Heroes of the Fight Against Covid-19
Hero is a weighty word, but one that has truly become familiar to every Chinese person in the great battle against Covid-19. Zhong Nanshan, Zhang Boli, Zhang Dingyu, and Chen Wei are the outstanding representatives of China's heroes. Standing up at a time of crisis, they risked their lives to fight the epidemic, manifesting the determination of the 1.4 billion Chinese people to come together and bravely push forward.
Zhong Nanshan: doctor, spokesman, and selfless fighter
Amidst the darkness and devastation of the epidemic, he was a shining light.
Zhong Nanshan, a leading figure in the field of respiratory disease research in China, bravely took on the challenge, contributing both his medical expertise and his voice. During both the SARS and Covid-19 epidemics, he made enormous contributions to response efforts. The containment strategies and control measures he introduced have saved countless lives.
From SARS to Covid-19, whenever a serious threat has put lives at stake, Zhong has been there.
It was the evening of January 18, 2020, and the travel rush for Chinese New Year was in full swing. All of the high-speed train tickets from Guangzhou to Wuhan were sold out, but after a fair bit of trouble, the elderly Zhong was able to get a standing-room ticket and hurriedly boarded train number G1022 bound for Wuhan. After mercifully finding a seat in the train's dining car, he mulled over all of the news he had heard recently from his students and other sources. As the head of a national team of high-level medical and epidemic control experts, he felt a growing sense of apprehension as the train drew closer to Wuhan.
Dr. Zhong Nanshan, recipient of the Medal of the Republic XINHUA
With a critical mission on his shoulders, the gray-haired and stern-faced Zhong closed his eyes and lay back in his seat with a look of utter exhaustion. This epidemic was both similar to and different from SARS, and at that moment, no one knew how dangerous this novel corona-virus was. The stress that he felt was out of concern for the lives of the patients.
In December 2019 in Wuhan, Hubei Province, hospitals were receiving a continuous stream of patients. Their symptoms were all basically the same, with fever, dry cough, and fatigue at first, and then respiratory distress as the condition worsened.
Since it was right in the midst of flu season, medical workers didn't want to take any chances, and collected samples that were sent for testing. By then, the diabolical virus had already started to spread through this megalopolis of more than 10 million. In this complicated and confusing situation, the information that people had was often incomplete, and experts were bogged down in debate and uncertainty.
Finding the source of the pathogen was only the first step. Figuring out how the virus was transmitted and its level of contagiousness was a gradual process of piecing together information, as well as a bitter struggle between man and disease. What kind of risk were we actually facing, and how should it be dealt with?
On January 7, 2020, the Chinese Center for Disease Control and Prevention isolated the novel coronavirus for the first time, and on January 9, an expert assessment committee of the National Health Commission (NHC) announced that the pathogen had been preliminarily identified as a novel coronavirus.
On this unusual battlefield, which was without gun smoke but nevertheless filled with the fog of uncertainty, a group of Chinese experts in viral etiology, prevention and control of contagious diseases, and clinical treatment of infectious diseases stepped bravely into the breach.
Zhong and other members were urgently called together by the NHC and formed into a national high-level expert team. Together with work groups that had been dispatched to the front earlier on, they assessed the state of the epidemic and provided advice to the central authorities in decision-making.
On January 19, Zhong had a tight schedule: after attending a meeting to discuss the epidemic in the morning, he immediately proceeded to Jinyintan Hospital and the Center for Disease Control and Prevention in Wuhan in order to get a sense of the situation on the ground. With no time to have a short rest at noon, he was in meetings until 5 PM, after which he boarded a plane to Beijing. Upon arrival, he and his colleagues immediately rushed to the NHC for a meeting. He then went back to the hotel, and was finally able to rest by about 2 AM.
While visiting Jinyintan Hospital and the Center for Disease Control and Prevention in Wuhan that day, Zhong did not let a single detail or concern slip past, and asked questions constantly: "How many cases were confirmed yesterday? And the day before that?"; "What is the illness like? How is it being treated? Are there actually more cases?"; "Have any medical workers been infected?" and so on and so forth.
He and the experts travelling with him became more and more convinced of this heavy yet unavoidable conclusion: the novel coronavirus showed person-to-person transmission, thus meeting the threshold of an acute infectious disease.
With the epidemic spreading like wildfire as vast numbers of people were travelling for traditional Chinese New Year, if decisive measures were not taken, the consequences would be unimaginable.
On January 20, the fight against the epidemic took a fundamental turn. On that day, President Xi Jinping issued important instructions on the pneumonia caused by novel corona-virus, stressing that the health and safety of the people should be the top priority and calling for resolute efforts to curb the spread of the virus. In the afternoon, the NHC organized a press conference with its high-level expert team. With a stern expression on his face, team leader Zhong Nanshan said, "We can now say with certainty that there is person-to-person transmission." Speaking in a succinct yet forceful manner, he continued, "From the epidemiological perspective, we are just at the beginning. Yesterday, we confirmed that person-to-person transmission has emerged, and that medical workers have been infected, which is an extremely important sign." He also added, "New year travel is a key element. The advice of our expert team is to avoid non-essential travel to and from Wuhan."
That night, Zhong delivered an urgent address to the public via live television broadcast, again confirming that there was person-to-person transmission. As if an alarm bell had rung out, the general public quickly started to become aware of the novel corona-virus epidemic.
With no time to stop and catch his breath, Zhong rushed back and forth between Wuhan, Beijing, and Guangzhou. He even refused to take a break on the eve of Chinese New Year. He knew that the only way to beat the epidemic was to understand it, and to adopt a science-based response. He asserted, "We must focus on two key points: detecting and quarantining cases as early as possible. This is the most effective approach to epidemic prevention and control." He recommended, "Outflows of people from Wuhan must be reduced. Strict monitoring measures, including temperature checks first and foremost, must be implemented at transport hubs like train stations and the airport." And he repeatedly pointed out, "Since there are no effective drugs at present, wearing a mask is very important."
In the early hours of January 23, the day before Chinese New Year"s eve, the epidemic response headquarters in Wuhan issued a No. 1 public notice closing routes out of the city in order to prevent the virus from spreading to the rest of the country.
After that, 30 provinces launched Level 1 Public Health Emergency Response, formulated and implemented community prevention and control measures, and put into effect grid-based blanket management.
In this time of crisis, experts demonstrated their courage and sense of duty. On the afternoon of January 29, Zhong consulted via video with a team of medical specialists sent from Guangdong to assist Wuhan on five critically ill patients. The consultations went on for six hours and eighteen minutes. On another occasion, he went for more than 30 hours without sleep as he attended lectures and different activities for guiding the epidemic response. Together with his team, he conducted 24 international online conferences, discussing experiences with experts in scientific research and clinical medicine from 13 countries and providing suggestions for the global fight against the coronavirus.
Doctors have to try and save every patient; they do not give up lightly. In the beginning of February, Mr. Liu, a 62-year-old coronavirus patient, was transferred to the intensive care unit (ICU) at the First Affiliated Hospital of Guangzhou Medical University. His condition had already worsened, progressing to acute respiratory distress syndrome. On February 9, the treatment team decided to put him on extracorporeal membrane oxygenation (ECMO).
Under Zhong's personal guidance, the hospital's ICU team put everything they had into treating Mr. Liu. After a touch and go fight to stop bleeding and prevent clotting, Mr. Liu ultimately recovered and was discharged from the hospital on August 27. He currently holds the world record as the coronavirus patient that spent the longest period of time on ECMO, at 111 days. Swelling with emotion, Zhong said, "Even if it seems certain that a patient is lost, we must still do everything we can to save them."
From the fight against SARS in 2003 to the battle with H1N1 in 2009, Zhong has time and time again helped soothe the fears of the public, and demonstrated his sense of duty as a scientist through his tireless efforts. Hanging on his wall at home is a piece of calligraphy that reads "Courage to treat, courage to speak." These words perfectly encapsulate his strength of character. After he was awarded the Medal of the Republic, the 84-year-old doctor remained committed to his mission, saying, "I will continue to devote myself to the prevention and control of respiratory diseases and public health emergencies, and not let down the trust that the nation has placed in me."
Zhang Boli: countering the epidemic with traditional knowledge
After soaking for 30 minutes, heaps of carefully measured herbal medicines were poured into enormous pots. An hour later, steam billowed from more than a hundred preparation machines, and the workshop was filled with a strong herbal smell. As soon as they were finished and poured out of the pots, the liquid medicine was quickly sealed and packaged, and then sent off to various temporary hospitals, medical institutions, and residential communities in Wuhan.
This scene of Chinese-style epidemic control fusing elements of the ancient and the modern drew worldwide attention, and brought Zhang Boli, who was the first to advocate using traditional Chinese medicine (TCM) to control the epidemic, into public view. Appearing before the camera lens with his firm gaze framed by rectangular glasses and thick eyebrows, Zhang always projected a calm and steady presence. At his instruction, TCM was incorporated into every aspect of coronavirus treatment, while methods combining Chinese and Western medical approaches that were researched and formulated under his charge became the highlight of China's treatment protocols and contributed greatly to the preservation, innovation, and development of TCM.
Dr. Zhang Boli, recipient of the national honorary title "People's Hero" XINHUA
However, there were skeptics who questioned whether TCM was just painting with a broad brush by having tens of thousands of people drink the same preparation of Chinese medicine. To them Zhang responded, "This fight will prove to you that this centuries-old treatment strategy works!" The source of his confidence was the traditional practice of differential diagnosis, supercharged with a modern approach. He explained, "For newly emerging epidemic diseases, what TCM focuses on is the reactions that occur after the virus enters the body, and doctors make a differential diagnosis on this basis."
Before getting on a plane to Wuhan, the 72-year-old doctor directed his team in urgently putting together a mobile survey application on the novel coronavirus pneumonia syndrome. Once off the plane, he managed to procure a hundred cellphones, which were loaded with the app. The phones were then distributed to doctors in hospital wards, who were asked to take pictures of patients' tongues and record observations of symptoms.
A week later, symptomological findings for more than 1,000 confirmed patients were received from 20 different hospitals. After this information was processed through big data analytics, a picture of how the condition developed gradually came into view, and it was quickly agreed that this disease demonstrated the core characteristics of a "damp toxin." Zhang explained, "As long as the syndrome does not change in substance, we can cope with a shifting situation through a fixed approach. We now have a rudimentary grasp of how to diagnose, treat, and rehabilitate patients."
His confidence was further inspired by TCM's tried and tested yet innovative approach to treatment. During the SARS epidemic, Zhang was sought by a friend of his who had caught the virus and wanted to try treatment with Chinese medicine. The prescription that he prepared delivered immediate results. This experience compelled him to submit a request to establish two independent "red zones" in which Chinese medicine would be used in conjunction with Western medicine. "TCM may be an ancient discipline, but its ideas and methods are by no means out of touch." Zhang firmly believes that many difficulties and challenges encountered in modern life sciences can be addressed by looking to TCM for inspiration.
Drawing upon the entire body of TCM knowledge, he went on the offensive against the coronavirus epidemic. At the Jiangxia temporary hospital, he put comprehensive TCM treatment into effect: apart from preparations of medicine that were given to patients to drink, tai chi and baduanjin exercises, acupuncture, massage, and topical therapy were incorporated into treatment. This philosophy was spread to other temporary hospitals and effectively lowered the rate of progression to serious illness, thus contributing enormously to epidemic control and science-based treatment.
Noting the strengths of Chinese medicine in patient rehabilitation, Zhang set up a rehabilitation clinic at the Wuhan Hospital of Traditional Chinese Medicine. He made arrangements for the composition of a guide on a combined Chinese and Western approach to coronavirus rehabilitation, and also set up a platform for the rehabilitation of Wuhan medical workers.
As he worked to find an effective prescription to fight the disease, he screened tens of thousands of medicinal ingredients to f ind ones that were effective, and led his team in developing concentrated medicine granules that were incorporated in national diagnosis and treatment protocols.
At the beginning of the outbreak, some derided treatment with Chinese medicine as a mere placebo to assuage the public. Unperturbed, Zhang took to TV to respond, saying "Chinese medicine has not only had a therapeutic effect, it has also been of benefit psychologically, because I believe that the biggest problem is not treatment, but rather fear."
When the epidemic situation was at an impasse, this veteran doctor of TCM donned his protective suit inscribed with words of encouragement from his colleagues and made his rounds in the wards, checking the tongues and pulses of patients and drawing up prescriptions for their symptoms. For a time, he only slept two or three hours a day.
As he worked day and night at high intensity, his gallbladder suddenly flared up, requiring immediate surgery. Without telling his family, he signed the consent for operation himself. He wanted to keep his condition secret from the outside world for fear of impacting morale, so when he had a video conference the day after his surgery, he draped his coat over his inward-patient gown, pulled up the collar, and sat for a full four hours on a wooden chair in the corner of the hospital room.
Large-scale use of Chinese medicine markedly reduced the rate of illness among four vulnerable categories of people. Over 90% of positive patients took Chinese medicine, while its clinical efficacy was also above 90%.
To Zhang, receiving the title of "People's Hero" from the Party and the state was an incredible honor, but one that for him is ultimately inconsequential. In his words, "I am supremely honored to receive this title as a credit to all the medical workers and TCM practitioners, but speaking for myself, I must now put this award away and continue to do the work that any ordinary doctor should."
He has returned to a quiet and low-profile life as of late, but he has not laid down the torch of TCM.
Zhang Dingyu: standing firm in the eye of the storm
As soon as the fight against the epidemic began, Jinyintan Hospital in Wuhan became like a lonely boat caught in a violent tempest. The hospital's president Zhang Dingyu, who suffers from amyotrophic lateral sclerosis (ALS), told his subordinates, "We are now in the eye of the storm. We must defend our city, and defend the people of Wuhan."
Despite his illness, Zhang Dingyu took to the front lines without hesitation, helping patients and saving lives. He thus made an extraordinary contribution to victory in the fight to defend Hubei and its capital city of Wuhan.
Dr. Zhang Dingyu, recipient of the national honorary title "People's Hero" XINHUA
On the evening of December 27, 2019, Zhang was still in his office, as usual. Since it was nearing the end of the year, and the season brought heightened incidence of respiratory diseases and common contagious illnesses, he had invited Huang Chaolin, the hospital's deputy president, for a chat. Just when the two doctors had begun their conversation, the phone rang with a call from a specialist at Wuhan's Tongji Hospital. Speaking in an urgent tone, he said that they had a patient with pneumonia of unknown cause and ground-glass opacity in the lungs. They suspected that it was a novel infectious disease. These words sent a shiver down Zhang's spine. His hospital was the only one in Wuhan specializing in infectious diseases, and under the law, patients with infectious diseases were supposed to be brought together at designated institutions for treatment. Zhang spoke firmly into the phone: "Get ready, I will notify the doctors on call to drive over and pick up the patient."
Soon after, there was another call, saying that the patient was unwilling to be transferred – the words "infectious disease" are always dreaded by some. But a few hours later, the results of preliminary genetic analysis showed that the cause of the illness was a coronavirus similar to SARS.
The virus emerged from the shadows and began its assault. At the end of December, Zhang received a message that several patients with unusual fevers had been discovered at the Hubei Provincial Hospital of Integrated Chinese and Western Medicine, and had described symptoms similar to the patient at Tong ji Hospital. He immediately made arrangements for his colleague Huang to go there with a consulting team, and also stressed that level two protective equipment should be used, dispatching special ambulances with negative pressure systems. Lastly, with a serious expression, he ordered that each patient be picked up and dropped off individually with a limit of one per vehicle, no matter the inconvenience. Thus, with great care, patients were brought to the ICU at Jinyintan Hospital one after the other until about midnight.
From that moment, Zhang became immersed in an anti-epidemic battle that was unprecedented in the history of the PRC. Every day, he rushed around the bustling hospital with the gait typical in sufferers of ALS, leading hospital officials and workers in saving more than 2,800 patients, including many that were in severe or critical condition. During the initial epidemiological investigation, he was the first to send in samples collected through a procedure called bronchoalveolar lavage for testing, thus helping to get a head start in identifying the pathogen. In addition, the more than 240 CPC members at his hospital displayed remarkable determination and bravery, with every single one of them sticking to their posts despite great risk and grave danger.
The facts prove that the exemplary steps taken at Jinyintan, including swiftly isolating patients, opening a dedicated ward, conducting thorough cleaning and disinfection, and rapidly allocating equipment, supplies, and personnel prevented a large-scale outbreak within the hospital, and enabled it to remain one of the main battle-grounds in Wuhan for saving patients in critical condition.
Zhang, with his rugged features and striking eyebrows, soon came under the national spotlight, and it was only thus that the public learned of the desperate and bitter struggle that he was going through. He never openly mentioned that he suffered from ALS, an extremely rare condition that will ultimately cut his life short, nor did he say anything when his wife was being treated for the virus at another hospital and it was uncertain if she would pull through. As he put it, "I don't have long left to live. I have to move quickly so that I can beat the clock and finish the important things before time runs out." There have been many highlights over his 33-year-long medical career: he went on an aid mission to Algeria as part of a Chinese medical team; after the Wenchuan earthquake in 2008, he led a medical team from Hubei Province which was based in the city of Shifang within the disaster area; and he was Hubei's first "doctor without borders," having once saved a pregnant women who had lost a dangerous amount of blood at a hospital in northwestern Pakistan.
Now serving as deputy director-general of the Hubei Provincial Health Commission, as well as president of Jinyintan Hospital, Zhang still insists upon working at the hospital every day, and is driven by the same mantra: "I want to do more."
Chen Wei: battling at close quarters with the deadly virus
For 113 days, Chen Wei held fast in Wuhan. Over those few short months, her black hair had become dusted with grey, a memento from so many days and nights without rest.
As head of the Institute of Bioengineering at the Academy of Military Medical Sciences, Chen has been researching the prevention and control of biological hazards for many years. After the novel coronavirus outbreak began, she immediately sprang to action, achieving major breakthroughs in basic research and the development of vaccines and drugs that contributed greatly to epidemic prevention and control.
On January 26, the second day of Chinese New Year, the call to muster was sent out. In accordance with her orders, Chen led a team of military medical experts that immediately flew to Wuhan. Since this was a totally new virus and the risks were unknown, it was crucial to plan for the worst, make the fullest possible preparations, and get ready for a potentially long fight.
At the beginning of the outbreak, there was a period of time in which testing capacity had difficulty keeping up, and gaps needed to be filled as quickly as possible.
Working around the clock, Chen and her team swiftly set up a tent-style mobile laboratory. Using independently developed testing kits, they soon had the ability to test 1,000 people per day, thus mitigating the pressure on frontline testing.
Understanding how the novel virus actually infected people was essential for effectively curbing its spread. Without even a moment of respite, Chen threw herself into the battle. The novel coronavirus was still full of unknowns, and if the push to produce a vaccine was even the least bit off the mark, it would mean wasting limited resources and precious time.
Dr. Chen Wei, recipient of the national honorary title "People's Hero" XINHUA
Taking on this heavy responsibility, Chen decided to focus on the development of a genetically engineered vaccine, saying, "Even though we face an unknown virus, with all the knowledge we have accumulated over recent decades, we have the ability to study it and defend against it." Days turned into weeks, but the lights of the laboratory always stayed on through the night as ideas from different disciplines including etiology, immunology, and genetics bounced back and forth and collided. Though at the time it seemed that there was no light at the end of this long and dark tunnel, Chen firmly believed in the power of science. Despite countless failed experiments, she was determined to keep trying. Even when vaccine development was at its most dire stage, she kept the faith and said "success is our only option." Finally, after days of waiting, blood samples came back showing an immune response, and a huge weight was lifted.
On March 16, their recombinant adeno-virus vaccine began phase I clinical trials, becoming the first novel coronavirus vaccine to enter clinical trials. On April 12, the vaccine marked another world first as it went into phase II trials. Clinical data showed that a single injection could achieve both humoral and cellular immunity in tissue, and these findings were published in the internationally renowned medical journal The Lancet. On August 11, the vaccine was granted a Chinese invention patent. In the meantime, phase III clinical trials are currently underway in other countries. Through countless challenges, successes, and failures, Chen carried on without giving any thought to the mortal danger that she faced. This was her choice, and a reflection of her sense of duty.
In 1991, Chen was recruited into the military. She earned doctorates in biology and medicine from the Academy of Military Medical Sciences, where she was subsequently assigned after graduation. From then on, dressed in her military uniform, she began the dangerous dance of her work with viruses. When SARS hit in 2003, the public was paralyzed with fear. At that time of crisis, Chen received orders to conduct research on the cause of the disease and a potential vaccine. Shutting herself in the lab, she and her team worked day in, day out. They were the first in China to isolate the SARS virus, and later proved that a type of interferon had a suppressive effect on the virus. By the time the interferon had been delivered into the hands of medical workers across the country, Chen had not been home for around 100 days, even though she lived just a few kilometers away from the laboratory.
Hers is a kind of conviction that is hard to put into words. Because she is so busy, she has not been able to go back to her hometown to visit relatives for more than 20 years. Because she was so busy, her young son who missed her dearly jumped up when he saw her appear on television so that he could give mom a kiss. After the Wenchuan earthquake in 2008, she immediately went to the affected area where she took part in post-disaster disease prevention and treatment efforts. During the Beijing Olympics, she worked nonstop on safety measures and successfully dealt with multiple suspected biosecurity threats. In 2014, during the Ebola outbreak in Africa, she decided to travel to the epidemic zone in order to gather new information and first-hand data. It was thanks to her willingness to face challenges head on and work without complaint, time and time again, that a vaccine was successfully developed and earned approval.
Some have asked her whether she feels afraid coming face to face with deadly viruses every day, to which she responds: "The uniform I wear means that this is my duty."
In an effort to gather more scientific data and see that the vaccine is available to more people as early as possible, she has made follow-up visits with the first batch of volunteers that were vaccinated in Wuhan to analyze the durability of their antibodies. Meanwhile, she has led the formation of an innovative national team for the prevention and control of biohazards, and the key facilities and technical systems they are setting up are laying the groundwork for responding to major epidemics that may emerge in the future.
In April 2020, more than 80,000 primary and middle school students in Chen Wei's hometown of Lanxi, Zhejiang Province received a letter from her before they resumed classes. It said, "If you are compassionate to others, you can make your world even more wonderful and meaningful."
The reporters are with Xinhua News Agency.
(Originally appeared in Qiushi Journal, Chinese edition, No. 23, 2020)