The day I arrived in Foshan, Guangdong Province, was a rainy day.
Fukuyama is about 16 km south-west of Guangzhou, and it took me more than half an hour to get out of the Guangdong Department of Health to go to Foshan, but it took me almost an hour to find the Centre for Disease Prevention and Control in Foshan City (known as the Center for Disease Control and Control, known internationally as the CDC). Because I know almost nothing about SARS, when I walked through the old wet streets of Old Town, I had a weird feeling: why did the first SARS patient appear here?
And the rain began to grow, and I stood in the old streets to avoid the rain from the old tree, which was dipped into my face with leaves, and a cold as though it had stinged into my skin, and I came out unconsciously, as if the rain, which was covered with dust, would strike me with a “Satanic” virus.
Foshan, a town with over 1,300 years of history. It has been reported that one of Fuoshan’s origins was the three copper Buddhas dug by the local inhabitants of the second year of Beijing Day (628 A.D.) in Tabpo, where they were known as Foshan. The old city of Foshan is still known as “Zeng City”. Fuoshan, during the period of commercial boom in history, was associated with Hanquo, the town of Gyeongdee, the town of Chu Sheng, and was known as the four major towns of China. Foshan, an old town.
What does SARS have to do with old times?
In the spring of 2003, I began to look for answers in the old town of Foshan, where the disease hit humans.
The CDC in Foshan is in that complex alley in the old city, and it was 12:18 p.m. when I found that building on the southern road of Puang.
The so-called “CDC” is what they used to call the “preventable station”. The Director of the Centre is waiting for me in his office. We didn’t even eat, so we started the interview.
The first retrospect of SARS in China took place in front of me with the introduction of Huang Zuzin:
On the evening of 16 November 2002, a Pang village official in Zhang Zheng Town, Zhang Zheng City, Fushan City, suddenly fell asleep after having become very hot and uncomfortable at first thinking that he was having a normal cold. The next day, the symptoms abated, and Mr. Pang was in charge of property management in town and still insisted on going to work. But in the next few days, the cold has become more and more severe and warmer.
On 20 November, Mr. Peng, accompanied by his family, recently arrived at the Stone Bay District People ‘ s Hospital in Foshan City. The hospital initially suspected him of typhoid, then treated him as a suspected patient of an insect disease caused by indigestion, and gave him some routine antibiotics. However, the condition has not decreased. At that time, Mr. Peng was living in a general ward without special measures to prevent infection. A nurse who had taken care of Mr. Peng said: “There was hardly one person wearing a mask at the time, but none of the medical personnel was infected. I’m sorry.
In the following days, Mr. Pang’s body temperature was rising, and on November 25, he had been burning for several days, 39.7 and began to suffer from diarrhoea, with an increasing trend. Mr. Pang was transferred urgently to the First People ‘ s Hospital in Foshan City.
In order to obtain more detailed information and first-hand information, I decided to go to the First People ‘ s Hospital in Foshan City for a field interview.
Director Wong told me that the First People ‘ s Hospital in Foshan City is in the new city of Foshan City.
When I got to the First People’s Hospital in Foshan City, New City, from the old city’s CDC, it was as if I had walked through the city for decades, because it appeared before me as a very modern general hospital. The entire hospital is completely new, with its chivalry and rejuvenation, but it is an old hospital that is almost 100 years old.
Zhou Ming of the Medical Section of the First People ‘ s Hospital in Foshan City and U Min, who had been treating Mr. Pang, informed me of the patient ‘ s admission and subsequent development.
Chief Zhou told me that, at the age of 45, the patient had already received severe diarrhoea and had been accompanied by a high fever, and that, as the cause of the disease had not been found at the Stone Bay District Hospital, the doctor at Foshan Hospital had initially suspected acute intestinitis and had been admitted to the infection section. After two days of treatment, the patient was found to have lung infections, coughing, and breathing problems, with normal people breathing about 18 or so times a minute, but the patient breathed more than 40 times a minute, as if he had just climbed 10 floors, with a typical “adult respiratory distress syndrome”. Immediately thereafter, the patient suffers from low haemooxin saturation and acoustic hair (i.e., purple) which is a serious oxygen deficiency. A shading of the lungs was observed through X-ray, indicating damage to both lungs. The patient ‘ s condition deteriorated and was rushed to the hospital ‘ s intensive care unit.
The Director-General of the Serious Care Unit, U Min, then explained that, after receiving Pang’s patient, because of the ineffectiveness of acute intestine treatment, the patients were shown to have fevers, colds and diarrhoeas, some of which were typhoid symptoms, which they suspected first.
typhoid typhoid, an ancient infectious disease known as traditional infectious diseases, is still listed in the Infectious Diseases Prevention and Control Act.
The first recorded plague in human history is typhoid.
The Athensian Shude, known by Westerners as a great historian, was a survivor of the plague 300 years ago, and later, in The History of the War of Poloponesa, he wrote in more than half a chapter the scene of the typhoid typhus at that time, leaving an invaluable resource for later research: “… even the very healthy ones suddenly began to have fever, inflammation and red eyes; bleeding on their throats and tongues, causing an abnormally bad breath, breathing and sneezing; shortly thereafter, their chest ache and then coughing. It’s gonna be a stomach ache and vomiting all kinds of gall juice that doctors don’t know about. It’s all painful. Most of the time was dry vomiting and twitching; then the convulsions were intermittent and, although the body was not very hot and white, small scabs and scabies appeared on the slightly red and earth-colored skin. The internal body is always hot, in thin linen, and the patient cannot bear it. Many unattended patients have to jump into large buckets of water and be soak in cold water to reduce heat and eliminate unstoppable thirst. No matter how much they drink, they’re always thirsty. They were unable to quiet down, and prolonged insomnia worsened their already fragile bodies. This lasts about seven or eight days, most patients die of high internal heat; even if some patients survive this high temperature, most of them die of gastrointestinal ulcer and uncontrolled diarrhoea…”
It was almost 300 years since humanity fought this infectious disease, which had caused the “Athenian civilization’s decline”, that the cause of the disease was gradually understood and ways were found to overcome it.
The first doctor to fight typhoid is Hippocrates, who has been proclaimed “father of medicine”. At that time, Hippocrates was the Royal Doctor of the Kingdom of Macedonia. After learning of the plague in Athens, he risked his life to reach the area. In spite of all the efforts made, many of the methods known at the time were ineffective, Hippocrates was not discouraged and, faithful to his duties, he has been working at the line of the epidemic and has discovered a strange phenomenon: The blacksmith who deals with fire every day in Athens seems to have no connection with the plague. He thought maybe fire could stop the plague. So he led the people to the fire throughout the city, and indeed the plague receded.
Hippocrates saved Athens with a fire, leaving behind a “Hippocratic oath” that inspired future generations to be held by all doctors to the present day as a sacred code of professional conduct, but it did not reveal the true pathology of the plague.
It wasn’t until the 20th century of modern medicine to get answers. In 1950, Ralph H. Meijer, Professor of Medical History at the University of Kansas, United States, studied that the plague in Athens was in fact typhoid. By the 1970s, Professor of History and expert in medical history at Temple University, Roderick E. Maglu, had studied and endorsed the conclusions of Professor Meijer.
Pathologists, after a generation of relentless efforts and even the cost of their lives, typhoid pathogens, were discovered by American pathologist Howard Taylor Rick in 1906. Unfortunately, Licht himself died of typhus infection in a laboratory in search of a pathogen. In memory of him, the typhus pathogen was named “Licte.” Subsequently, the French scientist Charles-Julé-Andrey Nicole, based on research by his predecessors, identified typhus transmission mechanisms, which were originally transmitted through lice and were naturally susceptible to infection in poor sanitation slums and military camps. French scientist Nicole was awarded the Nobel Prize for Physiology or Medicine.
With the progress and development of medicine, we now know not only that typhoid is transmitted by fleas, but also that fleas are transmitted by a form of typhoid fungi, but it took almost 300 years for humans to uncover this secret, which is the hard and long struggle against infectious diseases and plagues.
Today, in addition to more accurate tests, we have very effective treatments. Although typhoid has not been completely eradicated by humankind as smallpox, it is already very difficult to form a pandemic that harms human beings extensively.
The most accurate way to diagnose a person ‘ s typhoid condition is to test the patient ‘ s blood and find typhus. As a result, the doctor at the First People ‘ s Hospital in Foshan City carried out blood tests for Pang-name patients, and no typhoid fungi was detected through blood training for patients.
The lack of typhoid bacteria in the patient ‘ s blood suggests that the patient is not suffering from typhoid.
The cause of Pang’s illness was still unknown, and doctors suspected it to be “Afian flu”.
It’s a contagious disease that scares everyone.
Avian Influenza, which has caused Hong Kong people to talk about “chicken” changes over the years, has left the Hong Kong government in a state of shock.
Avian influenza is a combination of various symptoms, ranging from respiratory disease to severe sepsis, caused by influenza A viruses in poultry and wild birds. It’s called a “rooster plague”. Avian flu is also an ancient avian epidemic, and the first text I found was the 1878 bird flu outbreak in Italy, when more than 80 per cent of poultry had died in a few days. Avian influenza is mainly transmitted to humans through diseased poultry, such as secretions and faeces.
However, in 1997 there was a massive human avian flu pandemic in Hong Kong, resulting in the death of six people, and the patients were in their prime. Subsequent studies have learned that a new avian influenza virus, known as H5N1, has been infected by humans. In order to cut off the source of avian influenza, the Hong Kong Government had taken a painful decision to kill 3 million chickens. In May 2001, Hong Kong again discovered avian influenza, and on May 16, the Hong Kong SAR Government’s Fish and Agriculture Department announced that live chickens sold in three Hong Kong vegetable markets had experienced a highly pathogenic H5N1 avian flu, after which the HKSAR Government decided to destroy 1.2 million poultry in Hong Kong. The Macao SAR then separated from the geese to H5N1 avian influenza virus, and similar measures were taken. At the beginning of 2003, there were repeated cases of avian influenza in Hong Kong, which did not cause an infection.
The outbreak of avian influenza is not just a matter of human harm, but of the fact that the Hong Kong media at the time were already impressed by its “difficult” effect on Hong Kong, and its re-emergence is likely to have a greater psychological impact on people than it actually is, thus affecting social and economic stability.
Fukuyama is not far from Hong Kong, and Hong Kong people travel between Hong Kong and Fushan almost every day. There is some reason to suspect that a patient is infected with avian flu. The doctor then gave the patient a cedar swab culture test, i.e. a tampons to collect the secretion from the patient ‘ s throat, and then to perform the test. As a result, no H5N1 avian influenza virus was found to transmit to humans.
Laboratory tests at the University of Hong Kong showed that the genes of the H5N1 virus originated entirely from birds and that, as the genome of the virus did not contain human genes, avian influenza was generally not human-borne.
The development of Pang’s patient’s condition has since completely ruled out the possibility of avian flu, as he later infected five family members.
Mr. Poon ‘ s condition continued to deteriorate and was quickly placed in a breathing machine because of his breathing difficulties. For many days, the doctor has not been able to find his cause.
This was followed by a series of events that alerted doctors at the First People ‘ s Hospital in Foshan City.
On 27 November, Mr. Pang ‘ s mother-in-law fell ill and suffered from fever, cough and breathing difficulties;
On 30 November, the uncle ‘ s husband fell ill and the symptoms remained the same;
On 1 December, Mr. Poon ‘ s wife was also hospitalized with fever;
On 4 December, the infected aunt and 21-year-old daughter fell ill.
All of us, in general, are in the same condition, except that the symptoms vary in severity, with a fever, a cough and a shadow in the lungs.
The most seriously ill is the mother-in-law, who was with Mr. Pang for the longest time, who, like Mr. Pong, suffered from severe respiratory failure and was placed in a intensive care unit, where he was rescued.
Experience has told health-care personnel that this is not a general pneumonia, that it is contagious and that the hospital, on its part, reports to the Centre for Disease Control in Foshan City, in accordance with the provisions of our Communicable Diseases Act, while informing the armed health-care personnel of the necessary measures to prevent infection.
The primary responsibility of our CDCs at all levels is the monitoring and epidemiological investigation of infectious diseases. It was restructured on the basis of the former health station. China’s health prevention and treatment agencies began to be established in 1954, when the Soviet Union was called “sanitary prevention stations” and the national level was called the Academy of Preventive Medicine. Subsequently, in accordance with the 1997 Decision on Reform and Development of the Health Sector issued by the Central and State Councils of the Communist Party, the former health-care stations were divided into two parts, beginning in 2000 with the separation of the health-monitoring and monitoring functions of the preventive stations. The Health Surveillance Section has set up a Health Surveillance Unit to perform administrative health supervision functions, and the Disease Prevention and Control Centre has been set up for disease surveillance.
The family ‘ s case is characterized by an infectious disease and therefore falls under the responsibility of the Centre for Disease Prevention and Control, which, in accordance with the National Act for the Prevention and Control of Infectious Diseases, must be reported to all levels of the Centre for Disease Control and Control by any department that finds signs of an infectious disease.
Immediately after receiving the report, the Deputy Director of the Centre and the Chief of the Section in charge of epidemiological investigation and disease control arrived at the First People ‘ s Hospital in Foshan City. The CDC staff investigated and found the disease to be family-based and contagious, and analysed it with hospital doctors to eliminate communicable diseases such as typhoid, influenza and avian influenza. However, this disease does not coincide with any of the 35 infectious diseases that must be reported in the Infectious Diseases Act, so it was treated as a respiratory infectious disease and was not reported upwards after it was recommended that medical personnel take the necessary measures to prevent infection.
On 11 December 2002, the First People ‘ s Hospital in Foshan City invited experts from Guangzhou, who did not find specific causes.
Later, Mr. Pong and his aunt were treated in a combination of anti-viral medicine, Libavilein, sugar-coated hormones and C-ball protein. Mr. Pang and his aunt are getting less symptoms. After some time of treatment, Mr. Pang was finally discharged from hospital on January 8, 2003, and his four families were subsequently discharged.
Among the doctors who were invited to visit Mr. Pang, a deputy professor of the Division of Infectious Diseases of the Third College of Nakayama, who later joined the “Expert Investigation Team for Unidentified Pneumonia” organized by the Provincial Health Department, recalled the case on 23 January 2003, when the comrades of the Guangdong Provincial Health Department immediately telephoned Foshan in their car to compare Mr. Pang’s medical history with that of SARS, and called him the first one in China. Of course, when the expert went to Foshan, he did not diagnose Mr. Pong as SARS, because it was the same expert on infectious diseases who did not realize that there was a new epidemic, which was later named “transmissible atypical pneumonia”.
The interview in Fuoshan solved a mystery in my heart and a question in society and in the world at the time, which had led to a number of misunderstandings and accusations, namely, that SARS occurred on 16 November 2002 and that it was not until February 2003 that the government announced it!
The first case of SARS found in China
After the interview in Foshan, I immediately left for Hagen City, where the real first case of SARS found in China took place.
I drove directly from Foshan City to River Source, two completely different cities. The landscape, including eating habits, varies from one economic base to another, from one cultural language to another.
The city is about 200 km away from Foshan. The city of Foshan is south-west of Guangzhou, while the city of Hagen is north-east of Guangzhou. Fukuyama is located in the interior of the Pearl River Delta, which is essentially a consumer city, mostly in the interior of the country. Since the reform and opening up, the economy of Foshan has been growing rapidly, with many foreign-owned factories in the country, transport being very easy, in addition to well-developed railways and road traffic, as well as a number of highways passing through the country, and access to central cities such as Hong Kong, Macao, Chuhai, Shenzhen and Guangzhou. As a result, there are a large number of internal migrants, and the foreign population far exceeds the local population. According to the author of the book “The future disaster”, “AIDS will remain hidden in small villages in Central Africa without highways, trucks and jets. This means that the size of population movements will play a role in the spread of infectious diseases.
The city of River Source, with an area of 4413 square kilometres and 79.4 per cent mountainous, strictly controls the development of polluting plants in order to protect the water resources of the Green Lake and the New Fong River in the country. The source of the river is a less polluting city with a very different climate from that of Foshan. And when I left Foshan, the wet and hot subtropical climate suffocated me and my body was always sweaty. But when the car enters the source of the river, a fresh and cool wind comes to the surface, which gives a sense of spirituality. There is no highway in the river’s source, and there is a much smaller flow of people and a much smaller foreign population than in Foshan, so that there should be a relatively lower chance of disease being introduced.
But here is the first case of SARS found in China.
On the night of December 15, 2002, at more than 11 p.m., a patient named Yokoshi (to respect the right to privacy of SARS patients, whose real name does not appear in my work but who later went to the media and made public in the newspapers about her condition after the disease and made her own name known to society) entered the emergency room of the people’s hospital in Hagen City, accompanied by her family. At that time, the fever, red-faced necks, and the patient ‘ s physical strength were so strong that he was very weak, he had difficulty breathing, and he was sore, that he could move under the help of his family.
He is 35-year-old, native of the river, a cook who works in a liquor store in Shenzhen. According to him, he is usually in good health and usually has a hot head and a sleep. On the 5th and 6th of December, it began to feel a little uncomfortable, with no strength, and thought that it was too tired to be serious. A few days later, a fever began to spread, and 38.9 of them arrived at the hospital and thought they had a cold. When Huang said that they were cooks, he thought it was a fire, he made a phone call to his family, and the family said to take care of him, and he went home. Upon return, the condition did not improve and was hospitalized in the town health centre. The hospital doctor saw him with a high fever and his whole body was sore that he thought he had a cold, gave him anti-circle medication and gave him a pint. The following day, not only was the apricot condition not abating, but vomiting, dry coughing and fever had reached 40 degrees. The hospital doctor advised the family to take it to the people’s hospital in Hagen City for emergency care.
The emergency doctor at the People ‘ s Hospital in Hagen City admitted Huang to the hospital in the interior of the district. After hospitalization, the patient continues to suffer from high fever, coughing and further difficulty in breathing.
In the early morning of the following day, Dr. Ye Jieqiang entered the ward and saw only the patients with ice bags on their heads, arms, thighs and gutters. Because of the ineffectiveness of all types of deflammation pills, night doctors had to use ice bags to cool them physically. Despite this, the patient still has a high fever of 40 degrees. The X-rays revealed a shadow of both lungs, showing a heavier lung infection.
After two days of treatment, the condition has not improved, the breathing has become very difficult and the cough is so severe that it cannot speak. The shading of the lungs has widened further.
The people ‘ s hospital in Hawon City was unable to identify the pathogen of the almonds and, in order to prevent delays in yellow treatment, was advised to transfer to the provincial hospital.
Following contact, it was decided to transfer to the Guangzhou General Military Hospital for respiratory medical treatment. Dr. Hoang Wenjie, Director of Respiratory Medicine, was one of the first six experts of the group of experts to combat SARS in Guangdong Province.
At more than 5 p.m. on the same day, the people’s hospital in Hagen City used an ambulance to transport almonds to Guangzhou at first sight, and Ye Qianqiang was escorted by a doctor in charge. As a result of the high fever of the patient, he kept stopping the ambulance and buying ice water to cool the patient. According to Yokoshi, later on, he had burned everything down the road.
That night, at about 9 o’clock, he arrived at the Guangzhou General Military Hospital.
The almonds, who returned home after the outbreak in Shenzhen, can largely be excluded from being infected at the river’s local level.
Immediately thereafter, there was another case of a patient at the Riverside People ‘ s Hospital, exactly the same as the initial apricot symptoms, who was a native of the river and lived in the River Source City.
The reason why I compared the environment in Foshan and Riverside cities with so many words in front of me is that every new type of infectious disease occurs in a way that is more or less related to the environment, looking for sources from an epidemiological point of view, analysing the external causes of the first discovery of SARS patients, looking for suspicions, and it makes sense for an epidemiological investigation.
Dr. Yeshiqiang returned to the river by ambulance that night after he arrived at the Guangzhou military general hospital, and it was almost 3:00 in the night. There were no hours of sleep, and he came back to work, because there was a particularly high number of cases of cold, which was a respiratory infection and a specialty in respiratory medicine, and he was therefore particularly nervous. So I’m gonna have to work on time.
Ye Qiang came to Cori and found another Quo, male, 40 years old, individual taxi driver. All the symptoms of Quan’s patient are similar to those of the apricot that was sent out yesterday. They are fevers, coughs, breathing difficulties and lung shadows. But the patient Kwok didn’t know Yokoshi, neither of them had any contact history. They’re all independent, they’re SARS patients. Later, through more in-depth interviews, I learned that a number of cities, including Guangzhou, Sundeh, Jiangmen, Nakayama and others, had no history of contact with each other or of infection. I wonder why, in many cities in Guangdong, all of these people who have no cause or effect have suddenly got sick together. And I also learned that when the outbreak first started, 62.9% of patients could not find a direct source of infection, i.e., who infected SARS.
The post-hospital condition of the patient Guo Yi is developing rapidly. That night, after a cold and a high fever, the cough began. Following the examination of the gas lenses, it was found that there was a “glass change” in the bronchial, not only did young Zhang Zhang not have seen such a case, but also Professor Sheng, who had spent his last year in respiratory studies. Professor Xie contacted a fellow student working at the Guangzhou Institute for Respiratory Diseases, who asked him to send the patient to the Call Institute. The Guangzhou Institute for Respiratory Diseases is known as the Institute for Respiratory Diseases of the First Hospital attached to Guangzhou Medical School. It is headed by the Zhongnan Mountain Academy, which is now known throughout the country. It is called the Institute for Respiratory Diseases of the First People ‘ s Hospital attached to the Guangzhou Medical School. This created an opportunity for patients of Guo’s name to be brought to the Guangzhou Institute for Respiratory Diseases, drawing the attention of the Zhongnan Shan Academy, who first met with SARS patients and participated in treatment.
Patient Guo is also a patient of Ye Xianqiang, who, as the attending physician, sent the patient to Guangzhou for the second time.
Doctors infected with SARS in China
On April 30, when I interviewed John Ye at the People’s Hospital in Hagen City, the young man of Dark and Dark China laughed and said, “How come I was the first doctor infected by SARS? I’m sorry.
It was on the morning of December 21st that the patient Guo was taken to Guangzhou, where he had to use his rest time to send the patient to Guangzhou because of the stress on his hands. Patient Guo’s coughing and he kept leaning over and over for his heart and lungs. When he arrived in Guangzhou, Ye Xianqiang sent Guo’s patient to the Guangzhou Institute for Respiratory Diseases, located in the first annex hospital of Guangzhou Medical School, and returned to Riverside immediately.
On the way back, Jing was particularly tired.
He was young, was confident in his body and never felt as tired as he was today, and fell asleep when he returned home.
When I woke up, it was the next morning that Ip was feeling much better and then returned to work in Kori as usual. As a cold season and with a high number of fevers per day in the hospital, the doctor in the respiratory field is busy as a bee every day.
On the night of December 24, after a busy day of work, Fashion returned home with a telephone call from a doctor in neurosurgery at the hospital, his wife, a nurse in Yipshikuri, who was pregnant for more than four months, and now has a fever and calls to teach her how to use medicine without hurting the unborn child. Yip made his own point. At the time, he thought the nurse had a cold.
Dr. Ye Xianqiang, a native, was assigned to the People ‘ s Hospital in Hagen City after graduation from the Shanghai Institute of Railway Medicine. He is a man of great character and a man of great taste, and his wife is also a nurse in the house, and he already has a two-year-old son. That night, a good friend came to the house, and Ye Qiang talked to him for a long time, and he got up and they sang Carla OK at home. At that time, he had not felt any obvious difference in his body.
By the middle of the night, Fowler suddenly dreamt of entering the field in the middle of the night, and the cold wind of the winter blew him, and finally woke up from his sleep. After the cold, the heat went on, and the wife measured him with a temperature gauge, and the temperature was not very high, and it was 39 degrees high by dawn. The wife immediately accompanied him to the hospital for examination. Blood tests: White blood cells are low and filmed: the two lungs are unchanged and thought to be cold and treated as upper respiratory infections.
On the 26th of December, Fahrenheit started coughing, only dry coughing, no sipping, then taking a film and finding a shadow in his lungs. As a respiratory doctor, he knew he was suffering from pneumonia. After an examination by Prof. Keri ‘ s expert Professor Sheik, it was decided to stay in the hospital immediately.
At more than 5 p.m. on the same day, Yip was forced to enter the respiratory medicine of his own resident. After the hospital, the symptoms developed rapidly, as well as coughing and agitation, and the breathing had reached more than 30 times a minute, making it difficult to breathe and speak. Most worrying is the rapid development of pneumonia, which is already a double lung shadow the next day.
At that time, a situation had strained the hospital, and eight medical personnel who had been involved in the treatment of patients with Huang and Guo had fallen, including even a pharmacist in an outpatient pharmacy, two of whom were pregnant women, including the wife of a neurosurgeon who had called Yeh Qiang that night. The symptoms are all the same: fever, cough, breathing difficulties, lung shadows.
The head of the hospital immediately convened an emergency meeting and decided to remove a special ward immediately from the section (i.e., respiratory medicine) to house all sick medical staff, regardless of the severity of their symptoms, in hospital isolation.
A number of consultations were organized in the hospital at that time, but there was disagreement, as the pathogen could not be detected, but both agreed that it was a contagious pneumonia. The use of regular treatment programmes has not been effective.
At that time, there was a message that the hospital leadership had become more nervous, saying that two patients had been sent to Guangzhou, one of whom had died and one of whom was in critical condition. The director of the hospital, while taking stricter preventive measures within the hospital, gave all medical personnel some anti-viral drugs, such as erythroacin, and reported to the riverine city health service. The HSB decided to report to the Guangdong Department of Health and requested that experts be sent to Hagen for an investigation.
The report to the Provincial Health Department was drawn up that night by the People’s Hospital of Hagen City, which has some historical value in the fight against SARS, so that an expert has kept a copy of the report, which I also received, as follows:
Department of Health and Public Administration:
In mid-December, 2 patients with severe lung infections were admitted to one of the departments of the People ‘ s Hospital of Hagen City. Due to the severity of the illness, they were transferred to higher-level hospitals (1 for the Guangzhou Military General Hospital and 1 for the Guangzhou Institute for Respiratory Diseases), and upon their return, they also received “pulmonary infections” and seven more were treated with “pulmonary infections” in the internal section, with some endemic. The two patients who were allegedly taken to the higher hospital were not diagnosed in Guangzhou, where one died and the other was in critical condition and breathed by a breathing machine. Three of the eight medical personnel in our hospital suffered from serious lung infections, the causes and causes of these infections are currently unknown, and the comments of my hospital ‘ s general meeting were initially identified as being highly contagious in the military, viral or parageny, but the conditions in my hospital ‘ s laboratory are such that they cannot be detected. The treatment of all kinds of treatment, including anti-inflammation, anti-virus and anti-tuberculosis, has not been as effective as it should be, and the provincial authorities have therefore been asked to arrange for the visits of specialists to the hospital.
The total number of 8 medical staff, of whom 3 are men and 5 are women, all share the following characteristics: one, the first line of clinical medical staff of the young, who are healthy; two, who work in the same room and during the same period; three, symptoms of clinical performance, signs, X-lines and laboratory tests are similar: prior to the onset of the disease, they all have cold symptoms, gradual cold, high fever, coughing with a small amount of white, of which 2 cases involve a small amount of blood filament, a small amount of hysteria, a small amount of humid sound for the two lungs, but no changes in empty holes, aromatic chest, chest fluids and heart-pack fluids. The laboratory checked for low blood albino cells, and no fungus were detected in blood, sting and bone marrow culture.
People ‘ s Hospital, Hagen City, application unit
2003-1-2
As far as I know, although the report is due on 2 January 2003, it was drawn up in the evening of 1 January until late night, that is, the early morning of 2 January.
2 January 2003 Guangdong Department of Health
In the morning of January 2nd, 2003, on the first day of the New Year, the Guangdong Department of Health received a report from the People ‘ s Hospital of Hagen City. The Vice-President, Wang Ji-joon, was informed of the meeting as soon as he received the fax. Following this hearing, and aware of the gravity of the matter, the Director-General immediately convened the Deputy Director-General and the relevant sections and decided to organize the Group of Experts immediately to the river and to leave the same day.
The proposed team of experts from the Guangdong Department of Health consists of an epidemiological investigation team and a clinical team. The Clinical Team of Experts is Prof. Shao Zhenglun, Deputy Director, Guangzhou Institute for Respiratory Diseases, Dr. Hoang Wengjie, Director, Respiratory Section, Guangzhou General Military Hospital, and Associate Professor of Infectious Disease, Tanzide, 3rd Hospital, affiliated to Nakayama University. The Epidemiological Investigation Team is made up of the Director of the Epidemiology and Control Institute of the Centre for Disease Prevention and Control of Guangdong Province, Roh Ming, Vice-President of Peng Guowen, and Zhong Haoji of the Microbiology Laboratory.
In accordance with the professional division of labour, the responsibility for this lies with the Department of Health and Administration. Comrades from the Medical Department of the Provincial Health Department informed the members of the Group of Experts that they were concentrating at the Provincial Health Department and called the hospital where the two patients were treated. As a result, it was learned that both patients died without exception, although they were seriously ill and were placed in a breathing machine. The rumour about the death of a patient is probably the first false story in the outbreak of SARS. Such false rumours have since occurred in many cities and have caused some social panic.
At more than 2 p.m. on the same day, the experts on call arrived on time in the small conference room on the 5th floor of the Provincial Health Department. A brief presentation was made by the Assistant Inspector of the Department of Health, Ho Mingfu, who circulated the fax report from the People ‘ s Hospital in Hagen City and then left.
Later, in an interview, Deng Zid said to me that this temporary emergency task was common to all, so it did not require much talk or even a team from the health authorities, and that Shao Zhenglon, the oldest, was proposed as the leader of the team of experts, and then took off in an ambulance at the Centre for Disease Prevention and Control in Guangdong Province.
When the car was driven out of the yard of the health hall, it was generally thought by the people on it that it was a very common business trip, as it had been on many occasions. You’re joking, you’re on your way.
No one thought that you would be facing a new type of intensity that later spreads to a wide range of infectious diseases, and that even some of the experts were themselves infected and experienced life and death.
At the same time, there’s a “Phot of Flaming! Rumors have led to the acquisition of erythroacin, anti-viral drugs, etc., causing erythrocycin to be marketed off, and bad pharmacies to take advantage of the price, which is probably the first “shopping wind” in this fight against SARS.
The initial rumours started in the hospital. When the hospital experienced such a large-scale infection, when it was said that two heavy patients who had been sent to Guangzhou had died and that the other had died, the hospital ‘ s head had to do everything in his power to protect the hospital ‘ s staff. Each of the medical staff has a family, and they tend to their own protection. The family had relatives and friends, and some words were passed on. Later, it was said that there was a “people plague” that caused some panic among citizens.
On the same day, when the provincial team arrived at the river, as it was travelling in an ambulance bearing the name “The Center for Disease Prevention and Control in Guangdong Province”, it was immediately asked, “Are you here to investigate the human plague?” When the experts first checked into the hotel, they called the room and asked, “Is the river a plague?” I’m sorry.
The word “pest” is a strange term for many people today, especially young people, and it is only in Mao’s Zedong’s 7th poem, “Send the Pilgrim God” that we saw the tragic event of the “singing of a ghost in Mandarin” caused by schistosomiasis. It’s what old people call “the plague.”
“The human plague” is the plague that afflicts humans with a high level of infectious disease, causing widespread and sudden infections and deaths. Today, although the plague is unknown, the World Health Organization reports that nearly 20 million of the 45 million people who die globally every year die from infectious diseases.
Plague, not far from us. These are many examples from abroad, and here we look at China.
In recent times, in China, there have been dozens of documented plagues due to economic poverty and technological backwardness. In 1948 alone, there were more than 30,000 deaths in the eastern part of the country. In our southern part of the world, the wet and warm climate has allowed infectious disease pathogens, intermediate hostess, vector organisms to grow in a better environment. Historically, malaria, dysentery, cholera, dengue fever, etc., and even plagues are high. In July 1937, there was a cholera outbreak in Hong Kong, which killed approximately 1100 people in months, with a population of hundreds of thousands. The Guangzhou mother’s river, Pearl River, has been followed almost once in history by a plague. The First People’s Hospital in Guangzhou City is the product of the plague. According to historical records, in the summer of 1899, the epidemic in Guangzhou, which caused “many deaths among citizens, with many bodies spread throughout the country.” “A sick person or a sick person who is in the streets is in a terrible state, as a result of a donation from a local village gentleman who set up Guangzhou’s `City West Convent’ and later became the `Friendly Hospital’, which is the front of Guangzhou’s First People’s Hospital.
Since the establishment of the new China, despite a three-and-a-half blow to the economy, the people’s government has still spent its efforts to combat infectious diseases, and the epidemic has been significantly reduced, but we are still unable to get rid of the plague’s shadow. Between October 1979 and September 1982, and between September 1985 and the end of 1988, there were two outbreaks of dengue fever on Hainan Island, also in Guangdong Province, with a cumulative number of more than 600,000 people. The deaths were brought to 475 as a result of the timely mobilization of the local people ‘ s government to rescue the entire province and the support of the Central People ‘ s Government, as well as the fact that recent generations had found effective ways to treat dengue fever.
All older people will remember the plague. Thus, when a new type of “genocious disease” occurs that is unknown to people, it is natural that people think of the plague, which, in popular terms, is “the human plague” and that it is inevitable to cause social panic if they do not explain it in time.
If people panic, society will pay.
The first pressure is on leaders everywhere.
Late that night, at 1 p.m., the mayor of the city of Hagen urgently convened a joint meeting of deputy mayors, health directors, directors of education and media leaders in his home to study ways of overcoming rumours.
The next day, the daily Hagen newspaper and radio and television stations reported on the real situation in the people ‘ s hospital in Hagen City. The director of the People ‘ s Hospital in Hawon City also came to the television screen and explained it to the public, so that the panic in society could slowly be eliminated.
When the provincial team arrived at the source of the river, it was dark and did not eat, and the clinical team immediately entered the ward and consulted every infected person. The Epidemiological Investigation Team also immediately conducted environmental surveys and seroscopy of patients. The River Source City Health Board and the River Source City Center for Disease Prevention and Control were also involved in the survey and discussion.
After this is over 10 p.m. and having a simple meal, the Group’s comrades gather for discussion in the Riverside People’s Hospital conference room, plus the Riverside People’s Hospital and the Riverside Disease Control Centre, where the small room is filled. It is, of course, mainly to listen to experts from the province.
The provincial experts did not understand at this point what the disease was. Nor is it easy to define as an expert. Three points were then summarized in terms of symptoms based on the epidemiological characteristics of the disease: first, inflammation of the lungs; second, typical pneumonia caused by non-traditional pneumocococcal; and third, respiratory infections, contagious. However, the symptoms of the 35 infectious diseases listed in the National Infectious Diseases Control Act, all of which occurred in the people ‘ s hospital in the city of Hagen, cannot be fully matched with any of the symptoms of infectious diseases, but this is certainly an infectious disease. So, what kind of epidemic is it? The six experts did not agree at the outset.
Q: Is it a “troupe disease”?
In the early days of SARS, because of its complete ignorance of the clinical symptoms of its occurrence, which were respiratory infections caused by a source of infection, it was initially sought out among known infectious diseases of the same kind, such as “Afian flu” and “Serb Disease”. For example, the 301 hospital in Beijing, where the first case of SARS patients was transferred from Shanxi, also sent samples of the patient’s swabs (slurry samples) to the Academy of Military Medicine to request the separation of the legion of fungi and chlamydia. When humans were attacked by a mutated coronary virus, we first learned in the dark that it took a process to recognize the “enemies” that attacked us.
Regiment Disease, a new infectious disease that occurred in the United States almost 20 years ago, is not yet included in the Infectious Diseases Act. It’s also air-borne, infecting people’s respiratory system. The symptoms are quite similar to those of the riverine patients. The experts had a detailed discussion of the matter.
“The Legional Disease” is an infectious disease caused by the “Arms” infection. We note that the above-mentioned typhoid fever was also caused by an infection known as the typhoid fungi. So how did the bacteria come to be named?
People usually name it bacteria in its shape: “Spherical fungus” is round, “bacteria” is sticky, “bacteria” is like commas, and those like wires or spirals are called “helix.” “Virgin fungus” that can cause people to impregnate, is round. Human beings have struggled with it for centuries without completely defeating its “cholera” and are infected with a fungus shaped like comma. The Legionella is a stick, so it is medically referred to as the Pneumocococcal, which causes symptoms similar to pneumonia. Clinical manifestations were cold, discomfort, migraine, dizziness, headache, irritation, breathing difficulties and chest pain. More than 90 per cent of patients experience a rapid rise in body temperature, coughing and adhesiveness.
“The Regiment Disease” was first discovered in the United States in 1976.
On July 21st, the 2,500 members of the United States Veterans Corps of Pennsylvania gathered together with their families in Philadelphia to celebrate the 200th anniversary of American independence. Four days later, each of you returned to different parts of the United States. A few weeks later, 34 people mysteriously died of pneumonia. Its typical symptoms are similar to influenza: headaches, fever; no appetite; muscle pains; chest and abdominal pains, diarrhoea, nausea; high fever and cold fear; cough; pneumonia. In subsequent investigations, it was found that all the sick had been or had been to a hotel. The source of the infection was then sought, and no bacteria or viruses were detected in the victim ‘ s lung tissue. Later, a scientist named McDade discovered a pole-like bacteria in the victim’s lung tissue, which, after re-testing the antibody-antigen, was originally a brand-new bacteria, as it was first infected by a group of soldiers, and was named “Pneumocococcal Cacteria”. The disease has also been named “The Corps Disease”. Retrospective studies (i.e., as we recall today, the case of “SARS” in Foshan) found that there were cases of Legional Disease as early as 1943. More than 30 types of cactus have been proposed, at least 19 of which are human pneumonia. One of the most common pathogens is “pneumocococcal.”
Legional bacteria, mainly grown in humid areas such as water storage systems and air conditioning water. “The Legional Disease” was found in many parts of the world, not only in the military, but also in the growing modernization of our cities. Because large, modern buildings in cities are usually equipped with central air-conditioning systems, cold-hot water pipes and wettifiers, and if the water sources are contaminated by the Legion of Armories, those in the buildings may be infected with the Legional Disease. The expert cautioned that this is also a public health problem in our developing modern cities. I found this information online: from 1997 to 1999, the Beijing Center for Disease Prevention and Control sampled 14 four-star, five-star hotels in the city, and found Legionella in air-conditioning cooling towers. The survey showed that the circulosis is prevalent in air-conditioning cooling towers and has posed a threat to the health of hotel staff.
Now around 2,000 people in the world die every year of “soldier” disease, and fortunately antibiotics are good for it, with roacin doing better than penicillin.
So the patient in Hagen City is a troop infection? Experts, in particular clinical experts, believe that the patient ‘ s symptoms and signs do not support the presumption of infection with the Legion.
After the infection, although it is also an offensive respiratory system, many of the symptoms are the same as those in the river’s source, but the liver function and even kidney failure can occur in the case of serious “military disease” patients, who are mostly in the shadow of their lungs. Often, the outbreak of “corpional disease” takes place in mid-summer and early autumn, mainly in closed central air-conditioning rooms, and is now a low-temperature winter, with no central air-conditioning at the Riverside People’s Hospital. The most vulnerable population groups are the elderly, smokers, chronic pulmonary diseases and, at the same time, those with low immunization capacity, while the river-borne patients are almost all young adults.
In order to confirm that the “corpional disease” was a bacterial infection, Shaw Zhenglon immediately called the Guangzhou Institute for Respiratory Diseases and asked whether the patients sent by the river had been bacterized.
This largely precludes the possibility of being “corpion disease”.
So what kind of disease is it? There is still no uniform conclusion.
Finally, a decision was made to develop a diagnostic standard, which, after an article-by-article review, resulted in the concentration of the following: fever; cough; shading in the lungs; normal or decreasing white cells; pneumonia, but not traditional pneumonia; respiratory infections, contagious.
And then we’re going to set up the eight patients that were infected at the Riverside People’s Hospital, which is basically the same.
This diagnostic standard is the first map produced by experts for SARS.
The meeting was held late at 12 p.m. and no final conclusions were reached.
We’re dealing with a new kind of infectious disease, and it’s in the dark “smuggling” humans, so humans need a process to understand it. In the late night of 2 January 2003, experts searched in the dark and tried to identify it. But we can’t see it.
The discussion ended at a moment when people came out of Riverside City People’s Hospital.
The night is already very deep, the temperature is very low and the rain is cold. People are cold and hungry. The masters invited the experts for the night to eat. You’ve come to one of the big rows on the side of the New Fong River, where you’ve been drinking porridge around a short table and talking about it while you’re drinking.
Back at the hotel, the experts still didn’t leave the patients in Riverside until 4:00 in the morning.
The next day, it’s clear.
At more than 7 a.m. and after a few hours of sleep, the experts woke up and gathered together in the room of Team Leader Shao Zhenglon. Thanks to the full discussions last night, a common understanding emerged and a preliminary study was prepared.
The report of the investigation was written by Dunzid, only one piece of paper, less than 500 words. This is also reproduced below:
Report on the preliminary survey to the People ‘ s Hospital in Hagen City
On the evening of 2 January 2003, six members of the Working Group arrived at the People ‘ s Hospital in Hagen City. The leaders and personnel concerned at the River Source Municipal Health Board, the Municipal People ‘ s Hospital, and the Municipal Centre for Disease Control are consulted, all hospital records are consulted, inpatients are questioned and examined on a case-by-case basis, and the environment in the internal district and the infectious disease zone is examined on the spot.
The recent cases of medical personnel in a district of the People ‘ s Hospital in River Source City are prima facie considered to be the result of a local outbreak of undetected pneumonia (considered to be atypical pathogens). From 15 December to 26 December 2002, there were six cases of undiscovered pneumonia among medical personnel in a district of the People ‘ s Hospital in Hagen City. The main common manifestations of patients are heat, cough, pulmonary tablets with blurred shadows and no significant increase in albino count.
At present, 4 out of the 5 patients in hospital have improved and stabilized, fever has receded and cough has decreased. 1 There are still cases of fever and respiratory symptoms, which are under further observation. From 27 December to date, no similar new cases have been observed in the wards and in close contact, and there are no signs of epidemic spread. Patients are treated and the ward environment is sterilized to prevent new cases. The provincial Centers for Disease Prevention and Control have received a portion of the patient serotons intended for testing, for example, of paragens, influenza virus antibodies, etc.
(Signed) Xiao Jinglun
Two, three, three.
There’s a little bit of an episode, because the city just calmed down a “snatch-and-buy” and Hagen’s gays suggested that there should be no “brash” in the report. This word, because, after all, there are less than 10 patients, and using the word “breath” is a cause for misunderstanding. Dunzid explained that this is a term for epidemiology. One case is called “dispersion”, three in groups, and it’s called “emergence.” Finally, the term “emerging” is still used in the report.
Finally, the Group made a number of recommendations on disinfection: peroxyacetic acid; disinfection with chlorine-containing disinfectants, etc.
The Group then took the investigation report and reported back to the Provincial Health Department.
The People’s Hospital in Hagen, Guangdong Province, was the first hospital in China to be paid for fighting SARS. Dr. Ye Xianqiang became the first doctor in China to be infected by SARS patients, and was later taken to Guangzhou General Military Hospital, where he was rescued in the same region as the first time he brought him. The five infected nurses, two of whom were pregnant women, one who had an unfortunate miscarriage, and one who was afraid to take a lot of medicine to keep his tummy alive, survived on his young body. When I went to the river to interview her, she was not in bed, and everyone was worried about her baby, and I prayed for her and her. Two nurses could not find their names in the media at the time. No one knows not only that they were the first to be infected nurses in China, but also that they were the first to provide sero-sensor rehabilitation to patients infected with SARS in Beijing. They’re called Shotong Mae, and they’re both young. When I saw them at Riverside People’s Hospital, I asked them, “What does it feel like to be infected with SARS?” They said, “Thank you for your leadership, for keeping us alive, and for coming back to the clinic to help other SARS patients.” I’m sorry.
Behave and speak in a simple manner, and my heart is chorded with plain beauty.
Following an increase in the illness of Dr. Yeh Shang, the people ‘ s hospital in Hagen City quickly contacted him for transfer to Guangzhou General Military Hospital. This is not only because the first case of SARS patients was taken to Guangzhou General Military Hospital, but also because Dr. Hoang Wengjie, a provincial team of experts who came to Guangzhou General Military Hospital for a few days, is the head of respiratory medicine at Guangzhou General Military Hospital, and they already have experience with the first case of SARS patients.
A few days ago, Dr. Yeh was escorted to Guangzhou, but today someone else is needed. He was lying in an ambulance with a high fever, breathing fast and having difficulty speaking. The wife was by his side with the gods.
At Guangzhou General Military Hospital, Dr. Hwang Wenjie intentionally placed Yip Chang in the seriously ill ward sent by Yip, while the almonds were still in hospital. Document number: YX01N6jVWXZN0m4Ez
I don’t know.
Keep your eyes on the road.
