WUHAN (CAIXIN GLOBAL) - The following is Caixin's interview with Dr Li Wenliang on Jan 30, discussing his whistle-blowing and personal health. Dr Li, who was only 34, was punished by police for trying to warn the world of the emergence of the new strain of coronavirus. He died on Friday (Feb 7) from the disease.
Caixin: How do you feel now?
Li Wenliang: I am receiving treatment at the intensive care unit (ICU) for my critical respiratory illness. It is an isolation ward for four but only has two in the room now. I can have contact with the outside through a cellphone. There are doctors and nurses taking care of me. Today (Jan 30), I heard that my RNA test has turned negative, but it is only the result for a throat swab but not the alveoli. The recovery of my lung function will still take time. I still feel difficulty breathing and need oxygen. I don't have any appetite.
Can you tell us more about the warning you sent regarding the disease? What happened at that time?
I sent the message to a group of 150 former classmates and emphasised that the message should not be spread beyond the group. I wanted to remind my schoolmates who work on the front lines to protect themselves. I knew of the matter through my discussion with colleagues and was concerned that there would be an outbreak, although the confirmed cases were still small at that time. I felt that way because the virus looked quite similar to severe acute respiratory syndrome (Sars).
Do you mean the virus can be passed from human to human like Sars?
There is obvious human-to-human transmission. I saw patients infected by the virus around Jan 8. One of our patients who was hospitalised for glaucoma had a weak appetite but normal body temperature. We didn't realise anything was wrong at that time. But she still had a weak appetite after her eyes had healed and had a fever. A CT scan showed a lung infection, but all her other indicators were consistent with what was known about the mysterious pneumonia at that time.
The same day she got a fever, her family members also had a fever, indicating human-to-human transmission. We reported the case to the hospital and invited senior doctors at the hospital to examine her case. They suggested putting her in quarantine. Three days later, a CT scan showed her infection had spread and she was transferred to the respiratory isolation ward. I don't know what happened to her after that.
If there were signs of human-to-human transmission, why was the number of confirmed cases so small at that time?
I think there were difficulties diagnosing the disease at that time. Test kits were not available. Although the virus can be tested for by an RNA test, it is complicated and time consuming. The team of senior doctors at our hospital had a difficult time deciding whether an RNA test should be conducted for the glaucoma patient.
Is your infection related to the patient?
At first I didn't take any protective measures. After the patient was transferred, I started coughing and had a fever the next day. After that I started wearing an N95 mask. On Jan. 12, I had a test for respiratory viruses and a CT scan. The results were highly suspicious for a coronavirus infection. My colleagues showed similar symptoms later and my parents also fell sick three or four days later. My condition deteriorated and now I need antibiotic, antiviral and globulin injections and extra oxygen every day.
Do you pay for the treatments?
I pay for immunoglobulin injections myself. There are also gifts from drug stores and my schoolmates. I've received between 50,000 yuan (S$9,930) and 60,000 yuan. I am not sure whether the costs are covered by insurance.
How did you feel when your warning got out to the public?
That night, I received some WeChat messages asking me about the matter with screenshots of my earlier messages. Most of the screenshots were incomplete. After mentioning that there were seven confirmed Sars-like cases, I emphasised that it was some type of coronavirus that still needed confirmation. But that was not included in the screenshots that were widely spread online. I thought I could get in trouble because it was sensitive information and it was during a sensitive time when the city was having its annual meeting of legislators. At first I was angry at the people who spread the messages without hiding my identity. But later I understood that they were too worried about their families and friends when they distributed the message.
Were you punished for that?
After the night when the messages went viral, Wuhan's municipal health commission convened a meeting at about 1.30am. I was called by our hospital to explain the matter. In the morning when I got to the office, disciplinary officials at our hospital talked to me again, asking about the source of the information and whether I realised I had made a mistake.
I never thought the police would pursue me. On Jan 3, they called me to sign a letter of admonishment. I had never had trouble with the police before and was worried. So I went and signed without telling my family. I was worried that it might lead to punishment by the hospital and affect my career. Later, one of my schoolmates heard about the matter and introduced me to a reporter.
Police first announced a punishment on Jan 1 saying they made inquiries into eight people for spreading rumours. But you were summoned on Jan 3. Does that mean you were not among those eight?
I am not clear about this. What you said is possible. But now my only hope is recovery.
In their admonishment letter, the police said you posted false statements online. At that time, some people thought you were spreading rumours. What did you think about that?
I don't think it was a rumour, because the test report clearly stated that it was Sars. I just wanted to warn my former classmates not to panic.
(Editor's note: In his WeChat group chat, Dr Li also uploaded a test report, stating the patient's clinical pathogen screening results showed a "high level of confidence" in indicators including the Sars coronavirus, pseudomonas aeruginosa, 46 types of oral/respiratory colonising bacteria)
Since you don't think it was a rumour, have you ever thought about whether you would pursue legal means to clear your name?
No. I'm afraid a legal approach would be troublesome. I don't want to cause trouble with the police. I'm afraid of trouble. It is more important for people to know the truth. To clear my name is not that important to me. Justice lies in people's hearts. Some people said my doctor's licence was revoked. That's not true. I want to clarify that.
On Jan 28, China's Supreme People's Court published a commentary on its official WeChat account on whether the punishment of the eight Wuhan "rumourmongers" was appropriate. You were probably not one of those eight. What did you think when you read that article?
After reading the Supreme Court's article, I felt a lot of relief and didn't worry too much about how my hospital would deal with me. I believe there should be more than one voice in a healthy society. I don't agree with the use of public power to overly interfere. I also agree with the Supreme Court's article that each case should be treated separately. I don't care too much (about whether I am one of the eight), as the post most widely circulated online and cited in the Supreme Court's article was a screenshot of my original post.
On Jan 29, the Wuhan police responded to the Supreme Court's opinion on the punishment on the eight "rumourmongers". There was no mention of your admonition. What do you think about that?
I can only read the police's response. I can't comment on it. There's no point doing that now. I'm not sure myself whether I'm one of the eight.
Some people are calling you the "alert giver" and "whistle-blower." What do you think about that?
I don't deserve this designation. I was just aware of the information and warned my classmates. I didn't think that much at the time.
What do you plan to do next?
After I recover, I still want to go back to the front line. Now the epidemic is still spreading. I don't want to be a deserter.
How is your family?
My wife is at her parents' home in another city. She can't come back because Wuhan is locked down. My parents should be able to be discharged from the hospital soon, but I can't find anyone to help them. They are usually in good health and should be able to take care of themselves afterwards. They sounded fine when I talked with them by phone and can move around by themselves.
This story was originally published by Caixin Global.