Q: If shedding can last for up to >35 days, how long do you recommend isolation for non-hospitalized patients?


Wuhan's approach is to treat all the confirmed patients, light patients in the shelter hospital for medical observation and symptomatic treatment. When discharged according to discharge standard, it will focus on isolation point for 14 days, and then isolation at home for 14 days

Q: Should we wear N95 masks when seeing all patients?


We recommend that doctors wear N95 masks during treatment of all patients to avoid iatrogenic infection during treatment. Because we cannot determine which patients are safe or are asymptomatic carriers of the new coronavirus or are in the incubation period. Therefore, we advise all doctors to wear an N95 mask and further protect themselves when treating all patients.

Q: When did you wear the protective gear in the hospital? Were you wearing N95 all day? How to protect yourself and what is your approach within Wuhan?


We only wear protective gear in contaminated areas, in contact with patients and close contacts. In general wards and clean areas, we just wear surgical masks.  All  medical staff will receive safety training, and specialists will be set up to strictly supervise everyone to protect according to the operation protocol.

Q: One of our anesthesiologists asked me to ask you all if you are using airborne precautions for all aerosol generating procedures such as intubation of even patients who are not suspected of having COVID19 in high risk ar


In all of the aerosol generating procedures, heath care workers should pursue Level III protection including 

-Disposable surgical cap

-Medical protective mask (N95)

-Work uniform

-Disposable medical protective uniform

-Disposable latex gloves

-Full-face respiratory protective devices or powered air-purifying respirator

While all of the patients should use N95 mask. 

Q: When you say you take secondary and tertiary protection do you mean wearing N95 mask? Or are you wearing a regular surgical mask (droplet precautions) in the operating theater?


N95 mask is needed when we take secondary and tertiary protection. Regular surgical mask is only fit for the primary protection, such as pre-check triage, general outpatient service.

Q: Why do you intubate with ECMO? Can’t you spare the intubation if you do VV ECMO? Would this not decrease the risk of health care exposure to virus?


When patients developed ARDS and respiratory failure, we applied intubation and mechanical ventilation but not ECMO first. You know, some patients do not need ECMO necessarily and finally recovered. Intubation and mechanical ventilation has another advantage of sputum aspiration (in a closed aspiration equipment) and maintain opening of alveoli, which ECMO could not provide. Although intubation increased risk of exposure, but it was just less than a minute and we were well protected with N95 mask, faceplate and head cover. On the contrary, VV ECMO totally abandoned lung and that’s not physiological. A COVID-19 patient with ECMO and mask-protected mouth and nose, was regard to have higher risk for health providers than intubated patients (personal opinion).

Q: How is your criteria for use of isolation and ICU bed? And distribute limited materials.


 You know, early diagnosis, treatment and isolation should be carried out whenever possible. Suspected cases and confirmed cases should be treated in isolation with protective conditions. Suspected cases should be treated in a single room, and confirmed cases can be admitted to the same ward. Confirmed cases include mild cases, moderate cases, severe cases and critical cases, the critical cases should be treated in ICU as soon as possible.

Q: We have heard in the news that Wuhan has reinstated travel restrictions due to concerns over new asymptomatic cases. Can you tell us about this situation regarding asymptomatic cases?


So far we have found more than 100 asymptomatic cases in Wuhan, especially in my hospital.  Even if there were no symptoms, they have some signs and were at high risk of getting infected.  For example, the cleaning people in Wuhan's hospitals.  We are doing testing for every high risk close contact person to avoid a second wave of the epidemic.

Q: How can we protect people from in-hospital infections during the management of nConV-19 patients?


If you need to have close contact with COVID-19 patients, you need to wear N95, gloves, goggles.  You also need to wear and take off protective clothing properly.  It would be better to take off protective clothing with other doctors or nurses' help.


Q: What have you found to be most effective for protecting surgeons and anesthesiologists in the operating room in China from aerosol producing procedures?


In the early February, during the height of the epidemic, we stopped many regular procedures for almost one month.   After the situation got better, we restarted procedures. 

We will do routine CT scan and check before each procedure to check for COVID-19 first.  We will wear protective equipments.  

During this special period, only one family member is allowed to accompany the patient.  However, we try encourage patients to go to the hospital by themselves, without family members, to decrease infection risk.

Q: My private clinic only handles outpatient services. Do you recommend I wear a mask for every patient visit? I am only seeing patients who have no fever.


During the height of the epidemic in China, everyone wore masks to meet all patients.  Nowdays, for some social communications, we will take off our masks, but most of time, we will all wear mask.  

Whether you should use a mask for seeing every patient depends on whether your area has many cases and how strict the isolation policy in your area is.  If your city has many reported cases, and its isolation policies are not strict, I recommend you definitely wear a mask to see every patient.

Q: How long would you recommend for that infected people be quarantined? More than 14 days? 21 days?


2 weeks. 14 days.

Q: Are healthcare workers that work with infected patients in China isolated from their families?


Absolutely.  They must be isolated.

Q: For doctors who were infected, what did you do for self protection? In the current stage after getting COVID-19, how would you evaluate your situatition? Have you experienced symptoms relief, mild recovery or completel


No fever or feel better of short breath and no cough are signal of relief.  The most important signal is CT scan results.

Q: How can you prevent spreading if the test is only 40-50% sensitive? It means you’re missing half the cases.


Yes.  That is correct.  I personally believe that our major prevention is quarantine and isolation.  When Wuhan was locked down, it is kind of too late, vey much like New York now.