On January 22 (the 16th day of the Spring Festival, the first day of the first month of the Lunar Calendar), the national railroads, highways, waterways, civil aviation **** sent 17,052,000 passengers, an increase of 49.6% over the same period in 2022. It is estimated that the total number of passengers during the Spring Festival in 2023 is about 2.095 billion, 19 first-tier, new first-tier cities, the number of people going to Guangdong Province, Henan Province, Hunan Province, Anhui Province, Guangdong, Henan, Hunan and Anhui Province is the Spring Festival in 2023, "return family" the most provinces.
Such a large-scale population movement also makes people more worried about the rural epidemic. Before the Spring Festival, small and medium-sized cities and rural areas have been infected with the peak, the Spring Festival is likely to be ushered in these cities and regions of the emergency and the peak of serious illness. In this regard, a number of places have been launched in rural areas of the new coronavirus infection incidence of offline household survey.
How does the rural healthcare system cope with the impact during the Spring Festival? How is the medical resource reserve and supply in rural areas? What help is currently needed? Dr. Ming Pinghuang of Zhangpu Village, Taizi Town, Tieshan District, Huangshi, Hubei, described the local situation to the Observer.
Observer: Hi Dr. Ming, first of all, please describe the overall situation in Zhangpu village, including the population size, demographic structure, the usual clinic, and the medical habits of the locals.
Ming Pinghuang: Our Zhangpu Village was merged from the original two villages of Zhangshu Village and Mingpu Village, and there are two health centers in the village, and I belong to the second health center, which is in charge of Mingpu Village. Zhangpu village is far away from Prince Town, about 7.5 kilometers, the whole village has more than 4600 people, including more than 390 elderly people over 65 years old. The first health office is mainly responsible for the 2,800 people in Zhangshu village, with four doctors; the second health office is responsible for the 1,800 people in Mingpu village, with only two doctors, my wife and me.
I am responsible for the public **** health on the side of Mingpu village. There are 114 elderly people over 65 years old in Mingpu village, 102 hypertensive patients, 20 diabetic, and 6 mentally ill. At the same time have diabetes, hypertension elderly is two. Our village has one of the most serious patients is the "five-guarantee household" patients, now more than ten days past, the situation is relatively stable, did not develop into a serious illness.
The nearest hospital to Zhangpu Village is the Yangxin County People's Hospital, which is usually a 40-minute drive away. People in the village rarely go out unless they are experiencing a more serious illness, so I know the villagers well.
Ming Pinghuang, village doctor of Zhangpu, Taizi Town, Tieshan District - Development Zone, Huangshi, Hubei Province. Photo credit: Jingchu Positive Energy
Observer: this wave of rural infections came faster than expected, originally predicted by outsiders would be accompanied by a wave of returnees, but now it seems that the peak of infections in the countryside almost synchronized with the city, exceeding previous expectations, you observed on the ground, is the situation also like this? What is the situation of medicines and equipment in the village? What medicines are you prescribing to your patients?
Minh Binh Huong: The only equipment at the beginning was a thermometer, a sphygmomanometer, a stethoscope, and I bought myself an oxygen machine, and the Huangshi Health Commission gave me an oxygen machine, and there were two oxygen machines in one ****, but no other equipment.
I studied the combination of Chinese and Western medicine, with the main treatment of traditional Chinese medicine. The medicines prescribed to the patients include Ge Gen Tang, Nine flavors of Qiang Wu Tang, Ma Xing Shi Gan Tang, Xiao Chai Hu Tang. Epidemic infection in the early stage, the shortage of medicines, I looked for a formal into the drug channels, pharmaceutical companies will be sent over, but in the courier stuck on the road can not come. Usually I like to use lysergic acid, because it is good for pain relief, not hormonal drugs, but then also can not get into the medicine.
The peak of treatment in our village started on December 14, with 63 patients on the first day, 87 on the second day, 102 on the third day, 150 on the fourth day, 173 on the fifth day, and the number has been gradually decreasing since then.
A lot of patients started with fever and body aches, and then later on, they were coughing, and two of them were coughing more, and they went to the county hospital to take pictures and diagnose pneumonia, but there were no beds in the hospital, so they had to go home to recuperate, and I gave them injections, and I prescribed traditional Chinese medicines.
Just those days my son was on vacation, I let him help me to play the hand, the medical clinic I, my wife, my son, three people, every morning at five o'clock to start work, the end of the clinic is almost 12 o'clock in the morning. Half of the month, has been busy dizzy, those days my mother to do a good job of meals to send over, wait until the reception of a gap in time to eat, rice has been cold.
Observer: How was the clinic during this period? What were the patients' treatment requests, symptoms, and follow-up feedback?
Ming Pinghuang: During the treatment process, whether the patient has turned negative or not, the doctor and the patient do not know, because we do not have antigens to test. I was checking the patient's tongue and 95% of the patients were cold. The greatest need for medication is the elderly and small children, young people generally do not take medication, rest at home to rest can also survive.
The most impressive case, a 50-year-old patient just returned from Jiangxi, appeared to be floating slow pulse, just in time for all the Chinese medicine out of stock, I gave him a shot, the next day he wanted to come back to consolidate, next to the person said the doctor hit the hormone, told him to stop, he did not come to the follow-up.
After ten days or so, this patient came back, said he had a sore throat and hoarse, chest tightness, I felt the pulse of the hand, felt that the possibility of pneumonia is relatively large, and hastened to persuade him to go to take a picture, until now, he has basically cured.
There is also a case of a patient, he grew a pituitary tumor some time ago, which is also known as acromegaly, he did not feel anything about it, but I saw his nose, hands are growing signs, I advised him to go to the hospital for examination, at first he did not believe me, I told him three times, to his father said twice. I told him three times and his father twice. Then he went to Wuhan Hospital for examination, and it was indeed a pituitary tumor. Not long after going to the hospital to do surgery he was positive, because of the postoperative body is relatively weak, his symptoms are more serious, I gave him four days of traditional Chinese medicine, but also the infusion of supplemental nutrients, this time has been slowly improved.
Observer: There are media reports that many local village doctors are using "antiviral + antibiotics + hormones + antipyretic" four-piece treatment of new crown fever patients. What do you think of this four-piece treatment?
Minh Binh Huong: For antiviral, antibiotics, hormones, this prescription, the village doctor, many antibiotics do not have the authority, hormones, and even more can not be used casually, other people think that we are the "three elements of a soup" -- antibiotics, hormones, vitamins and other medicines. -- antibiotics, hormones, vitamins, glucose injection, but in practice, each person's situation is different, some patients require hanging water, some patients' conditions are not suitable for medicine.
Observer: we are all concerned about the lack of medical resources at the grassroots level, after the antipyretic, cough medicine, antibiotics and antiviral drugs are subject to strict control, hospitals, pharmacies reserve drugs are relatively small. County and town health bureaus to coordinate the deployment of supplemental situation?
Minh Binh Huong : Three years of the epidemic, the township health department of antipyretic, cough medicine and other drugs reserves are relatively small, ordinary people's homes are also very few, the notice to release, we do not feel at all, after the peak, Prince Township Health Center sent me four bottles of ibuprofen, but this time the visitors are not too much demand for it. I was given two oximeters in mid-January, and now that the peak of infection has passed, the patients don't need them.
Now there are still people to ask for diarrhea medicine, because they heard that there are patients with diarrhea in the Zhejiang side of the contagion, in order to prevent people from grabbing the medicine stockpiling, I give each person to sell only three packets at most.
Observer: antiviral drugs like Pfizer and Azulfidine, can they be supplied in county and township hospitals?
Minh Binh Huong : This side of the people do not understand the Pfizer drug, the economic conditions are not so good, people like to buy immunoglobulin, this drug was more than 500 yuan, the peak period of the infection has also risen to the price of 1,800-2,100 yuan ranging from the peak of the drug, I did not buy the drug, but also told people around do not grab this thing, put the The company's website is a great source of information about the company's products and services, and the company's website is a great source of information.
Observer: Previously on the news, I saw that many grass-roots rural areas, for the local elderly groups have some help policies, such as the delivery of medicines, door-to-door medical care, volunteer services, and so on. What is the specific situation? What are the suggestions for this?
Minh Binh Huong: The above let us do a good job of registering patients with serious illnesses, and visit more often, grassroots cadres will also go to visit.
I personally suggest that rural cooperative medical insurance needs to actively support rural doctors, rural cooperative medical platform on the medicine is too small a variety of drugs, the people have no benefit at all.
At present, the national rural medical insurance is to pay 350 yuan a year, up about 30 yuan a year, but the actual reimbursement ratio of patients, reimbursement of traditional Chinese medicine, etc. There are problems, the percentage of people in the village who have paid the insurance is 85%, the reimbursement is difficult to reimburse the less will also become a problem for the folks to get medical treatment and buy medicine. There are 273 medicines in one **** of the medicine platform, and less than 100 medicines are available to primary care doctors, almost all of which are high blood pressure medicines, cough medicines, and antibiotics, etc.
We have 29 villages in the town of Prince Edward, and there are less than 10 doctors who can combine Chinese and Western medicine and traditional Chinese medicine. Three years since the epidemic, village health centers can not admit patients with coughs and fever, so our experience in treatment is almost zero. I hope that county and city hospitals can organize training for rural doctors in Chinese medicine techniques, because we have a lack of first-hand information.
Tongren, Guizhou, has launched a Level IV emergency response to combat freezing. Medical personnel provide door-to-door services for key rural populations. Photo: Visual China
Observer: netizens have discussed the recent increase in the number of elderly people passing away in rural areas, what is the situation in your township?
Minh Binh Huong : In our village, there has only been one death from lung cancer since the peak. The next village has two cases, one is the old man positive fainted, I gave him acupuncture, after a few days, I heard that the old man went to the hospital to check, the hospital judged more serious not to admit, not long after the old man died. This old man has always been in good health, this time suddenly passed away, let a person feel quite surprised quite shocked. Another situation said to have a large white lung, he had diabetes and stroke, positive soon after also passed away.
OBSERVER: How does this wave of infections look different than past winter flu season situations?
Minh Binh Huong: In the three years since the epidemic, there has been no peak in the number of consultations on our side, and the days when the outpatient clinic has more than 10 people have almost never happened. Before the epidemic, for example, in 2019, probably only about 20 patients came every day. It's been three years of checking for positives, so anyone suspected of being positive goes to the county hospital.
OBSERVER: Is there panic among villagers about this wave of infections? What is everyone's attitude towards this?
Minh Binh Huong: There is definitely some fear, for example, some people are tired and exhausted after infection, and come to see the doctor in a car, and when people see it, they will deliberately stay away from it, and do not want to say hello, for fear of infection. I also went to reassure people that not everyone gets the disease.
Observer: the wave of homecoming will soon begin, the peak on your side appeared earlier, you think the rural health care system during the Spring Festival, how much impact will face?
Ming Pinghuang : It's hard to say at the moment, there may be some people who will still have symptoms and still need some antipyretic drugs and equipment. The first many people say that they are "back to the sun", I judge may be the last infection is not completely recuperated, the new crown needs at least a month of recuperation, superimposed on the high incidence of influenza in the winter, more attention to rest.
Observer: Although we have been through three years of anti-epidemic, but many grassroots hospitals in fact did not have a large-scale, real treatment of the new crown, the lack of first-hand experience, in many cases, the patient came to be advised to go to the higher level of hospitals, resulting in the second and third tier of hospitals, health care resources are tense. What are your suggestions for hierarchical diagnosis and treatment?
Minh Binh Huong: It is difficult to apply hierarchical diagnosis and treatment on our side, when the peak of the infection comes, everyone piles up in the health center, it is difficult to differentiate between different patients and their needs, and everyone gets infected very quickly.
Three years after the outbreak, there hasn't been much change in primary care conditions, equipment and medicines, and it's still the same. But the price of medicines has obviously gone up, the cost has gone up by ten or twenty dollars, but the medicines I sell to patients can't go up that much.
In addition, the medicines of the health insurance are expensive and less varied. Primary care doctors use drugs more narrow, for example, a lot of cephalosporins do not allow the use of, because our level is not enough, if the patient develops into a severe pneumonia, the effect of penicillin is certainly not good, if the patient is allergic to penicillin, we really have no medicine available.