72 hours of continuous research. On January 3, the National Health Commission organized 4 research units, including the Chinese Center for Disease Control, the Chinese Academy of Medical Sciences, the Wuhan Institute of Virology of the Chinese Academy of Sciences, and the Academy of Military Medical Sciences, to conduct parallel laboratory tests on case samples. After urgent scientific researches, experts assessed and concluded that the COVID-19 was the causative agent of Wuhan unexplained viral pneumonia, and the veil of the pandemic was to be lifted. On the same day, break was canceled in Jinyintan Hospital and its medical staff dedicated themselves to clinical data compilation of the virus supported by plentiful resources. They intended to collect as much information of the new virus as possible to prepare for further study by experts while getting a more comprehensive view of it. On January 5, according to the Wuhan Health Commission, until 8 a.m. on that day, there were totally 59 cases of patients who had been diagnosed with the viral pneumonia of unknown origin, including 7 severe cases. On the same day, Wuhan Virus Research Institute successfully extracted the new virus strain. On January 8, the Wuhan Health Commission reported in the evening 8 patients with the unexplained viral pneumonia were cured and discharged. It was reported that 8 patients had been diagnosed and treated in some Wuhan hospitals before they were transferred to Jinyintan Hospital. After treatment, they had no fever, pneumonia and other clinical manifestation for many days and were discharged after diagnosis and permission of experienced doctors. On Jan. 9th, Wuhan Institute of Virology, CAS completed the storage and standardized preservation of the virus. On Jan. 10th, newly developed PCR nucleic acid detection reagents were transported in urgent to Wuhan for diagnosis of existing patients. Two days later, the disease was officially named "pneumonia resulted from novel coronavirus infection". The virus is so contagious that patients must be quarantined while receiving proper therapies and adjunctive treatments. Due to its infectivity, patients lost the help of their volunteers and the company of their families. All treatments and nursing must be done by existing hospital staff. The workload of the medical staff in Jinyintan Hospital surged to 5 times that of the usual.

In Jinyintan Hospital, nurses had worn protective clothing and were ready to enter the ward. (Photo by Xiao Yijiu/Xinhua News Agency)

Medical stuff were going to take patient's dinner into the potentially contaminated area of the isolation ward on the fifth floor of the North Building of Jinyintan Hospital (Photo by Xiao Yijiu/Xinhua News Agency)

The first death case appeared

The first death occurred on January 6, when it was raining in Wuhan and the weather was wet and cold. "We feel compelled to understand the pathophysiological features and disease rules of patients. Only under the guidance of science can we treat patients more effectively.” Outside the ICU ward, Professor Cao Bin, who was the first batch of panel members, vice President of China-Japan friendship hospital and the experts in the respiratory and critical care medicine, vice President of the Jinyintan Hospital named Huang Chaolin and Director of ICU in Jinyintan Hospital named Wu Wenjuan, communicated with the families of patients with death for nearly an hour, in order to persuade families that they could agree to the deceased autopsy to study, but the patients' families did not agree. On January 11, Jinyintan Hospital submitted the virus sequence of the novel coronavirus to the World Health Organization. The Wuhan Municipal Health Commission issued a notice on the same day: a total of 41 novel coronavirus pneumonia cases were initially diagnosed, of which 2 have been discharged, 7 were severe and 1 died, and the rest were in stable condition. From this day on, with the consistently increasing patients and diseases areas, the medical stuff in Jinyintan Hospital couldn't arrange shifts and they were exhausted all day long. By the middle of January, the Hospital had accepted and treated more than 100 patients with COVID-19 and the ICU wards with 14 beds couldn't meet the treatment needs of critical patients. The specialists who came to support Wuhan told Zhang Dingy that Zhang should prepare more make-shift ICU wards as more severe patients may be sent to the hospital in the future.

There is a phenomenon of "human-to-human" transmission of COVID-19

In the afternoon of January 20, National Health Commission held a press conference with the high-level expert groups. Zhong Nanshan, as the leader of this group, together with other specialists, made it clear that there is a "human to human" phenomenon in COVID-19. On the same day, Wuhan City announced the list of 61 medical institutions which set up fever clinics, among them Wuhan Jinyintan Hospital, Wuhan Pulmonary Hospital, Wuhan Hangout Hospital were designated medical institutions for COVID-19 in the central urban area.

Nurses were spraying disinfectant in the corridor of isolation ward of Jinyintan Hospital. (Photo by Xiao Yijiu/Xinhua News Agency)

A total of 800 beds have been set up in the three designated hospitals for treating patients, and other city-owned medical institutions will free up 1,200 beds to treat patients. The total number of confirmed COVID-19 cases in Wuhan reached 258 in current date. Apart from the Jinyintan Hospital, thousands of patients flooded into fever clinics of medical institutions every day in Wuhan for some time after COVID-19 was confirmed as an emerging infectious disease, bringing many hospitals in Wuhan to the brink of collapse. Amid growing awareness of COVID-19, the highly contagious virus has spread quietly and quickly in Wuhan, creating a large number of virus carriers.

Part 3

孤岛求生，与“疫魔”展开“肉搏战”

在越来越多危重患者的围困中，金银潭宛若一座孤岛。 蔡艳萍是金银潭医院感染二科的副主任医师。1月20日，蔡艳萍所在病区清空，接收重症患者。刚开始，蔡艳萍并不感到体力上的辛苦，“12月份收流感也很忙的，基本上就不能休 息"，更大的折磨来自精神压力。1月上旬，她在与一位同济医院医生的通话中，得知同济医院的门诊已经涌满了发热患者， “如果门诊有那么多患者，住院的患者肯定不会少”。 然后她不断接到询问能不能来金银潭看病的电话，微信上无论朋友圈还是公众号，都充斥悲伤甚至惨烈的消息：无法出门，无法看病，无法住院...... 在发布的《新型冠状病毒感染的肺炎诊疗方案（试行）》中，要求“危重病例应尽早收入ICU治疗”，但后续的疫情救治并没有能按照科学的指导进行，受制于当时的客观条件，武汉大量的病患因延误治疗转为危重症。 患者人数从1月1日起暴发式增长。1月11日，同济医院最先抽调医院急诊与危重症科副主任钟强和另外四名医护人员，带着医疗设备支援金银潭。4日后，湖北省卫健委要求同济医院、湖北省人民医院、协和医院，分别接管金银潭的南七楼、南六楼、南五楼。

2020年1月26日，金银潭医院，脚步匆匆的医护人员。（新华社记者 肖艺九 摄）（图）

这三层楼随后全部改造成重症ICU病房，同时市级医院抽调人手前来支援。 1月19日，湖北省人民医院提出，希望湖北省内组建专门的ICU重症团队支援金银潭。5日后，国家卫健委开始抽调各地医疗力量接连进驻。 “有人来了，还来蛮多，我们真的就觉得好有依靠感了，觉得安全一些了。”蔡艳萍说。金银潭的医护人员已经做出了他们所能做的一切，但仍远不能抵御疫情蔓延。 钟强是最早在金银潭支援的专家，值班一周后，他得知与自己搭档的金银潭ICU主任吴文娟肺部CT显示感染。他回同济医院也拍了个CT，同样显示轻微感染。 金银潭首先被指定为新冠肺炎收治医院，但金银潭的ICU力量薄弱，只有5位医生，全院的各类氧疗仪器加起来不过二十台。 国家卫健委专家组专家杜斌、童朝晖和邱海波一同查房时发现，情况比想象的还要糟糕。 查房从早上八点开始，先用一个多小时查看了一遍所有患者的病历，再换防护服进病区。 ICU病房共有14个患者，如按惯例，一个医生查房根本管不过来。 14个患者的生命体征极其不稳定，可能上一小时看着还不错，下一小时就要抢救。升压药物怎么用，呼吸机怎么调整，液体的出量入量如何平衡，需不需要引流，需不需要抗凝，每天要拍胸片、抽血查生化、做几次血气分析、做几次口腔护理等等，这需要医生对患者有透彻的了解，每时每刻都密切观察。 就算在平时,救治两个ICU患者，就会让一个医生忙得回不了家。 现实是，当时病区里只有3名真正的ICU医生。面对14个患者，医生进去查房一圈，出来以后就有可能忘记其中几个患者的一些情况。 传染病房是不能带任何东西进去的，只能凭借大脑记忆。但即使记忆力卓越，医生也无力分身对每个患者都制定出足够完善的治疗方案。 查房结束的当天下午，3位专家坐在金银潭ICU里决定，要向国家卫健委申请，再派一些专家进驻金银潭。至少一个病房增加两个专家，一个人管六七个患者，手下再有三到四个医生做临床救治。 金银潭将南六楼改造成的ICU，同样也是人手不足。 南六楼二十多个病床，医护人员加起来约40人，而ICU的标准医护比为0.5—1个医生和3个护士对一个患者。 而对于有些危重症患者来说，死亡不过是一个瞬间，根本不给医生留下抢救的时间。有时候患者似乎突然被卡住了喉咙，再也喘不上最后一口气；有时医生查房结束，认为一切都好，脱下防护服时，身后一台心电监护仪上的曲线已经直了……

金银潭医院隔离病房，护士为患者换药。（新华社记者 肖艺九 摄）（图）

金银潭医院，走出隔离病房的护士满脸印痕。（新华社记者 肖艺九 摄）（图）

可以毫不夸张地说，在全国各地医护人员进驻支援之前，武汉市率先开展的前期战"疫"，是一场没有充分准备、没有经验可循、人力与装备严重不足的与“疫魔”的“贴身肉搏战”。

封城，救治力量和医疗物资均告急

1月23日凌晨2点，武汉发布通告宣布自10时起，武汉全面进入战时状态，全市城市公交、地铁、轮渡、长途客运暂停运营，无特殊原因，市民不要离开武汉；机场、火车站离汉通道暂时关闭，恢复日期另行通告。 这是新中国成立以来，第一次对一个千万人口级别的城市进出采取最严厉的措施——封城。 传染性疾病流行（传播）的三要素：传染源、传播途径、人群的易感性。在没有查清传染源、消灭传染源的情况下，采取封城举措，切断传播途径，无疑是阻断传染性疾病流行的最佳选择。 但封城后，感染人数仍在迅速扩大。 进入一月下旬后，武汉三镇几乎所有的定点医院均已超负荷运转。集中隔离跟不上，床位储备跟不上，大量确诊轻症患者、疑似患者被要求居家隔离。事后证明，这造成了更多社区居民感染。 随着核酸检测能力逐步到位，未能收治的新冠肺炎患者越来越多，现有床位已经远远不足以应对疫情防控的需要。

金银潭医院，刚从隔离病房出来的护工更换口罩。（新华社记者 肖艺九 摄）（图）

随着确诊病例的急剧增加，包括金银潭医院医护人员在内的所有武汉一线医护人员都承受着精神和身体的双重高度压力。 与压力同时到来的，还有各个医院防护服、口罩等医疗物资严重短缺与告急。

竭尽全力，应收尽收

1月27日，国务院副总理孙春兰率中央指导组驻扎武汉，深入研究疫情，作出科学研判，围绕提高收治率、治愈率，降低感染率、病亡率的目标，不断做出疫情防控和救治工作的重大部署和决策。 火神山医院开建，雷神山医院开建，近50家医疗机构先后被纳入定点医院，但仍然无法收治大量的确诊患者。

金银潭医院隔离病房护士站摆放的血液采集管。（新华社记者 肖艺九 摄）（图） 2020年1月26日，金银潭医院北楼5楼隔离病房走道，护士长潘丽红透过窗口观察患者。（新华社记者 肖艺九 摄）（图）

随后，征用体育场馆、会展中心，建设大型方舱医院，开设简易床位收治轻症患者。 当武汉市的开放床位逐渐达到数万张的时候，新冠肺炎患者“应收尽收”的目标才逐渐得以实现。 在国家、省、市医疗专家的指导下，金银潭医院积极对患者开展救治，做好医务人员的隔离防护工作。 截至2020年2月2日10时，金银潭医院在院患者581人, 其中重症157人，危重108人。 为了应对不断增加的患者，医院总共腾退21个病区，全部用来收治新冠病毒感染的肺炎患者，并积极开展救治，做好医务人员的防护工作。

2020年1月26日，金银潭医院北楼5楼隔离病区走廊，护士长潘丽红帮助同事穿戴防护服。（新华社记者 肖艺九 摄）（图）

作为武汉市收治危重患者的重点医院，金银潭医院的病房属于无陪病房，除了正常的治疗之外，所有的生活护理均由护理人员完成，如送餐、送水、收拾生活垃圾等。对于生活不能自理的危重患者，护理人员还要喂饭、穿衣、擦拭身体、照顾大小便等。 截至2月6日，武汉市金银潭医院累计收治患者1288人，治愈出院467人，住院治疗681人，其中重症238人，危重117人。 医护人员防护用品，保洁、护理人员等都存在一定缺口。 在医护人员兼做保洁工作的同时，全院保洁人员缺口仍在50人以上。防护服、口罩等防护服理想状态是使用1500套以上/天，能保证基本运转，实际每天只能按800套左右供应，靠着医护人员减少进去的频次和人数来支撑。 截至2月10日，金银潭医院已累计收治1589人，治愈出院605人，在院治疗816人，重症277人，危重129人。

不是一个人在战斗

从大年夜开始，来自全国各地的医务人员开始支援武汉。 自中国中医科学院首支医疗队率先支援金银潭医院后，陆军军医大学医疗队、上海医疗队等一支又一支医疗队相继驰援金银潭医院，使这里迅速成为举国关注的疫情风暴中心。

2020年1月26日，陆军军医大学医疗队成员与金银潭医院医护人员进行工作交接。（新华社记者 黎云 摄）（图）

全国医疗队伍的到来，明显缓解了金银潭医院的工作压力，缓解了金银潭医院医护人员紧绷的神经，让他们能够休整。 金银潭医院在职职工830人，拥有卫生专业技术人员685 人，其中博士研究生10人，硕士研究生50人，副高以上专业技术人员100多人。 到2月2日，全国上海医疗队136人、福建医疗队137人、国家中医药管理局中国中医研究院40人支援金银潭医院。武汉市内还有同济医院、协和医院、湖北省人民医院等医疗机构也分别派遣医疗团队进驻金银潭医院支援。 支援金银潭医院的还有湖北省内各大医疗机构调配的130多名有经验的护理人员和来自上海、安徽、广东、湖南、河北等地的护理人员近200人。 张定宇说，在降低死亡率方面两个因素起到了积极作用：一方面，驰援武汉的国家级专家团队与各地抽调的多支医疗队为病患救治提供了许多帮助与支持；另一方面，国家卫健委等发布的《新型冠状病毒感染的肺炎诊疗方案（试行第五版）》 为患者提供了更专业和规范的治疗方案。 金银潭医院设置有南五、南六、南七三个楼层ICU的病房。 南七病区ICU病房有16张床，南五病区、南六病区各有 24张床，这些ICU病区由同济医院、协和医院和湖北省人民医院三家医院危重症医学专家团队主导临床救治工作，国家专家 组的专家也参与指导临床医疗救治。 除了上述三个重症ICU以外，上海医疗队在北三楼病区也建立了一个ICU病房，四个ICU病房很好地缓解了金银潭医院对危重患者救治的压力。

2020年1月26日，陆军军医大学医疗队开始进驻武汉市金银潭医院。（新华社记者 程敏 摄）（图）

2020年1月31日，解放军感染病防控专家毛青（左）进入金银潭医院红区病房查房。（新华社发 高涛 摄）

在配置上，每个ICU病区配置有将近50名护士、12名医生，同时配备有呼吸机、监护设备、ECMO（体外膜氧合设备），还有床旁心电图、床旁超声、输液泵等各种设备，随时为危重患者提供各种生命支持服务。 张定宇说：“我们的条件虽然很艰苦，但大家的士气很高涨，我们与各地驰援武汉的医疗队员们并肩战斗，充满信心地共同抗击这场凶顽的新冠肺炎疫情，我们从来没有感受到孤单， 而是深深感受到祖国和人民对我们的关爱、鼓励和加油。”

Survival on an isolated island, "hand-to-hand combat" with the "pandemic"

Besieged by more and more critically ill patients, Jinyintan hospital was like an isolated island. Cai Yanping was the deputy chief physician of the second department of infection at Jinyintan hospital. On January 20th, the ward where Cai worked was emptied to receive severe patients. Cai did not feel tired physically at first, “In December it was also busy to receive flu patients, and I basically could not rest”, but the greater torture came from mental pressure. In early January, she learned that the outpatient department of Tongji hospital had been full of patients with fever in a phone call with a doctor in Tongji hospital,“If there are so many patients in the outpatient department, there must be a lot of inpatients”. Then she kept getting phone calls if they could go to Jinyintan hospital for medical treatment. Both moments and public accounts in WeChat were full of sad and even tragic news: unable to go out, unable to see a doctor, and unable to stay in hospital... In the published "Diagnosis and Treatment Plan of the COVID-19 (Trial)", it was required that "critical cases should be admitted to ICU as soon as possible", but the subsequent treatment of the pandemic was not carried out according to the scientific guidance. Subject to the objective conditions, at that time a large number of patients in Wuhan became seriously ill without prompt treatment. The number of patients grew exponentially from January 1. On January 11, Zhong Qiang, deputy director of the emergency and critical care department of Tongji Hospital, and four other medical staff were sent to assist the Jinyintan hospital with medical equipment. Four days later, the Hubei Provincial Health Commission asked Tongji Hospital, People's Hospital of Hubei province and Union Hospital to take over the South seventh floor, the South sixth floor and the South fifth floor.

Medical staff were seen in a hurry at Yintintan Hospital, on January 26, 2020. (Photo by Xiao Yijiu/Xinhua News Agency)

All three floors were then transformed into ICU wards, and the municipal hospital transferred staff to support them. On January 19, the People's Hospital of Hubei province proposed to set up a special ICU critical care team in Hubei Province to support Jinyintan. Five days later, the National Health Commission began to transfer medical forces from all over the country. "There are a lot of people coming. We really feel more dependent and safer. " Cai Yanping said. The medical staff in Jinyintan have done everything they can, but they are still far from resisting the spread of the pandemic. Zhong Qiang was the first expert to support Jinyintan. After a week on duty, he learned that Wu Wenjuan, the director of Jinyintan ICU who worked with him, had lung CT findings of infection. He also took a CT at Tongji Hospital, which also showed a slight infection. Jinyintan was first designated as the hospital for COVID-19, but the medical strength of the ICU in Jinyintan is weak, with only 5 doctors, and the total number of oxygen therapy instruments in the hospital is only 20. When the experts from the National Health Commission, Du Bin, Tong Zhaohui and Qiu Haibo, checked the room together, they found that the situation was even worse than expected. The check-in started at 8:00 a.m. and took more than an hour to review all the patients' medical records before changing into protective clothing and entering the ward. There were 14 patients in the ICU ward, and it is not possible for one doctor to check on them as usual. The vital signs of the 14 patients were extremely unstable and could look good one hour and have to be rescued the next. How to use pressure-raising drugs, how to adjust the ventilator, how to balance the amount of fluid out and in, the need for drainage, the need for anticoagulation, the need for daily chest X-ray, poor blood biochemistry, several blood gas analysis, several oral care, etc., which requires doctors to have a thorough understanding of the patient, every moment to closely observe. Even in normal times, treating two ICU patients can keep a doctor too busy to return home. The reality was that there were only three real ICU doctors in the ward at the time. Faced with 14 patients, the doctor went in for a round and comes out with the possibility of forgetting something about a few of them. You can't take anything into the infection ward. You can only rely on your brain. But even with a brilliant memory, doctors have a lot on their plate and cannot come up with an adequate treatment plan for each patient. In the afternoon of finishing the ward round, 3 specialists sat in the ICU of Jinyintan decided that they should apply for the National Health commission to assign more experts to enter and garrison in Jinyintan. At least one inpatient ward should increase two experts, a person in charge of six or seven patients, remaining three to four doctors to do clinical treatment. The ICU that Jinyintan remolded on the south sixth floor was also understaffed. There are more than 20 hospital beds on the sixth floor of the south, and the total number of medical staff is about 40, while the standard care ratio of ICU is 0.5-1 doctor and 3 nurses match one patient. However, for some critically ill patients, death is no more than a moment, leaving no time for doctors to rescue them. Sometimes patients seem like they abruptly get caught in the throat, and could not get out of breath. Sometimes when a doctor finishes the rounds of the wards, thinks everything is ok and takes off the protective suit, the curve on an electrocardiogram monitor behind him has straighted...

Nurses were changing medicines for a patient in the isolation ward of Jinyintan Hospital. (Photo by Xiao Yijiu/Xinhua News Agency)

Nurses were coming out from the isolation ward at Jinyintan Hospital with red marks on their faces. (Photo by Xiao Yijiu/Xinhua News Agency)

Before the medical personnel all over China supported the city, it is no exaggeration to say that Wuhan took the lead in the fight against the "pandemic", a "close physical combat" against the "pandemic devil" without much preparation and experience and in desperate shortage of medical staff.

The city was in lock-down, the rescue force and medical supplies were urgent

At 2:00 a.m. on January 23, Wuhan announced that from 10:00 a.m. onwards, Wuhan entered a full state of war. Buses, subways, ferries and long-distance passenger transport has been suspended. Citizens were not allowed to leave Wuhan without special reasons. Airplanes and trains from Wuhan station were canceled temporarily until further notice. Since the establishment of the Republic of China, It is the first time that China ordered a lockdown across a city with 10 million people, which was considered as the most rigorous measure to avoid movement. The three elements of the transmission of infectious diseases are sources of infection, channels of transmission, and susceptibility among people. Before finding out the infectious source and eliminating it, undoubtedly, the best option to block the spreading of infectious diseases is to lock down a city and cut the transmission. However, after the lockdown, the number of infected people is still mounting rapidly. By the late January, almost all the designated hospitals in the Sanzhen of Wuhan province have been overloaded. Without the conditions for centralized isolation and with the lack of beds in hospitals, a large number of confirmed patients with mild symptoms and suspected patients are required to stay at home. It turns out that this leads to more community residents infected. As the nucleic acid test methods are developed, more and more confirmed patients have not been hospitalized. The existing beds were far from enough to meet the needs of pandemic prevention and control.

In Jinyintan Hospital, nurses who just came out of the isolation ward are changing their masks. (Photo by Xiao Yijiu/Xinhua News Agency)

There is a sharp increase in confirmed cases, all front-line medical staff in Wuhan including medical staffs working in Jinyintan Hospital are under high mental and physical pressure. Meanwhile, there is a serious shortage of medical materials in many hospitals, such as protective clothing and masks. We should strive to collect all the available materials.

Do our best to ensure all patients in necessary conditions were admitted

On January 27, the Central Guiding Team led by Vice Premier of the State Council Sun Chunlan arrived in Wuhan to investigate the pandemic and make scientific judgments. With the goal to increase treatment and cure rate while decreasing infection and death rate, this team also needed to make major arrangements and decisions on pandemic prevention and control, and treating and curing patients. With nearly 50 medical institutions been incorporated in designated hospitals and the Huoshenshan Hospital and Leishenshan Hospital being constructed, yet it is still inadequate to treat a flood of confirmed patients.

Blood collection tube placed in nurse station of isolation ward of Jinyintan Hospital. (Photo by Xiao Yijiu/Xinhua News Agency)

On January 26, 2020, Pan Lihong, the head nurse, observed the patients through the window in the aisle of the isolation ward on the 5th floor of the North Building of Jinyintan Hospital. (Photo by Xiao Yijiu/Xinhua News Agency)

Afterwards, with stadiums and exhibition centers requisitioned and large makeshift hospitals built, simple beds were set up to treat patients with mild symptoms. As the number of open beds gradually increased to more ten thousand in Wuhan City, the goal of "taking in patients with Covid-19 as much as possible" could be realized. Under the guidance of medical experts at national, provincial and municipal levels, Jinyintan Hospital actively reponded to cure patients while making sure the quarantine protection of medical staff. As of 10 o'clock of 2nd Feburary 2020, there were 581 hospitalized patients, among which 157 and 108 were serious and critical respectively. In order to cope with the growing number of patients, the hospital vacated a total of 21 wards, all of which were used to treat pneumonia patients infected with COVID-19, and actively carried out treatment and protection work for medical personnel.

On January 26,2020, Pan Lihong, the head nurse, helped colleagues wear protective clothing in the corridor of the isolated ward on the 5th floor of the north building of Jinyintan Hospital. (Photo by Xiao Yijiu/Xinhua News Agency)

As a key hospital for critically ill patients in Wuhan City, the ward of Jinyintan Hospital is the unaccompanied ward. Apart from normal treatment, all daily care is done by nursing staff, such as delivering meals and water, cleaning up garbage and so on. For the critically ill patients who cannot take care of themselves, the nursing staff also nedd to feed them, dress them, wipe their bodies and take care of their urine and feces. Until February 6, Wuhan Jinyintan Hospital has admitted 1288 patients, discharged 467 patients, and hospitalized 681 patients, including 238 in severe condition and 117 in critical condition. There is a shortage of protective equipments for meical staff, and a shortage of cleaning and nursing staff. While medical and nursing staffs are also doing cleaning work, the shortage of cleaning staffs in the whole hospital is still more than 50 people. Ideally, more than 1,500 sets of protective clothing such as gowns and masks are used per day to ensure basic operation, but in reality, only about 800 sets can be supplied per day, relying on the reduced frequency and number of medical and nursing staff to support. Until February 10, a total of 1,589 people had been treated in Jinyintan Hospital, 605 of whom had been cured and discharged, 816 of whom were under hospital treatment, 277 severe cases and 129 critical cases.

Not fighting alone

Ever since the new year's nighht, medical staff all over the country had came to support Wuhan. Since the first medical team from the China Academy of Chinese Medical Sciences took the lead in supporting the hospital, medical teams from the Army Military Medical University and the Shanghai Medical Team had rushed to help the hospital one after another, quickly making it the center of the epidemic and attracted nationwide concern.

On January 26,2020, members of the medical team of the Sixth Military Medical University handed over their work with the medical staff of Jinyintan Hospital. (Photo by Li Yun/Xinhua News Agency)

The National Medical Team has obviously relieved the work pressure of Jinyintan Hospital and the tense nerves of the medical staff of Jinyintan Hospital, so that they can rest and recuperate. Jinyintan Hospital has 830 working staff, with 685 health professionals and technicians, including 10 doctoral students, 50 master's students and more than 100 professional technicians above associate level. By February 2, 136 people from Shanghai medical team, 137 people from Fujian medical team and 40 people from the Chinese Academy of Traditional Chinese Medicine of the State Administration of Traditional Chinese Medicine supported Jinyintan Hospital. In Wuhan, medical institutions such as Tongji Hospital, Union Hospital and Hubei Provincial People's Hospital also sent medical teams to Jinyintan Hospital to support them. More than 130 experienced nursing staff from major medical institutions in Hubei Province and nearly 200 nursing staff from Shanghai, Anhui, Guangdong, Hunan, Hebei and other places were also deployed to support Jinyintan Hospital. Zhang Dingyu said two factors played a positive role in reducing mortality: On the one hand, the national experts rescuing Wuhan and many medical teams transferred from various places have provided help and support for the treatment of patients; On the other hand, the National Health Commission issued the "Diagnosis and Treatment Protocol for the COVID-19(Trial Version 5)" to provide patients with more professional and standardized treatment options. Jinyintan Hospital has three floors of ICU wards in South Fifth, South Sixth and South Seventh. There are 16 beds in ICU ward of South Seventh Ward, 24 beds in South Fifth Ward and 24 beds in South Sixth Ward respectively. The critical medical expert team of Tongji Hospital, Union Medical College Hospital and Hubei Provincial People's Medical Hospital leads the clinical treatment work in these ICU wards, and experts from the national expert group also participate in guiding clinical medical treatment. In addition to the above three intensive care units, the Shanghai medical team has also established an ICU ward in the ward on the third floor of the north. The four ICU wards have well relieved the pressure of Jinyintan Hospital on the treatment of critically ill patients.

On January 26, 2020, a medical team from the PLA Military Medical University was stationed at the Yintan Hospital in Wuhan.(Photo by Cheng Min/ Xinhua News Agency)

On January 31, 2020, Mao Qing (left), an infectious disease prevention and control expert of the PLA, entered the red ward of Jinyintan Hospital for rounds. (Photo by Gao Tao/ Xinhua News Agency)

In terms of configuration, each ICU ward is equipped with nearly 50 nurses, 12 doctors, ventilator, monitoring equipment, ECMO (extracorporeal membrane oxygenation equipment), bedside ECG, bedside ultrasound, infusion pump and other equipment to provide various life support services for critical patients at any time. Zhang Dingyu said: "Although our conditions are very difficult, everyone's morale is high. We fought side by side with medical team members from all over Wuhan to fight with confidence against the ferocious COVID-19. We never felt lonely, but felt deeply loved, encouraged and cheered on by our motherland and people."