Covid 19 coronavirus: Wuhan doctor tells what it was really like

Medical staff transfer patients to a hospital in Wuhan in January, 2020. Photo / Getty

In a book that forced him to flee his homeland, Murong Xuecun went to a locked-down Wuhan to tell the real story of the Covid-19 pandemic. That included interviewing a doctor made to work 24-hour shifts while infected. The Herald has the exclusive New Zealand extract.

Hiding deep in the mountains, Murong Xuecun emailed his draft to a friend and said, "No matter what happens to me, this book must be published".

Despite having been silenced before and terrified of China's "secret police", the author had earlier left his home in Beijing and spent weeks in Wuhan as the Covid-19 pandemic raged around him. He was determined to look beyond the heroic images of sacrifice and victory propagated by the regime to expose the suffering of those living through the world's first lockdown.

And now, after he was able to flee China safely, his book Deadly Quiet City has been published.

Murong covertly interviewed people on the ground including an exhausted doctor in a small hospital battling the virus while sick, an extract of which is below.

After each interview, he sent the material to his editor, Australian public ethics professor and author Clive Hamilton, for safekeeping.

He would receive phone calls from mysterious numbers, which he suspected were intelligence agents'. One call, in which a man asked him what he was doing in Wuhan, was the final straw and he decided to leave.

But he was too scared to return to Beijing, "with all the surveillance", so he flew to Sichuan in southwest China to write the book in a small town deep in the mountains.

Murang completed the draft in March last year and handed it to Hamilton. Then he fled to London with all his belongings in one suitcase.

Chinese author Murong Xuecun. Photo / Supplied

"I left behind everything I had built and accumulated in my 47 years. When I recall all those times of trembling over the previous year, I still feel the heart-sinking, bitter taste of terror."

The book was launched this week during Adelaide Writers Week.

"Murong's courage is extraordinary, beyond what we in free societies can imagine," says Hamilton, a professor at Charles Sturt University in Canberra.

"There was a high chance he would be arrested and disappear forever. We knew that could happen on any day, just as several other citizen journalists disappeared into black prisons."

'The dry coughing begins'

Lin Qingchuan holds down a patient's tongue with a spatula and stoops over to examine his tonsils. The patient coughs reflexively. Lin feels a rush of air on his face and subconsciously pulls back.

Ten minutes later, Lin begins to feel something in his throat. "Phlegm was constantly bubbling up like spring water," he says later. Then the dry coughing begins. After two hours he feels weak all over, and his throat begins to ache a little, "like a bad cold". He tells another doctor, "Bad news, I hit the jackpot".

At that time the term "novel coronavirus" was not widely used. A friend who is a doctor at the Wuhan No. 1 Hospital tells him, "Don't delay. Come here right now and I'll help you get a bed."

Lin Qingchuan declines his friend's offer. He doesn't have a fever and the symptoms are not serious, so he decides to just observe for a day. After 24 hours, his chest begins to hurt but he is not concerned.

The next day the pain becomes acute. He has an X-ray at the radiology department of the hospital where he works, which shows the lower part of his right lung infected with the virus. He immediately contacts his friend at the Wuhan No. 1 Hospital. "I'm really sorry," comes the reply. "Now even our own doctors can't get a bed."

Two days later the city would be locked down, entering a 76-day period of tribulation and pain. But the Government's concealment of information and deception means the 11 million people of Wuhan still know next to nothing about the virus.

Lin is a doctor at a small community hospital in Wuhan. Usually, he says, the hospital treats two or three cases of cold or fever each day, but in the middle of November 2019 the numbers began to rise sharply. "In an eight-hour shift a doctor would treat 25 to 30 patients, of which more than half would have fevers. And many were children."

In their social media groups, doctors begin cautiously to talk with friends, classmates and colleagues about the explosive increase in fever cases and discuss the symptoms and causes. On 8 December, someone informs Lin that the labs in the Wuhan Union Hospital or Tongji Hospital have identified an atypical pneumonia virus.

From that day on, Lin Qingchuan begins to wear a face mask. Around Christmas he also dons gloves and protective goggles.

Lin tells his friends that a huge epidemic is about to break out, but few believe him. He begins to stock up on foodstuff and vegetables. Masks are still cheap – just thirteen fen, or three cents, each – and Lin buys three hundred for his elderly parents. He thinks that will be enough. "We all thought it was an atypical pneumonia virus. No one imagined it would become such a terrible mess."

Taking a risk

On 31 December, the Wuhan Municipal Health Commission issues a "situation notice" claiming that 27 cases of "viral pneumonia" have been discovered but there is no "obvious human-to-human transmission". It also announces that "the disease is preventable and controllable".

On the same day, the same organisation issues a very different internal "emergency notification" in which the "viral pneumonia" becomes "pneumonia of unknown cause". The commission requires hospitals to begin collecting infection data.

Lin knows writing such things is a big risk. He's seen the news about eight doctors being dealt with by the police for "spreading rumours" but feels he has an obligation to speak the truth.

In early January, almost every doctor is hearing news of deaths, either by word of mouth or by witnessing them. But in media reports and government announcements there is no mention of death, just daily exhortations to citizens not to panic. It isn't until 11 January that the government reluctantly announces the first death.

On 23 January, the day Wuhan is locked down, Lin has a day at home and begins self-treatment. "A one-gram dose of amoxicillin will cure me in three to five days," he tells his friends. He's optimistic. "If I don't die in nine days, I won't die."

On the evening of 25 January, Lin Qingchuan receives a notice from the hospital: all personnel must return to work. "I'm still infectious," he tries to reason with the hospital director. The hospital director says he has no choice because the "order came from upstairs. Without an official diagnosis you have to return to your post."

His friends tell him not to go back to work, but Lin is thinking of his colleagues. "If I don't go, their workload will go up. I'm a doctor, but I'm also a source of infection. What a disgrace."

Medical staff at the entrance to the clinic for fever or Wuhan-related patients in a hospital in Fuyang in central China. Photo / Getty

In his small community hospital, there is only one box of fever medication, almost no anti-inflammatories, no protective goggles or gowns, only 40 masks, and even a shortage of thermometers.

Lin's condition worsens. On 28 January, while on overnight duty in the outpatient department, his chest suddenly begins to hurt. "The kind of pain we call 'end-of-life pain'." It makes him very nervous. He consults his colleagues; one doctor tells him levofloxacin might be effective because she has used it to relieve symptoms.

He prescribes himself five packets of levofloxacin. The broad-spectrum antibiotics are administered by IV drip the next day and he returns to his overnight duties.

On the evening of 28 January, a woman calls Lin to say that her 75-year-old father is losing consciousness. She implores Lin for help, but he is the only doctor on duty so cannot leave his post. A few hours later she calls again to say her father has lost consciousness, his breathing is shallow and his pulse is weak. "Doctor, I beg you. I just need someone to help me get my father into my car so I can take him to hospital. I can't carry him to the car by myself."

The next morning, an exhausted Lin leaves his hospital's outpatient department and resumes his self-administered IV drip. He receives another phone call from the woman. Her voice is despairing yet calm. "My father died. What now?"

Even months later Lin is reluctant to recall that scene. "Watching patients die without being able to help them, we doctors …" He chokes up. "We really were completely useless."

In January, Lin had received an instruction from "higher up": no mention of pneumonia can be made on death certificates. This instruction is relayed by telephone, probably to prevent any document from being leaked.

After infusing the five packs of levofloxacin, Lin's symptoms improve but he still coughs often and his chest hurts. Moreover, the point of pain keeps moving about.

"Sometimes it was in the hilum, sometimes it was in the upper left lung." On 30 January, he rushes to the Wuhan Pu'ai Hospital hoping to get a CT scan, but there are too many people in front of him and he gives up.

Many doctors and nurses are "battling the virus while sick", and without support. "They treat patients during the day and treat themselves after hours… The government said it would provide transportation for doctors and nurses, but in fact it was impossible to find a vehicle. They also said hotels would be provided," he says contemptuously, "but it was all empty talk."

Two young nurses make a deep impression on Lin. Their home is over 6km from the hospital. To get to work on time they set off on foot before dawn, and at the end of the day they plod home. "Their monthly salary was only 601 RMB [$139.50] but their return journey was a dozen kilometres, and that's as the crow flies."

'Even slaves have to eat'

On 9 February, Lin is transferred from the community hospital to a very busy isolation station, where sick patients are separated from the public.

Lin has to work twenty-four-hour shifts at the isolation station every three days. It has over one hundred beds and is often full. Most admissions are later diagnosed with the novel coronavirus, but some are isolated for different causes.

The station has no sterilisation equipment and no partitioning between dirty zones and isolation zones. Lin is issued with one set of PPE for each shift, so he wears his protective equipment while eating, washing and going to the toilet. He wears it walking up five floors and back down again because the lifts are reserved for patients.

At the end of each day's work, Lin is completely exhausted, so tired that he doesn't feel like talking. The exhaustion also means he can't get better.

On 17 February, he has another X-ray. The infection has moved from the lower part of his right lung to the middle of his right lung. He prescribes himself another three packs of levofloxacin. Later he sounds guilty when he talks about it, as if being able to survive is shameful: "My hospital only had a tiny amount of medicine, just enough to save ourselves."

On 7 March, as the Wuhan government tries to implement "gratitude education" to encourage people to express thanks to the Communist Party for its leadership in fighting the virus outbreak, Lin meets an ambulance driver. Mr Zhang is in his 50s. After Wuhan was locked down, he drove there from another province without telling his family and became a volunteer in Lin's hospital. In the next month, he busily drove several thousand kilometres around the streets of Wuhan, ferrying hundreds of patients, including critically ill ones. To avoid cross infection, he usually slept in his car. On 6 March, a tumour had been found on Zhang's lung.

Lin and his colleagues arrange for treatment and start a collection which quickly exceeds 30,000 RMB ($6964). They take the donations to Zhang but he firmly refuses to accept because he "didn't want to bring any trouble to Wuhan".

Eight months later, Zhang will die at home. "I thought his condition was not too bad. Never would have thought …" Lin writes on WeChat. "I cried."

Lin believes people who died at home or didn't present to hospitals were most likely excluded from government statistics. "Take my own case. I was definitely infected but
did not have an official diagnosis, so I was not included."

Based on the number of community hospitals and death certificates that he signed, Lin estimates the real number of deaths at around 16 times the official figure.

In May, Lin Qingchuan posts on WeChat several photographs of himself posing as a beggar. He writes: "Today I'm not only begging for food for myself, but also for colleagues
who are encountering difficulties."

Lin Qingchuan's monthly salary is less than 3000 RMB ($696). In a city like Wuhan, that's barely enough for the basics of life. But he hasn't been paid for several months.

On 24 December 2019, a relative of a patient in Beijing stabbed a doctor to death. Incidents like this occur across China because people are incensed by high fees and ineffective treatments.

Deadly Quiet City.

Lin's begging act is a kind of performance art. He is protesting at the government's incompetence and extravagance. Shortly before the epidemic exploded, Wuhan hosted the grand Military World Games. Many stadiums had been built, requiring an enormous workforce and 140 billion RMB ($32 billion).

There is a medical theory in China called "traditional Chinese medicine". Lin sees three kinds of traditional medicines at the isolation station, one of which has six ingredients, including orange peel, mulberry leaf and red root. Lin snorts disdainfully: "Even the worst medical student would not use that stuff to prevent and combat a virus."

Lin works at the isolation station until June. He is not sure if he is cured, but he stops coughing and he moves normally although when he is tired his chest hurts.

He writes on social media, "Excuse me, leaders, would one of you please settle our outstanding salaries. We medical workers are waiting for our rice. Even slaves have to eat."

Deadly Quiet City
By Murong Xuecun
Published by Hardie Grant
RRP $32.99