'No Way Out': In China, coronavirus takes toll on other patients

WUHAN (NYTIMES) - The three-year-old boy was anxiously waiting for yet another round of chemotherapy. Then the coronavirus outbreak hit, and doctors suddenly turned him away.

The boy, Fu Haoran, who has leukemia, is one of many seriously ill people struggling to get urgent, lifesaving treatment, as China pours nearly all its resources into the Covid-19 epidemic.

Some have not survived. Others like Haoran are in limbo, and their families fear for their future.

In Wuhan city - the centre of the outbreak, many hospitals have been converted into facilities for treating only patients with the virus. Elsewhere, other facilities have closed amid shortages of medical workers or rejected patients because of fears of cross-infection in the wards. Elective surgeries have been postponed indefinitely.

Many cities have imposed travel restrictions and quarantine requirements that, for many critically ill patients, mean delays they cannot afford.

"The country is in a state of crisis - this we understand," said the boy's father, Mr Fu Hetian, in Wuhan. "But when will it end?"

Since the outbreak took hold in late January, it has killed nearly 3,000 people and sickened over 80,000 people in China. With the daily tally of the virus infections now on the decline, Chinese officials have begun to tout the country's efforts to combat the epidemic as a victory.

But the outbreak is straining a health care system that was overburdened even before the virus surfaced, and many patients with other illnesses are now falling through the cracks.

The concern is the country's containment efforts may be saving some lives at the expense of others.

"There are so many medical conditions out there that require timely care," said Dr Amesh Adalja, a senior scholar at the Johns Hopkins Centre for Health Security. "You're going to have people die or they are going to get really bad outcomes if they don't get care."

Assistant professor of health policy and economics Chen Xi at the Yale School of Public Health said he thought it was likely that deaths from cardiovascular and other chronic diseases that could have been prevented could outnumber the lives saved from treating Covid-19 patients.

Many patients and their family members say they have been left to fend for themselves, so have turned to Chinese social media, posting desperate messages to find care.

One such post on Sina Weibo, a Twitter-like microblog platform, described the dire situation that 19-year-old Tian Guanglin was in when his condition from a rare and aggressive form of muscle cancer took a turn for the worse in early January.

Doctors in the southern city of Shenzhen recommended an immediate transfer to a better hospital in a bigger city, but no facility would take him, his mother said.

The teenager died on Tuesday (March 3) morning.

"We had no way out, we had no choice, but to delay his treatment," said Ms Zhao Huaqing, the boy's mother. "If he had been admitted to a better hospital, then he wouldn't be dead now."

In Wuhan, one woman wrote that her 62-year-old mother who had leukemia had been turned away by several hospitals because of concerns about cross-infection.

Blood banks in Wuhan have experienced severe shortages because of the extended lockdown, according to China Newsweek, a state-run magazine, and other news outlets. This made it next to impossible for her mother to get the weekly blood transfusions she needed to stay alive.

"My family has given up," the woman said over WeChat, a popular messaging platform, while declining to give her name. "All we can do now is wait for her death."

In an update on Weibo last week, the woman wrote that days after waiting at home for help that never came, her mother had died in a hospital emergency room.

Assistant professor Chen said that the Chinese government could have possibly made the crisis worse in Wuhan by suddenly imposing a security cordon.

"The decision to lock down was hasty and did not allow for sufficient time to think about how long medical resources and resources in general may last," he said in an email.

The government has acknowledged the problem.

Last month, the Wuhan health commission said it would open six hospitals specifically for treating patients with illnesses other than the virus.

The National Health Commission has also ordered hospitals to begin normalising operations, and some hospitals in Shanghai and Guangzhou announced that they were re-opening their outpatient clinics this week.

But for many patients in Hubei province - where Wuhan is its provincial capital - just getting to a hospital has been a challenge. Cities there are on a strict lockdown and public transportation has been suspended.

Since the lockdown began in late January, patients seeking treatment in Wuhan have been forced to walk for several hours. People with severe and chronic diseases have found themselves cut off from vital supplies of medicine because of the lockdown, including more than 400,000 patients in Wuhan, according to China's official Xinhua news agency.

A survey of HIV-positive people in China conducted last month found that nearly one-third were at risk of running out of their antiretroviral treatment in the coming days because of lockdowns and restrictions on movement, according to a United Nations agency that combats Aids.

One 27-year-old man with HIV who was visiting his family in the city of Huanggang, in Hubei, for the Chinese New Year holiday, had brought antiretroviral drugs to last him only two weeks.

When the government abruptly imposed the lockdown, he started to panic. Finally, he found a volunteer who helped to deliver a supply of medicine from a hospital.

"Oh my god, it was like a welcome rain after a long drought, like coming back from death's door," he said in an interview. He spoke on condition of anonymity because of the stigma attached to the virus.

Some patients are finding themselves in a bureaucratic mess as they are bounced between hospitals and Covid-19 testing facilities.

Last month, Mr Liao Jiahao, 23, went to a hospital in the southern Chinese city of Guangzhou hoping to get surgery for a detached retina which, if left untreated, could result in blindness. But doctors said he could not be treated until he tested negative for Covid-19.

The second hospital he was referred to refused to test him for the virus because he was not showing any symptoms.

Finally, a doctor at a third hospital agreed to do the test. But days after Mr Liao submitted the results to the first hospital, he learned that his case had been dropped. Calls for help to the police and to a local government hotline went nowhere.

It has been nearly two weeks since Mr Liao first sought help from doctors. With each passing day, his vision had become increasingly blurred, said his girlfriend Liang Wanying.

"We are so lost," Ms Liang said. "There are just no resources left for patients who don't have the coronavirus."

In recent weeks, networks of volunteers within China and abroad have emerged in response to the many non-Covid-19 patients pleading for help online.

In self-organised groups on WeChat, the volunteers work together to gather information about patients and hospitals. Some reach out to community workers, local government offices and hospitals on behalf of patients; others serve as liaisons between families and reporters.

"Sometimes we can't help as much as we would like," said Ms Pu Yan, a writer who has been volunteering from her home in California. "A lot of patients weren't able to get admitted to hospitals in a timely manner, so the optimal window for treatment had already passed."

The sick and their relatives often speak with a tone of resignation that comes from the knowledge that their suffering is not unique - that even those with the virus have had difficulty getting treatment at hospitals.

Stuck in Wuhan, Fu Haoran, the little boy with leukemia, could rely only on a fast-dwindling supply of oral medicine.

Two weeks ago, the family was relieved to hear that the hospital could take him for another round of chemotherapy.

Two days later, the family was back in their rented apartment, wondering when the next opportunity for treatment would come along.

"Right now, all I'm worried about is whether the cancer will come back," said the boy's father. "If it does, I really don't know what I'll do. Maybe I'll just give up."