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Chinese regional dishes cheering on Wuhan's signature noodle dish. Their little signs say "keep fighting, Hot Dry Noodles"*. I can't fucking take these emotions. pic.twitter.com/AyrYPvb3fj

— Sneer Review (@TheSneerReview) February 1, 2020

With permission, from longtime lurker / new commentor YY_Sima Qian:

(Caveat, what follows are entirely my experience and my opinions from my observations, I am not a medical professional and do not work in public policy)

What is life like in Wuhan under lock down?

To date, most people are just hunkering down to ride out the storm. I don’t sense mass panic or groundswell for social unrest. People are anxious, glued to TV and phone screens, news outlets and social media platforms for updates. Of course, we are early into the lock down (I can’t believe it’s only been a week). If it persists, then the level of disquiet could rise rapidly, but the epidemic will prevent people from congregating physically. So far there is not a significant shortage of food or basic necessities, no disruption of utilities. The supermarkets are mostly open, but shopping needs to be done in the morning, or a lot of shelves will be empty by afternoon. We are planning to order via APP and have grocery delivered to our building, to avoid the crowds. Prices are generally stable and align with historical norms, as the government has vowed to severely punish any price gouging. Medical supplies (masks, alcohol, sanitizing agent, etc.) are more difficult to get, but I understand it may actually be easier to obtain in Wuhan than the rest of China.

The exception to the above are families of those diagnosed or suspected to have contracted the 2019-nCoV. The medical services are overwhelmed, despite herculean efforts to date. Lots of horror stories to be found on Chinese social media or even digital platforms of state media (but not print or TV). More on that later.

How is the medical care situation in Wuhan?

Dire. Hospitals are completely overwhelmed with people seeking treatment, both actual infected and those suffering from common flu (because this winter there has been a widespread flu epidemic in China, too). There are not enough beds in isolation ICU in all of Wuhan to take in all of the people with severe symptoms (2019-nCoV or not). Respiratory infectious diseases require rooms with negative pressure, so total number of hospital beds available is meaningless as a metric.

In my wife’s admittedly large circle acquaintances, we are aware of two cases where the elderly infected developed severe and life-threatening symptoms, but could not get tested with the 2019-nCoV test kit and be admitted into the isolation ICU. One died in the hall way of the overcrowded ER. We are also aware of two cases where the elderly infected have severe enough symptoms that would warrant going into ICU, but cannot due to lack of beds. Nothing anyone can do but hope and pray they either pull through or hang on long enough for beds to become available.

Wuhan’s response started too late, and has been desperately playing catch up. I think they are taking the right courses of action on paper, but several steps too late and often executed poorly to date. When the public became really aware of the epidemic on 1/22, people with symptoms (2019-nCoV or not) all rushed to hospitals (especially the five or six biggest ones with the best reputation), leading to massive overcrowding and likely significant cross-contamination. The day after the lock down was declared, a number of hospitals were designated for treatment of suspected 2019-nCoV cases. However, they often do not have large isolation wards built, and the conversion take time. To relieve overcrowding at hospitals, the government then instituted a system asking people to go to community clinics first for initial screening. Those with light or moderate symptoms are asked to stay home and self-quarantine (which I think is what the WHO recommends as well). If people develop severe symptoms, they are to report the neighborhood committee and the community clinic, and arrangements will be made for transfer to one of the designated hospitals. Select people are given lists of people to check up on daily (via phone). Both my wife and my mother-in-law are responsible for such lists. Looks great on paper, but in practices the medical staff and the community clinics are poorly trained to identify moderate symptoms from severe ones, and 2019-nCoV symptoms from the common flu, so they are not yet performing the filtering function as intended. Furthermore, I have seen cases reported to neighborhood committees and community clinics, but no follow up from the authorities. I can only imagine the chaos behind the scenes.

Hopefully, when the two temporary hospitals are build and come online next week, the bed availability issue can at least be relieved. Construction is being live streamed, with 20 – 40 million viewers at any given time. Huanggang, another city in Hubei, is also building such a facility.

Medical supplies (masks, suits, goggles) are in dire shortage. Lots of stories of doctors and nurses on the front lines in close contact with patients have to make do with masks that are not quite rated for the job, but they do it anyway. To minimize consumption of masks/suits/goggles, doctors and nurses are working 6 hour shifts without meal or bathroom breaks. Medical staffs are exhausted, working extended, even with thousands transported in from hospitals around the country, but seems to be better than this time last week.

Test kits are also in dire shortage, leading to slow confirmation of cases.

What about the situation in the rest of Hubei province?

I don’t really know. The focus of new media and social media in China has been understandably on Wuhan. The other cities in Wuhan have even less medical service resources than Wuhan, and people from the province have tended to go to one of the top hospitals in Wuhan for major illnesses. On the other hand, the reported cases are also much lower than Wuhan, relative to the respective populations. I haven’t seen many horror stories on social media from other cities in Wuhan.

How about the rural areas? Are they able to cope?

Medical care in the villages are much more limited than in the cities, and they would not be able to handle a significant outbreak. However, Chinese villages are mostly close-knit, self-contained and self-sufficient communities. As soon as awareness became widespread and containing the epidemic became a national priority, villages in China essentially raised their draw bridges – raising road blocks and manning check points to prevent outsiders from entering. Anyone returning from Wuhan or Hubei province for the Chinese New Year are quickly identified and families placed into virtual quarantine, or convinced to go back.

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