Coronavirus: Wuhan nurses retract open letter detailing physical and mental toll of fighting the outbreak
Stating that the environment in Wuhan is much more difficult and extreme than they could have imagined, two nurses published a disturbing open letter in the journal Lancet on February 24. Besides physical exhaustion -- which includes fainting due to low blood sugar and developing painful rashes -- the nurses also described how the outbreak was taking a psychological toll on them.
The correspondence seemed to be in contradiction to the optimistic statements coming from Chinese officials and the positive state media coverage praising the government’s handling of the crisis. The letter, which appealed for global help to fight against COVID-19, has now been retracted. However, the journal has not removed the contents of the letter from its website. The letter is currently watermarked with several instances of the word “RETRACTED”.
The Lancet has also published a brief explanation as to why the correspondence was retracted on February 26. It said, “On February 26, 2020, we were informed by the authors of this Correspondence that the account described therein was not a first-hand account, as the authors had claimed, and that they wished to withdraw the piece. We have therefore taken the decision to retract this Correspondence.”
Nurses Yingchun Zeng and Yan Zhen wrote that they entered the Wuhan isolation ward as the first batch of medical aid workers from Guangdong Province, China.
“On January 24, 2020, we came to Wuhan, China, to support the local nurses in their fight against the COVID-19 infection. The conditions and environment here in Wuhan are more difficult and extreme than we could ever have imagined,” they said.
While Zeng is with the Department of Nursing, Third Affiliated Hospital of Guangzhou Medical Hospital, Guangzhou; Zhen is from the Department of Traditional Chinese Medicine, Sun Yet-sen Memorial Hospital, Sun Yet-sen University, Guangzhou, China.
They described that due to an extreme shortage of healthcare professionals in Wuhan, 14,000 nurses from across China had voluntarily come to Wuhan to support local medical health-care professionals.
“But we need much more help. We are asking nurses and medical staff from countries around the world to come to China now, to help us in this battle. We hope the COVID-19 epidemic will end soon, and that people worldwide will remain in good health,” they said in their appeal.
They described their current work in Wuhan as mainly focused on the provision of oxygen, electrocardiogram (ECG) monitoring, tube care, airway management, ventilator debugging, central venous intubation, hemodialysis care, and basic nursing care such as disposal and disinfection.
In the correspondence, they spoke about a severe shortage of protective equipment, such as N95 respirators, face shields, goggles, gowns, and gloves. The goggles are made of plastic that must be repeatedly cleaned and sterilized in the ward, making them difficult to see through, they said.
“Due to the need for frequent hand washing, several of our colleagues' hands are covered in painful rashes. As a result of wearing an N95 respirator for extended periods of time and layers of protective equipment, some nurses now have pressure ulcers on their ears and forehead. When wearing a mask to speak with patients, our voices are muted, so we have to speak very loudly,” they stated in the letter.
The nurses emphasized that even a simple task of giving an injection to a patient was challenging as they had to wear four layers of gloves, which is “abnormally clumsy and does not work.”
“Often, nurses' mouths are covered in blisters. Some nurses have fainted due to hypoglycaemia (low blood sugar) and hypoxia (when the body does not have enough oxygen),” they added.
The nurses wrote they avoid eating and drinking for 2 hours before entering the isolation ward to save the energy and the time that is needed for putting on and taking off the protective clothing.
Zeng and Zhen also highlighted the emotional toll the work had taken.
“In addition to the physical exhaustion, we are also suffering psychologically. While we are professional nurses, we are also human. Like everyone else, we feel helplessness, anxiety, and fear,” they said.
They further said that experienced nurses occasionally find the time to comfort colleagues and try to relieve our anxiety.
“But even experienced nurses may also cry, possibly because we do not know how long we need to stay here and we are the highest-risk group for COVID-19 infection. So far, 1,716 Chinese staff have been infected with COVID-19 and nine of them have unfortunately passed away,” they wrote.
During a media briefing by the World Health Organization (WHO)-China joint mission, Liang Wannian, head of the Chinese expert panel on outbreak response and disposal, had said that over 3000 medical staff have got infected. Experts are trying to determine how many got infected due to community-acquired infections and how many while delivering hospital care to patients.
In the latest figures released on February 27, the Chinese National Health Commission reported 327 new cases of confirmed infections, 452 new cases of suspected infections, and 44 deaths. Thursday’s updates brings the country’s tally to 78,824 confirmed cases and 2,788 deaths.