In the early morning of December 30, 2019 the streets were quiet in Wuhan, a city in the Hubei province of China. Doctor Li Wenliang arrived at the Central Hospital of Wuhan ready for his normal routine. Except this day would be anything but normal. Over the next several hours seven cases came in with pneumonia like symptoms, having a fever and dry cough. After testing the patients, Li’s staff was finding the infection unfamiliar. Li on the other hand, felt that he recognized this virus to be similar to that of the SARS virus that caused a global epidemic in 2003.
Asking where the patients had been, the common answer was the Seafood market in Wuhan. Had they ingested something toxic? To treat these patients, Li decided to quarantine them in his hospital. Concerned for his colleagues, Li sent a message to associate doctors in a chat group warning them about this possible outbreak. He urged them to take caution when treating patients and wear protective clothing to avoid infection.
Continuing to treat his patients, Doctor Li Wienlaing found himself summoned to the Public Security Bureau four days later and police officers arrived to escort him out of the hospital. To his surprise, the Bureau was accruing him of spreading false information and making false claims about a possible outbreak. Threatening him with prison, he was forced to sign a letter as an admission that he “severely disturbed the social order”. Li was in shock. He was simply doing his duty as a doctor to protect the public, and the Communist Party of China wanted his warning kept silent.
They said to Li, “We solemnly warn you: If you keep being stubborn, with such impertinence, and continue this illegal activity, you will be brought to justice – is that understood?” Fists clenched with anger, Doctor Li responded in writing, “Yes, I do.”
Li returned to work visibly shaken by what had happened. The commission had ordered that, “organizations or individuals are not allowed to release treatment information to the public without authorization.” The Chinese Government appeared to already be aware of the virus.
Only a few days earlier on December 26, 2019 an elderly couple was awaiting treatment in the waiting room of Hubei Provincial Hospital of Integrated Chinese & Western Medicine, fifteen minutes north of the Central Hospital of Wuhan. They had become concerned when they both contracted a severe fever and cough that was restricting their ability to breath. After what felt like an eternity of waiting in their frail state, they were seen. The doctors initiated a CT thorax scan on both patients. Confused by the images, they were brought to Doctor Zhang Jixian, the director of the respiratory and critical care medicine department, the next day. While looking at the images, her stomach sank as a feeling of dread came over her. These images were different from what would be expected in typical pneumonia scans. This was not caused by a common virus. Zhang had seen this before.
She swallowed, reflecting on her experience investigating the 2003 SARS outbreak. She looked at these results and knew without a doubt in her mind that this was not a common virus. It was an epidemic. Zhang put the results down and quickly approached the couple, “I need you to call you son in too.” “What’s wrong?” the elderly man asked. “Please do as I ask,” Zhang left the room. She had to prepare for the worst.
The son arrived looking concerned for his parents, “What’s wrong with them?” Zhang approach, “If you could please, I would like to put you through a quick scan.” The son was put off by this becoming suspicious, “What for?” “We need to cross test you for infection.” “I’m not sick,” the son was started to become irritated. Zhang put her hand up to calm him, “I know, we must see if you are infected with the same virus your parents have.” The son stomped his foot, “No! You people are just trying to pull more money out of us! That’s how this always works!” “Son, please.” He looked over to see his week mother laying in bed, “Please just do as she asks.” “But,” he started to protest. She lifted her hand week to wave him off, “please.” The son sighed reluctantly, “Fine.” “Thank you,” Doctor Zhang said as she led him out of the room.
Putting him through the same CT scans, Zhang’s concerns were quickly confirmed. The son’s lungs showed the same abnormalities as those of his parents. “What does this mean?” Another doctor asked. Zhang took a breath, “Usually, a family comes to the hospital and there is little chance for all the family members to have the same disease except for infectious diseases.”
More patients came in that day on the 27th with the same results. She prescribed them all a series of influenza-related tests which all came back negative. She knew what this meant and it could not stay quiet. That night Zhang filed a report to the hospital which was submitted to the district-level Center for Disease Control (CDC) in the Jianghan district of Wuhan. She explained that she had discovered a viral disease that shows signs of being infectious similar to what she believed to be a SARS virus.
After finishing the report, Doctor Zhang ordered that area of the department’s ward to be cordoned off to isolate the patients. She required that any medics who were to enter the ward to be fully covered with masks and gowns for self-protection. She was not taking any chances. Taking the initiative, she ordered thirty pieces of canvas as protective clothing online with her own money. When asked why she did not have the hospital order then she responded, “If it is delivered uniformly by the hospital, it needs to be customized” not having that kind of time she said, “if it is online shopping, they can receive the goods very quickly.”
Over the next two days three more patients with the same lung imagery arrived and continued to fill up the ward. By December 29th, nine beds were full. Reports were coming in of other patients with similar cases from other hospitals as well. The CDC responded by sending Epidemiologists to investigate and conduct testing. Over twenty four hours later, the Wuhan Municipal Health and Health Commission issued the official document “emergency notice on reporting the treatment of pneumonia of unknown causes.” The National Health Commission (NHC) dispatched a team of experts to Wuhan to lead the response to this impending epidemic and continue investigations.
Because of Doctor Zhang’s efforts, none of her medical team was infected through the following February when the outbreak was at its worst in Wuhan. According to later reports, Chinese authorities claimed that the Wuhan Municipal Health Commission sent out an urgent notification to medical institutions under its jurisdiction about a pneumonia contagion on December 30th. A notification Doctor Li Wenliang and his staff apparently never got if such a notification was released at all. China would not make an official confirmation of the existence of COVID-19 to the public until January 5th, 2020. The WHO China Country Office admitted to knowledge about a cluster of 27 pneumonia cases of unknown etiology detected in Wuhan, but Wuhan officials claimed that it was not causing death, saying there was no human to human transfer, but could only be contracted by coming into contact with infected animals. It would not be until January 20th that China would declare the outbreak an emergency.
Visibly shaken by the Chinese government’s reaction to his warning, Doctor Li Wenliang returned to work on January 8, 2020, finding his concentration wavering. Li saw a patient with glaucoma who, unbeknownst to him, had the unknown virus. On January 10th, Li began coughing. The next day his fever spiked. For the next two days he battled this illness. Frustrated with his own carelessness, he checked into the hospital. He found out later that his parents had also fallen ill and were taken to the hospital. Had he exposed them too?
In the hospital Li tested several times for the coronavirus, the original SARS tests, and they all came back negative. It looked and felt like SARS, but something was different. At this point he did not care what the government would do to him. The public had to be warned of this danger. He began to report on his own infection status on the Weibo chat app on his phone.
Speaking to reporters about the situation he declared, “I think a healthy society should not have just one voice.” Although frustrated with his government’s response and persistence at silencing information about the epidemic, he was still focused on beating this virus for himself and his fellow citizens. He wanted to be clear that he planned to continue his practice; “After I recover, I still want to return to the front line. The epidemic is still spreading, and I don’t want to be a deserter.”
Li posted on January 30th that, “Today nucleic acid testing came back with a positive result, the dust has settled, finally diagnosed.” He ended the post with an emoji of a dog with its eyes rolled back and tongue hanging out. He followed up by claiming that the virus resembled that of Severe Acute Respiratory Syndrome (SARS). Thousands of supporters commented on the post saying, “Dr Li Wenliang is a hero.” Criticizing the Chinese government, users complained in posts saying, “In the future, doctors will be more afraid to issue early warnings when they find signs of infectious diseases.”
On January 31st, eleven days after China declared the outbreak an emergency, Li wrote a final post from his hospital bed, “I was wondering why official notices were still saying there was no human-to-human transmission, and there were no healthcare workers infected.” Referring to himself in his own critical condition, Li was becoming more and more agitated by the government’s lies.
On the night of February 6th Doctor Li passed away in his hospital bed at the age of 34, leaving behind his expecting wife who was pregnant with their second child. Chinese citizens were outraged that not only was this viral outbreak spreading unchecked, but that Doctor Li had been punished for trying to warn them.
As word of the virus was spreading online, China stepped up its censorship to dampen the information leaked regarding the severity of the virus and to remove criticism of the government’s response to the contagion. Hours after Li had passed, official reports were coming from the hospital that they were still fighting to save him. They did not want to admit that this virus was deadly to citizens, let alone health workers. Li’s death world inspire journalists to expose the missteps taken by Chinese officials. His death also exposed the danger at which doctors and nurses were in when treating those infected by the virus. A report from a prominent infectious disease expert claimed that a single patient had infected 14 medical workers at one hospital. While protests over Li’s death would likely have occurred in Wuhan during normal times, citizens were too scared to leave their homes for fear of infection.
Two days after Doctor Li’s death, Professor Xu Zhangrun published a scathing review on how the Chinese Communist Party has handled the outbreak thus far, “They all blithely stood by as the crucial window of opportunity to deal with the outbreak of the infection snapped shut in their faces.” Xu was suggesting that the government’s censorship of information affected China’s ability to control its spread.
The essay was almost immediately taken down and Xu was placed under house arrest under the pretext of being quarantined after returning home from a trip. While authorities cut off his internet access and scrubbed all traces of Xu from social media sites, others who had obtained his essay were doing their best to share it across the web. Guards were reported being seen patrolling outside Xu’s home during his first week of house arrest. China was being locked down.
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In 2020, panic plagued the world with natural disasters, riots, and the COVID-19 virus. Amongst this chaos, individuals set their own needs aside to help others. When disaster brings out the worst in our world, it brings out the best in our communities.