IF the medical workers are the frontline "soldiers," then the epidemic investigation and disposal personnel are the "scouts" on the frontier. They are responsible for the epidemiological investigation of infected patients, standing at the very forefront of the battle for prevention and control of the novel coronavirus.
"Maybe there is a risk of infection afflicting us, maybe no one will remember what we have done in the future, but it is our duty to prevent the spread of the epidemic and protect the public’s health," said Guan Xuhua, director of the Institute of Prevention and Control of Infectious Diseases under Hubei Provincial Center for Disease Control and Prevention. As the epidemic came so unexpectedly and the task so pressing, Guan revealed that their on-site epidemiology investigators even didn’t get a chance to have a picture while doing their job at the isolation area in the beginning.
Novel coronavirus.
To Better Know the Virus
At 7:00 p.m. on December 29, 2019, Wuhan Jinyintan Hospital issued an emergency notice: a number of patients with pneumonia of unknown causes received by the hospital were related to the Huanan Seafood Wholesale Market, and requested the Center for Disease Control and Prevention to send personnel to carry out epidemiological investigation.
Receiving the task, Chen Qi, an epidemiology investigator who had worked for eight years in the field, felt a "conditioned reflex." She knew that it was a race against the virus, and they had to uncover its true face before the virus became rampant. Only by understanding the information of each patient in detail and finding out the similarities and differences, can the basis be provided for decision-making for the planning of the next phase of prevention and control measures and the formulation of the diagnosis and treatment plan.
Epidemiological investigation needs clues to be sifted from the massive amount of information provided by patients with elimination of the confounding factors. Chen Qi said she was more like Sherlock Holmes. The enemy was an "invisible devil" that could not be spotted by the naked eye or felt by touch. Therefore, no details could be ignored.
Doctors review test results.
Risks abound naturally in this line of work. As she entered the isolation zone step by step, her heart tightened as she did not know how obstinate the unknown virus was, and whether her own protection was adequate enough to deal with the invisible "enemy."
In fact, this occupation also encounters puzzlement from many people. Can't it be done by phone? Why to venture into the quarantine area again and again? Liu Gongping, Chen Qi's colleague, who has been working in the epidemiology investigation field for 41 years, said that when encountering an epidemic, we cannot afford to miss a single detail. Only a deeper understanding of the situation and a painstaking investigation can expose the true nature of the virus.
Liu is the deputy director of the Institute of Prevention and Control of Infectious Diseases under Hubei Provincial Center for Disease Control and Prevention. For over a month, he, like other epidemiology investigators, has been on the front line of the investigation.
"Although we take more risks, we can reduce the risk of proliferation; if we know more about it, we can save more lives from the virus," Liu said.
For Accuracy, to "Interrogate" Every Detail
Asking different patients the same questions over and over again, and cross-checking every detail over and over again; boredom and dullness are an inevitability of this profession, but they dare not to relax at all, because the closer they get to the details, the closer they will get to the truth.
Every day, Guan Xuhua, leads the team to several hospitals. After putting on two layers of gloves and masks, protective clothing, face shield, and shoe covers, the eyes behind the protective goggles are the only "name cards" for them to identify each other.
After putting on the protective outfit like this, Guan Xuhua enters the semi-polluted area alone, goes through the sealed gate, and then enters the isolation area.
"Happy Spring Festival! I am a staff member of Hubei Provincial Center for Disease Control and Prevention. Are you feeling better now? You have been diagnosed with the novel coronavirus pneumonia and now we need to learn more about your situation. Thank you for your cooperation," She repeats such opening remarks countless times a day.
Details from the patient's daily itinerary, the places they’ve been to, the people they got in contact with physically, to the clinical details, and the past medical history are all the key points she captures and records on the questionnaire one by one. "While longer stay means increasing risk, we must ensure that the information is accurate and complete," she said.
Medical workers observe the pathological findings.
In order to avoid risks, Guan Xuhua cannot take paper, pens, and other items out of the isolation area. Then her colleague Liu Man took pictures of all the questionnaire pages with his mobile phone from across the glass. Then they took off their protective gear but had no time to rest. They went on to the next site and the next battlefield...
Do they feel fear going deep into the isolation area to face the confirmed patients? The investigators all admitted that they are also someone’s children, parents, husbands or wives, and ordinary persons, "and of course, we also feel afraid, but when the task comes, we will go for it without hesitation."
Helping Patients Defeat "Psychological Virus"
Talking to the patient is not an easy task. Facing unfamiliar investigators, resistance and repulsion are the instinctive reactions of many patients.
"Some patients have a hazy memory or even deliberately conceal details, which makes the work more difficult. In addition to patience, we also need to be gentle in use of language and empathy must be visible from our eyes," said Wu Yang, head of the acute infectious disease prevention and control department of the institute. In reality, the isolated patients are panic stricken and helpless. According to him, what they need to defeat is not only the novel coronavirus, but also the "psychological virus".
An expert from Hubei Provincial Center for Disease Control and Prevention teaches people virus prevention knowledge.
A female patient in the isolation ward told Wu Yang about her experience. Their whole families got infected and quarantined for taking care of her sick father. The difficulty of confronting the uncertain future filled her with fear. With tears in her eyes, she said, "I'm hospitalized now. I just hope to get better soon and go home early!"
"At that moment, her words touched me, and I felt that my duty was not only to investigate, but also to provide psychological counseling," Wu said. According to him, many investigators began to equip themselves with psychological counseling knowledge by reading professional books, hoping to help patients get rid of psychological shadow.
For about 20 days, over hundreds of case studies had been completed. To get a better understanding of the epidemic and provide strong empirical evidence and supporting data, the investigation team is still on the go.
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HU MAN and ZENG LI are reporters with Hubei Daily.
