San Hai City was a small city and San Hai City's Jiang Xin town was even smaller. Even though it was located by the sea, there was no tourism industry.
The town hospital in this small place had treated more than 20 similar cases from morning to night on August 2nd: fever, fatigue, coughing.
The mild cases were suspected to be the common cold while the more severe cases were suspected to be pneumonia.
When Huang Lin, who was on the night shift, saw an 18-year-old patient named Shen Haoxuan, she heard the patient say he was infected by a middle-aged uncle's cough on the bus. That was when she sensed something was wrong.
This was more like a contagious disease outbreak.
Therefore, Huang Lin became vigilant. She searched through the medical record system for all the similar cases that the hospital had received for the whole day.
The middle-aged uncle that Shen Haoxuan mentioned was indeed a 43-year-old patient who was admitted to the hospital at 8 am that morning, Wang Guoxin.
The more Huang Lin read through Wang Guoxin's medical records, the more anxious she became.
The doctor on duty, Zhang Bo, diagnosed Wang Guoxin as right lower lung pneumonia.
Wang Guoxin's condition was serious. His body temperature ranged from 39.5 to 41 degrees Celsius. He coughed up dark brown sticky phlegm, occasional hemoptysis and what appeared to be rotting flesh. This was accompanied by fatigue and soreness all over his body. There was an audible moist rale at the back of his right lung. The chest X-ray showed a 6cm x 8cm heterogeneous shadow. The inflammation was severe but there was nothing specific about it.
He said he had been coughing for days. This morning, he started coughing up phlegm and hemoptysis. That was why he came to the hospital.
At the time, Doctor Zhang checked the patient's liver and kidney function. The blood test showed an obvious increase in white blood cells. Based on the results of the chest X-ray, Doctor Zhang suspected that it was a bacterial infection of the lungs. After the patient's sputum and blood were sent for bacterial culture, he was given cefuroxime sodium intravenously to fight the infection, ethamphenolsulfonamide to stop the bleeding, glucose and saline as support and acetaminophen to reduce the fever.
The patient's temperature report made Huang Lin's heart skip a beat. Even though the patient was given antipyretics, his temperature did not drop, it remained above 39 degrees.
"I hope it's just me being too sensitive." Huang Lin called the inpatient department to check on Wang Guoxin's condition. Her heart sank to the bottom of an ice cellar.
The nurse on duty reported that the patient's coughing, hemoptysis and other symptoms had worsened and he was even more listless …
Huang Lin had a feeling this was not a normal case of pneumonia.
Dr. Zhang might have misdiagnosed …
Huang Lin's university internship experience told her that it was normal for a Class Three Grade A hospital to receive 40 to 50 patients with pneumonia a day; however, for Jiang Xin Hospital, 20 patients a day was too much. She had worked here for a few years after she graduated, so she was familiar with this fact.
Wang Guoxin was the first patient admitted with pneumonia that day. The second patient appeared at around 3 pm, and the second one broke out after 7 pm.
She had already treated eighteen patients with pneumonia! Coupled with what Shen Haoxuan said …
"This may be a contagious atypical pneumonia."
Huang Lin reported her discovery to the other doctor on duty in the emergency room, Zhao Yutao, who was in charge of the surgery department. She considered reporting this to the higher-ups.
The town hospital was small, and there were only two doctors in the emergency room.
"Epidemic?!" The middle-aged Zhao Yutao frowned when he heard that. "The weather has been sultry these days. It's normal to have a few more pneumonia patients than usual."
Once an epidemic was reported, regardless of whether it was true or not, there would be a lot of problems. Especially since it was so late at night, Zhao Yutao was reluctant to do so.
Zhao Yutao had never liked this Huang Lin. She graduated from Eastern State University's medical school, she was young and hot-blooded. She loved to cause trouble. "Then why don't we transfer the first patient to the city hospital for treatment, our resources are limited." He tried to persuade her.
"Brother Zhao, this is really unusual." Huang Lin insisted, "We need to invite the people from the disease control center."
She immediately called the hospital infection control office and the medical department. She wanted to report this as contagious atypical pneumonia and it was not just one case, it was already an outbreak.
"The incubation period of the first patient should be more than 5 days. There were symptoms but after the fever appeared this morning, the disease progressed very quickly. The other patient who was suspected to be infected by the first patient had the same symptoms. He started to vomit blood after 6 to 7 hours! "
Huang Lin said seriously. She emphasized the severity of the situation and requested for them to report it immediately.
There was a time limit for reporting infectious diseases, 2 hours for category A infectious diseases and 24 hours for category B and C infectious diseases.
When there was an outbreak for category B infectious diseases, the report would be made according to the time limit for category A.
But that could be within 2 hours. Huang Lin was worried that the medical department would drag it out and only report it after an hour.
Right now, every minute was extremely precious. The earlier measures taken to control the epidemic, the more lives that could be saved.
The medical department responded quickly. When they called the disease control center, it was 20: 32 on the night of 2nd August.
Huang Lin returned to her post after giving the report. She had already admitted the 21st pneumonia patient, then the 22nd, the 23rd …
When the number of cases quickly exceeded thirty, Zhao Yutao panicked. The Department of Infection Control also panicked. All the nurses understood that something was wrong.
At the same time, the disease control center came up with a plan to deal with this public health emergency. They requested Jiang Xin Hospital to isolate the patients and protect the medical staff. On the other hand, they sent their head specialist, He Feng, to lead a team to conduct an epidemiological investigation.
"Oh, okay, okay." When He Feng received the call from the centre, he was having dinner with his family. "I'll depart now."
His wife was also part of the disease control center, she understood that but his 7 year old daughter, Niu Niu, was not too happy about it. "Daddy, you can leave after dinner."
"Daddy needs to go, listen to mommy." He Feng patted his daughter's head and left the house.
Being a disease control center was a race against time. He had to go wherever there was a suspected epidemic, that had become his daily routine.
Under the dark sky, He Feng got into the disease control vehicle that came to pick him up. His assistant, Lee Wen, handed him a stack of documents. It was the Infectious Disease Report Card filled out by Doctor Huang Lin, the patient's medical records and personal reports. He Feng read through them page by page and his heart sank …
The town hospital could not complete most of the antibodies, they did not even have CT equipment. Furthermore, half a day was too short, it was hard to tell what kind of pneumonia Wang Guoxin had.
However, He Feng agreed with Doctor Huang Lin's diagnosis, this did not look like a normal pneumonia.
Right then, his assistant, Lee Wen, received a call and said coldly, "Leader He, Jiang Xin Hospital has more than 30 cases."
"Isolate the whole hospital immediately." He Feng's wrinkles creased as he ordered decisively, "The patient's vomit cannot leave Jiang Xin Hospital. Have the centre send the equipment in and everyone be in level 3 protective gear. This time, we might have to apply for a lockdown … of Jiang Xin Hospital. "
He paused but in the end, he did not say 'lockdown of San Hai City'.
'Hopefully, it's just a false alarm, hopefully, it can only be transmitted through close contact with the patient and inhalation of their coughed up saliva.
'Hopefully … the epidemic area is not too big …'
The uneven road caused the car to jolt. He Feng glanced out the window and the faces of his wife and daughter flashed across his mind.
'Niu Niu, daddy might not be home for a few days.'
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