’I want to live’: China’s workers struggle amid virus shutdown

Chinese in informal work are struggling to make ends meet as coronavirus empties streets and shuts down businesses.

Photo: People in China are staying at home because of the coronavirus, leaving streets and public transport almost empty and creating serious problems for the country’s legions of low-paid workers [Carlos Garcia Rawlins/Reuters]

Beijing, China - On Tuesday morning, Lanying Guo began work at her small dumpling restaurant in a Beijing alleyway - just as she had for the previous seven days.

With people advised to stay indoors to minimise the spread of the coronavirus, Guo had earned a pittance the previous week. But she was hoping for more customers on Tuesday as more people were supposed to be back at work after the Lunar New Year holiday.

But the alley remained eerily quiet.

To control the transmission of the virus, municipal officials in Beijing extended the Lunar New Year holiday and told employees to work from home, as was the case in many other Chinese provinces and municipalities.

“In order to further ensure the containment of the novel coronavirus outbreak, all employees, excluding essential personnel supporting the government services, are expected to return to work on February 10^th,” the statement from the Beijing municipality government read.

But that meant hardly any customers for Guo.

“I haven’t really earned any money for almost two weeks now, and I don’t know how long I can last,” she said as she wept. “I want to live.”

Guo is in the last stage of kidney failure and has been on dialysis for four years. A divorcee without any children, she has to be entirely self-sufficient - but she still needs to go to hospital three days a week for treatment. Without daily earnings to pay for her doctor’s visits, she would not live long.

’They see us as viruses’

The coronavirus is expected to take a substantial toll on China’s economy, but for low-income, informal workers such as Guo, the loss of income can be far more devastating.

According to the International Labour Organization (ILO), 54.5 percent of Chinese workers such as couriers and construction workers are employed in informal sectors. Others are self-employed. Without a stable income or contractual insurance, these workers are the first to be hit in any economic downturn.

“There is this constant struggle between maximising the effort to contain the outbreak and minimising the economic impact whatever measures we take will have on both the macroeconomy and ordinary people’s lives,” said Shao’an Huang, a professor of economics at China’s Central University of Finance and Economics.

In Jun Xiang’s case, the government’s virus containment efforts affect not just him, but his entire family.

Before the outbreak began, he worked in Wuhan as a construction worker but returned to his hometown in Hunan province for the Lunar New Year. Then Wuhan was sealed off. Now he worries about finding enough money to feed his family and keeping his daughter in school.

“I helped building the Wuhan’s Greenland Centre,” Xiang said proudly over the phone, referring to an as-yet-unfinished skyscraper in Wuhan. Construction workers normally get paid by the hour or by the day. If they do not work, they are not paid.

China dumpling

“Honestly, if I could go back, I would, because my daughter needs to go to school,” he said, sighing. “Nobody would hire me here in Hunan, either. They all see us as viruses.”

Xiang is the family’s sole breadwinner. If he remains stuck in Hunan without being able to find work, his whole family would starve, he said.

Subsidy proposal

Guo and Xiang are just two among the hundreds of millions of people who live on the economic margins in China.

Analysts have proposed that the authorities subsidise low-income groups and provide sweeteners for people to stay at home as the lockdown continues.

“The government should ensure low-income groups and jobless people enjoy a stable level of livelihood without being impacted by the outbreak,” said Hongze Ren, director of Tsinghua University’s Hengda Economy Research Institute. “It’s also the government’s responsibility to prepare for the possible social instability as a result of the economic hardships.”

According to the latest data released by China’s Bureau of Statistics, the average annual disposable income among all people in China was 22,832 Yuan ($3,262) in 2019, but more than 60 percent of the population has less than that.

Ren said no matter how the government planned to mitigate the harm done to susceptible groups, it needed to act fast. “As the policies are being debated, people’s lives don’t get put on pause,” he said.

As the number of people in China affected by the coronavirus continues to rise, workers such as Guo or Xiang might find it hard to obey government edicts to stay home.

“People say that I am irresponsible if I don’t stay at home, I get it,” Guo said, as she recounted the gossip she had heard from her neighbours.

“But maybe they don’t understand what money means to me - it means life.”

Shawn Yuan

• AL JAZEERA NEWS. 6 Feb 2020:
https://www.aljazeera.com/news/2020/02/live-china-workers-struggle-virus-shutdown-200205072512702.html

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 Wuhan turns to social media to vent anger at coronavirus response

Residents of virus-hit city accuse government of withholding information and downplaying severity of viral outbreak.

The 52-year-old cleaner said his hospital was overwhelmed by the sheer number of people seeking medical care, with doctors and nurses overworked and supplies running low.

Since the new virus was first detected in Wuhan in late December, nearly 400 people have died and more than 17,000 others infected - the vast majority of deaths and infections have occurred in Hubei province, of which Wuhan is the capital. The rapidly spreading virus has stretched the healthcare systems in Hubei, with some medical personnel saying China’s government was completely unprepared for the outbreak and describing its response as chaotic.

But when Jianguo turned on his television on January 28, he was greeted by television anchors hailing the government’s “transparent and swift” response and videos of Wuhan residents joyfully expressing faith in the Chinese Communist Party to contain the virus.

Speaking to Al Jazeera on the telephone, Jianguo, who preferred to give one name, said he immediately contacted his son, an avid user of the Chinese micro-blogging site, Weibo.

“Are you seeing the news? Are they serious?” he recalled telling his son. “Doctors and nurses at my hospital are so exhausted that they are on the edge of breaking down. And those people who look so happy on camera - are they living in a different universe?”

[Video not reproduced here: The Listening Post: China: Covering the Coronavirus Contagion (23:42)]

Jianguo’s son immediately posted a message on his Weibo account, along with a picture from the hospital of doctors and nurses sleeping on chairs in apparent exhaustion. “I don’t care what CCTV is saying,” he wrote, referring to Chinese state television. “But the situation in Wuhan is still dire.”

The picture, which was quickly shared and liked by thousands of Weibo users, is just one among many posted on Chinese social media in recent days, challenging the official narrative offered by the heavily-censored state-media

China has tightly controlled the coverage of the outbreak, according to Human Rights Watch, which on January 30 accused Chinese authorities of withholding information from the public, under-reporting cases of infection and downplaying the severity of the infection. The New York-based rights group said Chinese police have harassed people on allegations of “spreading rumours” about the outbreak, including the detention of a doctor who had warned colleagues that the new virus was similar to Severe Acute Respiratory Syndrome (SARS), which had killed 349 people and infected 5,300 others in mainland China in 2003.

Indeed, it was only after January 20, when President Xi Jinping issued a statement saying he would curb the spread of the outbreak and called for the release of information in a “timely manner”, that state media started to report on the extent of the crisis. Days later, Wuhan, a city of 11 million, was placed under quarantine and the lockdown was extended to an area of more than 50 million people - measures the World Health Organization (WHO) has praised Chinese authorities for.

But in the days that followed, many Wuhan residents took to social media to criticise the government’s handling of the crisis, with users complaining about what they said was a lack of adequate care at hospitals as well as what they called a delay in informing citizens of the outbreak.

On Wednesday, another Weibo user posted a picture of her grandfather lying in the hallway of a hospital and wrote: “My grandfather has been having a fever for three days now, and no hospital is admitting him! Is the government going to let all of us die like this?!”

[Video not reproduced here: Philippines reports coronavirus death as China toll jumps (2:04)]

On January 22, one user posted an article asking the question: “Why did it take the outbreak so long to attract public attention?”. In response to the article, another user alleged: “The government already knew the existence of human-to-human transmission in early January, but still, news kept telling us there was no such possibility. They also arrested eight people who shared the information initially for spreading rumours. Not until there were over 200 confirmed cases did the government start to respond. Shouldn’t the government be responsible?”

Another young man from the neighbouring city of Huanggang said in a video posted online on January 30: “I might be arrested after posting this video. But I still want all of you to know how dire the situation is in Huanggang, and we are in desperate need of help - the government doesn’t care about us any more!”

That video has since been taken down.

The Chinese authorities closely monitor all information shared on Weibo and other platforms, deleting posts that counter the government narrative and banning users that do so. And so in this context, some observers say the current anger and frustration on Weibo is extraordinary.

China’s more tech-savvy citizens are also turning to platforms blocked in the country, such as Twitter and YouTube, using virtual private network services to get the message out.

“I am not even afraid of death; do you think I’ll be afraid of you - Communist Party?” Qiushi Chen, a well-known lawyer who travelled to Wuhan to report on the outbreak said in a Twitter video that also complained about the lack of medical supplies at hospitals.

Another Wuhan resident, in a video posted on YouTube, described life under lockdown. “It’s like living in hell, waiting for death,” he said.

This and other social media posts not only offer a closer look at what is happening on the ground in Wuhan but also give a human face to the suffering in the city.

For instance, in one article posted on WeChat, one woman described her mother’s death in detail.

“The car that picked up my mother’s corpse drove away, and I was running after it, crying like I never did before,” she wrote. “It was a cold day - I felt despair and hopelessness.”

[Video not reproduced here: : China opens new coronavirus hospital (1:41)]

Amid the apparent frustration in Wuhan, some of China’s privately-owned media have also begun to question the official narrative, publishing stories on the lack of medical supplies and questioning the conduct of the local Red Cross, which has been accused of failing to disburse donations.

Caixin, a widely read news website, even published an interview with the doctor who was questioned for speaking out on the spread of the new virus and another article suggesting the lack of freedom of speech in China had affected the effort to contain the outbreak.

Yet, state-media coverage of the coronavirus remains overwhelmingly positive - there is little mention of the apparent anger in Wuhan and news anchors on state television repeat on an almost hourly basis the message that the “international society has been highly impressed by Chinese government’s fast response and the unprecedented measures to contain the outbreak”.

The state-owned English language Global Times, meanwhile, has focused on measures taken by the Chinese government in addressing the crisis, including the wide-ranging lockdown and the construction of a new hospital in Wuhan within 10 days.

“Some measures which are unbelievable at ordinary times have been quickly implemented and the entire society has been cooperating. A large but orderly situation against the epidemic has been formed,” it said in an article that also slammed the United States’s recent decision to bar travellers from China in a bid to limit the spread of the new virus.

“The pandemic will finally pass. Many people bad-mouthed China during SARS 17 years ago, but what happened after? Nobody should underestimate China’s ability to fight a public health crisis. Since we can take measures that many countries cannot take, we can also quickly recover vitality after the crisis,” the article said.

Shawn Yuan

For the videos and the links, see the original article.

• AL JAZEERA NEWS. 3 Feb 2020:
https://www.aljazeera.com/news/2020/02/wuhan-turns-social-media-vent-anger-coronavirus-response-200203085324619.html

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 Local Red Cross under fire over China coronavirus donation mess

Public has sent medical supplies and money to help Hubei’s front-line medics, but most remains in Red Cross warehouse.

Chongqing, China - The Wuhan Red Cross and Hubei provincial Red Cross have come under fire after donations of crucial medical supplies from across China failed to arrive at the hospitals on the front lines of a coronavirus outbreak that has killed more than 300 people.

Health workers, who are at high risk of infection without effective protection, including masks and suits, have been appealing for more supplies for days.

“The entire country has been mobilised to donate - why are doctors still not getting enough supplies?” read a reply to a doctor from Wuhan Union Hospital - one of the seven hospitals designated to treat coronavirus - who wrote on social media on Thursday that the hospital was out of supplies.

As more people scrambled to find ways to get much-needed masks and protective suits to hospitals, a report on donations and deliveries from Hubei’s Red Cross - the first since the beginning of the outbreak - showed that of two million masks donated from across China, the local Red Cross had delivered 200,000 to hospitals.

The masks had also been sent to hospitals that did not really need them.

Medical supplies donated from the coastal province of Jiangsu arrive at a hospital in Wuhan. The local Red Cross has come under fire for being slow to distribute much-needed masks and protective suits [Yuan Zheng/EPA]
Wuhan Union Hospital received just 5,000 surgical masks, while two other hospitals - Wuhan Ren’ai and Wuhan Tianyou - received 32,000. Neither Ren’ai nor Tianyou hospital treats coronavirus-infected patients, and each has one-tenth of the number of medics employed by Wuhan Union.

“Do they really understand what these supplies mean to the doctors and nurses?” Yukun Liu, a businessman from Chongqing who donated 2,000 surgical masks and 200 medical goggles to Wuhan, told Al Jazeera.

“I am honestly having a hard time trying to understand what the Red Cross was thinking - this is unforgivable.”

[Videi not reproduced here: ’Utter chaos’: Coronavirus exposes China healthcare weaknesses (7:01)]

Key role

In any crisis in China, the local Red Cross is a key part of relief efforts - acting to ensure donations made by the public reach the places they are needed - but the coronavirus outbreak appears to have overwhelmed the organisation in Hubei.

In a statement, a Red Cross official explained that the masks delivered to Ren’ai and Tianyou were manufactured to the “KN95” standard rather than the “N95” standard required for medical workers on the front line.

N95, graded according to US standards, means the mask should be able to filter at least 95 percent of non-oily particles - a requirement for most medical workers treating respiratory diseases. KN95 is the China version of N95; the local standard, offering the same level of protection under a different name.

The public was unconvinced.

“The problem right now is that there are no masks in hospitals,” one person wrote on Weibo, China’s version of Twitter. “When there isn’t even any surgical mask left, KN95 offers at least some protection, and the Red Cross has no right not to deliver them!”

Nurses and doctors at Wuhan Union Hospital have said they were forced to make masks and protective suits using the cloth from their medical overalls. In other cities, doctors have been using disposable rain ponchos as protection.

Apart from distribution issues, Wuhan Red Cross is being asked another question: Why is it not spending the cash donations it has received?

As of January 29, the organisation had been given cash donations of 390 million yuan ($56m) but had used only 13 percent of the money to buy supplies.

’Absolutely outrageous’

WHO declares coronavirus global emergency as death toll rises (6:00)
Respected Chinese media group Caixin reported that the Red Cross warehouse, which is approximately the size of two football fields, was almost entirely full of medical supplies but only a handful of people were sorting them for distribution.

“This is absolutely outrageous, but for now, let’s get these supplies to the hospitals as soon as we can,” Liu said. “Then we need to hold these people accountable.”

Le Chang, a supply office administrator at Wuhan’s Hankou Hospital said he had waited for three hours at the Red Cross warehouse only to receive two boxes of masks and no protective suits.

On Saturday evening, some 9,000 protective suits and surgical masks - donated by people in nine different provinces - were airdropped into Wuhan Union Hospital by a helicopter provided by a private company.

A number of hospitals are now saying they will only accept direct donations, effectively bypassing the Red Cross. This includes Huoshenshan, the 1,000-bed field hospital built by the military in eight days, which is due to open this week.

“We appreciate all donations from society; and in order to make sure all supplies go to the most needed, we have decided to accept donations ourselves without working with the Red Cross,” Song Zhan, donation coordination officer for Huoshenshan Hospital, told local media.

Hubei Red Cross later apologised on its official Weibo account and said it was “deeply regretful” about what had happened in the province.

Shawn Yuan

• AL JAZEERA NEWS. 2 Feb 2020:
https://www.aljazeera.com/news/2020/02/local-red-cross-fire-china-coronavirus-donation-mess-200202055418491.html

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 Diary of a Wuhan native: A week under coronavirus quarantine

A teacher from epicentre of deadly outbreak describes the growing anxiety under lockdown and anger towards government.

At least nine million people in Wuhan were put under quarantine on January 23 after the authorities decided to seal off the entire city. The order was later expanded to the entire Hubei province, affecting nearly 56 million people. Now a week has passed. What does Wuhan look like under quarantine? How has the city’s population been handling it?

I have been in touch with a few local residents since the beginning of this outbreak, and here is one of the stories of all those people living in the epicentre of this epidemic. The storyteller is a teacher. He has requested to remain anonymous.

Story as told to Shawn Yuan on January 30

My city has been ill for over a month now, and it has been sealed off for a week. Millions of us have been put under quarantine for seven days now, and all of this still feels surreal.

These days, I have been doing the same things over and over again: eat, sleep, eat, and the cycle continues.

All entertainment shows have also been cancelled by the government, and that leaves only the news about the virus playing on a loop on TV. Every aspect of my life is constantly reminding me of a single fact - the virus outbreak is still very real.

Video - Coronavirus: Walking around Ground Zero

Last night, I looked outside of the window of my apartment - absolutely empty streets, eerily quiet neighbourhood, some flickering streetlights, and one giant LED screen playing the public service announcement, advising people to stay indoors. All of this almost feels like a scene out of a zombie movie.

I try to distract myself and keep my mind fresh: I read books, I make podcasts, I watch films, trying my best to make sure this whole mess doesn’t get me. But sometimes, in this repetitive daily routine, we start to forget what we used to and aspire to be. This epidemic has taken a toll on all of us.

The memory of waking up to a city completely sealed off remains fresh. “Dumbstruck” is probably the best word to describe how I felt. This had never happened - not in my life, not in my parents’.

Fear and anxiety

Having seen what the SARS outbreak did, this still is the first time we all became nervous. That’s also when I realised the situation had gone way beyond what the official facade looked like. In the first days following the lockdown, I was overwhelmed, but more afraid, I guess.

The morning of the lockdown, many private cars were trying to get out of Wuhan. But all my family is in Wuhan and it made no sense for me to leave. Instead, I rushed out to get more masks, but at that time, the supply for masks had already dwindled significantly - many pharmacies had run out of them. That’s when I first started to freak out - what if I couldn’t get them? What if I or someone in my family got infected?

Luckily, I managed to get some after a few tries in different pharmacies. And that was the last day I was out of my house for more than one hour during a day. Almost hourly anxiety took over me during these past seven days.

Video INSIDE STORY: What’s the economic impact of China’s coronavirus outbreak? (24:51)

I went out yesterday to go to a supermarket. Food was running out at home, but also because I really needed to get out. I was going crazy - it’s ironic that when I was working, I always wanted to stay at home and rest, but now that I am spending almost my entire time at home, it feels like torture.

Luckily, food is still readily available, and the price wasn’t ridiculous, either. There were a lot more people than I expected at the supermarkets. Waiting outside of the market to get temperature checked and using hand sanitiser before going in have become the requirement for all the markets.

’Eerily empty neighbourhood’

Yesterday I saw the video of people singing the national anthem and shouting from their homes to each other to keep the morale high.

“Add oil! You can do this!” It really made me smile and want to cry at the same time. It’s a tough time but I have always thought Wuhan is a place full of potential and energy.

Today is the fifth day of the Chinese New Year, so according to traditions, we are supposed to go to temples and pay tribute to the God of Wealth today. Most of the businesses should be open today, too. But I took a walk around my neighbourhood this morning - just like the past seven days, it’s empty - eerily empty. But at least the weather is getting better.

I took a photo of my dad today standing on the pavement of a park. His quarantine life, like so many others, has been eating and sleeping and eating again. No friends to talk to, no relatives to visit, and no TV programmes that he loved to watch nowadays. The only little “entertainment” for him is to take a look at this empty road and do nothing.

Whenever I get bored and start thinking, which happens quite often these days, the feeling of anger started to boil inside of me - why did this local government keep hiding the truth and even arresting the eight people who initially shared the information?

I had already known the situation wasn’t as rosy as pictured by the government at that time, but I never for a second thought the scale of the crisis had reached a level to warrant a city-wide lockdown.

’An incredibly difficult time’

The Lunar New Year couldn’t have come at a worse time, either. My family had already planned some trips during the week, and we’re supposed to go to my grandmother’s. Of course, all of this has been cancelled, but the thought of what this could have been is making what this ended up being even more unbearable.

On New Year’s Eve, my dad went to sleep early because the Lunar New Year has been ruined - no visiting family, no drinking with them, no entertainment, but more importantly, a constant fear looming the entire family and the city.

Al Jazeera attempts to visit China’s coronavirus epicentre (1:44)
I saw him turning off the light before 10pm - this is the first time I saw him turning off lights on New Year’s Eve. He always told me that we should leave one light on for New Year’s Eve. I guess a new year like this has made him forget about all the rituals.

The gala hosted by China’s state television angered me even more. The entire country was struggling to cope with the virus outbreak and thousands of people were getting infected in Wuhan alone. But there was almost no mention of Wuhan during the gala except for poetry recitation.

“Wang Qiang defeated Serena Williams during the Australian Open, so that means we can defeat anything,” one host said.

That only made me angrier - their response to how we are going to defeat the outbreak is this completely unrelated analogy? I guess, after this crisis, people’s trust towards the “Big Brother” will be more fragile.

It’s an incredibly difficult time for this city, but I’m so very proud of my city: everyone is trying their best to make sure the city continues to operate as normal - something we desperately need right now.

But still, Wuhan will be forever changed, and now we are just anxiously waiting for the epidemic to end so we can start getting used to whatever the shape new life will take.

Years or even decades from now, how are we supposed to tell this story to our next generation? Can we really realise what it means to be a “citizen” of the society?

The only thing I hope now is that our generation doesn’t fail the next. At least I know I will keep this memory fresh.

Shawn Yuan

• AL JAZEERA NEWS. 31 Jan 2020:
https://www.aljazeera.com/news/2020/01/diary-wuhan-native-week-coronavirus-quarantine-200131045152448.html

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 ’Utter chaos’: Coronavirus exposes China healthcare weaknesses

With more people infected with the coronavirus than had been with SARS, China’s healthcare system is feeling the strain.

Hospitals in Wuhan and the wider province of Hubei are facing a flood of patients as a result of the coronavirus [The Central Hospital of Wuhan via Weibo/Reuters]

Chengdu, China - On January 20, Fubin’s father started coughing and running a fever. As residents of Wuhan, they knew about a deadly new coronavirus that had originated in the central Chinese city weeks ago, but decided to stay home and hope the symptoms would subside.

Four days later, when his father’s body temperature soared to 40 degrees, Fubin rushed him to hospital.

Together they headed to the Wuhan Union Hospital but, at reception, they were turned away. They were told they had to go to one of seven hospitals the government had designated for fever patients.

The two men went to Wuhan Red Cross Hospital, one of the designated facilities, and found the line of people waiting to get checked was so long they would have to wait outside - potentially for hours - in the cold and rain. They decided to try their luck elsewhere.

The second and third hospital were both packed. It took Fubin two days to get his father admitted to Wuhan No 5 Hospital, and he is one of the lucky ones.

Video Coronavirus: Life under lockdown in Wuhan

As thousands, if not tens of thousands, of fever patients who fear they might have caught the novel coronavirus that has now killed more than 100 people rush to Wuhan’s hospitals, the outbreak is testing China’s healthcare system on a scale not seen since the country was hit by the Severe Acute Respiratory Syndrome, or SARS, 17 years ago.

“The response from the government has been utter chaos,” said a nurse who works in Wuhan and preferred not to disclose her name. “The current healthcare system was completely unready for a situation like this.”

The nurse works at one of the designated hospitals, treating victims of a virus that has already infected nearly 10,000 people.

“You would think the government and hospitals had learned something from the SARS outbreak and prepared ourselves for another emergency like this,” she said angrily over the phone. “But no - they learned nothing.”

First line of defence

There have been urgent appeals for medical supplies not only in Wuhan and the province of Hubei, but beyond. The government has blamed the Lunar New Year holiday, when factories traditionally close, for the shortages of masks, goggles and other crucial supplies, saying it is hard to step up manufacturing during the festive season.

Shortly after the SARS epidemic, the Chinese government established and updated several times a medical materials reserve system that was supposed to ensure sufficient supplies in the event of any public health emergency.

However, reports filed with the Chinese Centre for Disease Control and Prevention suggest reserves at some hospitals have not been maintained.

In a 2019 article detailing Guiyang province’s emergency medical supplies reserve, the provincial CDC said that, of the 11 items needed in the event of a public health emergency, only five items were fully stocked at the local level.

“There are priorities in our expenditure budget and none of us could’ve expected an emergency like this,” an officer from Sichuan’s provincial CDC told Al Jazeera on condition of anonymity. “So I believe sometimes the supplies reserve might not be ideal.”

For ordinary patients like Fubin, it is not just the lack of medical supplies.

In China, a lack of properly trained general practitioners means the first line of defence often does not exist. There is a lack of trust in clinics and GPs, who are often difficult to find, and people prefer to go straight to hospital as soon as they need medical care.

In Wuhan, the capital of Hubei province, that meant a flood of patients in the initial days of the outbreak as people lined up in front of hospitals, hoping to get treatment.

Health inequality

The majority of people rushed to a limited number of well-known hospitals, also known as a Grade III Level A hospitals, the highest category determined by the Ministry of Health.

Grade III Level A hospitals have attracted the most qualified medical staff and modern equipment, and the well-known concentration of resources has put immense pressure on these hospitals.

“Of course, I’d only go to Grade III Level A hospital,” Fubin said. “I doubt other hospitals have doctors good enough to treat diseases properly.”

Many experts have said that a sudden rush to these medical facilities might have contributed to the widespread cross-infection.

Authorities are now building two more - temporary - hospitals to accommodate the expected thousands of cases.

“We understand that a lot of patients are choosing top hospitals over others,” the Municipal Party Secretary of Wuhan said during a news conference. “But we’re trying to change the mentality now so more people could get treated.”

But that does not address a larger problem: the unequal distribution of medical resources across China.

The level of medical care available in an area almost directly correlates with a province’s level of development.

In Hubei province, 44 out of 88 Grade III Level A hospitals are located in Wuhan, home to 11 million of the province’s more than 50 million people. In China overall, most of the best hospitals are found in the more developed, and wealthier, eastern coastal cities.

Such inequality also extends to the provision of medical staff in different locations.

In Beijing, the capital and home to approximately 20 million people, there are 100,000 registered doctors, whereas in Sichuan, a western province of more than 80 million people, there are 200,000, according to the National Bureau of Statistics.

That means while there are 4.63 doctors per 1,000 people in the capital, there are only 2.46 per 1,000 in Sichuan.

Hubei province has only 150,000 doctors, the majority of whom are stationed in Wuhan.

To relieve the pressure on the limited number of medics currently fighting on the front line, close to 6,000 doctors and nurses from across China have been parachuted into Wuhan and other surrounding cities, in the hope of containing the outbreak.

’Work harder’

But the lack of doctors is not specific to Wuhan: China simply does not have enough of them, especially those who work in intensive care.

The World Health Organization says that China has 17 doctors for every 10,000 people, well behind the world’s best 82 per 10,000 people in Cuba. And, while the country has made progress in improving health indicators over the past decade, few see much incentive to become a doctor.

“The hyper tension and mistrust between the patients and doctors, the low salary of most doctors, and unpredictable hours all contribute to the lack of motive to become a doctor in China,” said Zhou, a surgeon at Chengdu’s Huaxi Hospital who preferred not to share their full name.

“This outbreak has revealed some of the major problems in our healthcare system that should’ve been addressed before,” Zhou added. “I have confidence that these problems will be fixed soon.”

In Wuhan, having had three days of treatment, Fubin’s father is on the mend.

His son is relieved.

“I would be lying if I said that I wasn’t terrified that my father might not be able to get treatment,” he said. “I’m glad that he’s getting better, but there are still so many people unable to get treatment, and the government should really work harder to address the problem.”

Shawn Yuan

• AL JAZEERA NEWS. 29 Jan 2020:
https://www.aljazeera.com/news/2020/01/chaos-coronavirus-exposes-china-healthcare-weaknesses-200129050408104.html

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 Hubei cities fearful as medical supplies run low

Doctors say they have resorted to using raincoats and plastic bags as protection as officials call for more supplies.

Beijing, China - As China scrambles to cope with its worst public health crisis since the SARS outbreak in 2003, people living in cities near Wuhan, epicentre of the coronavirus epidemic, fear they are at increasing risk because hospitals and clinics do not have the resources needed to identify and treat those infected.

“We already ran out of protective suits a few days ago, and now we are using disposable raincoats to offer minimum protection,” a doctor at Xiaogan First People’s hospital in Hubei, who preferred not to be named, told Al Jazeera.

“Please help us spread the word. We don’t know how long we can last.”

Xiaogan lies about 73 kilometres (45 miles) northwest of Wuhan, the capital of Hubei.

Even in Wuhan, where supplies are being sent and an emergency hospital is under construction, doctors say they are under-resourced and the hospitals designated to treat coronavirus patients have been dangerously packed for days.

Some have asked for donations from the general public and, thanks to campaigns via GoFundMe, Weibo, and WeChat, medical supplies are being sent from all over China to Hubei province - almost all are directed to Wuhan.

In the 13 municipalities outside Wuhan, unease is growing - that people are faced with an outbreak they do not have the resources to handle.

’Please help us!’

Wuhan, the capital of Hubei, provided work for many people coming from other cities in the province.

Before the city was sealed off on January 23, many of these people had already returned to their hometowns to celebrate the Lunar New Year, and there are concerns they might have unwittingly brought the virus with them.

“Please don’t forget about us! Hubei doesn’t only have Wuhan,” one netizen wrote on Weibo, China’s popular microblogging platform. “We need supplies! Please help us!”

In Xiangyang, the third-largest city in Hubei and home to more than five million people, there were zero confirmed cases as of January 25, but that has not brought any relief.

“There are no hospitals in Xiangyang that have the diagnostic kit and can provide diagnosis,” Yixin Yu, a resident of Xiangyang told Al Jazeera. “The most likely diagnosis you get is viral pneumonia and will be asked to go back home to exercise self-quarantine.”

“It can’t be that there are no infected people - it’s only that no case is being confirmed,” Yu added. Xiangyang is about 300 kilometres (186 miles) northwest of Wuhan.

The media office of the Xiangyang Local Health Commission told Al Jazeera that despite intensified efforts to try and diagnose patients and treat accordingly, local clinics and hospitals were overcrowded and there was a severe shortage of medical resources.

“We are aware of the situation in local hospitals,” the director of the office told Al Jazeera in a phone interview. “We have liaised with our superiors and requested more diagnostic kits. We hope to get our hands on them as soon as possible.”

One of the biggest concerns across the province is that doctors cannot confirm an infection, or take necessary action, without the kit.

Some residents from cities outside Wuhan fear that means the number of cases is much higher than officially reported because of local hospitals’ inability to officially diagnose the infection.

Shortage of masks, goggles, suits

In Xiaogan, also home to five million people, patients reported that only the most severe suspected cases were referred for the diagnostic test and the rest were told to isolate themselves at home, leaving them at risk of developing the disease, spreading the virus and becoming even sicker.

“If you die alone at home, then you won’t go on record and no one will know that you died from the coronavirus,” one patient said during an interview with China’s nationally circulated weekly magazine, Sanlian.

More than a dozen cities in Hubei province have been sealed off to varying degrees, restricting the movement of more than 50 million people. That means that if there is no way to confirm a diagnosis in a provincial city, there is also no way to get a diagnosis anywhere else.

Some 11 million people live in Wuhan, capital of Hubei, but millions who live in cities around it fear they are as vulnerable to the virus and are calling for help [Al Jazeera]

Apart from the difficulty in securing the supply of diagnostic devices, local hospitals have also said there is an urgent shortage of medical masks, goggles, gloves, and protective suits.

In Xiaogan, some doctors and nurses say they have been battling the deadly virus without any effective protective gear.

The doctor from Xiaogan First People’s Hospital said some of her colleagues had to tear apart transparent plastic file bags to cover their heads because there was no longer a supply of medical protective goggles.

In Jingzhou, about 220 kilometres (137 miles) west of Wuhan, doctors say they are also grappling with shortages.

“I can’t go and use the bathroom because every time I go, I’d have to change the protective suit and I call myself lucky that I have this one that I’m wearing already,” Lu, a doctor at Jingzhou Central Hospital, said.

Given the lack of supplies, some medical equipment manufacturing factories have summoned staff back to work during Lunar New Year.

Medical staff say the need is urgent.

Yuan, head of the department of public health at Qichun People’s hospital located at Huanggang, said they had solicited public donations of N95 respirator masks, goggles, medical gloves, and protective gear.

“Our resources are incredibly stretched, especially when Wuhan is taking priority over us,” Yuan said. “But of course, we understand that because Wuhan, after all, is taking the hardest hit.”

Shawn Yuan

• AL JAZEERA NEWS. 26 Jan 2020:
https://www.aljazeera.com/news/2020/01/hubei-cities-fearful-china-virus-medical-supplies-run-200126034425456.html

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