Patients with chronic diseases struggle to receive care in COVID-19-era China

Patients fill out questionnaire before entering the hospital
In order to contain the spread of the coronavirus in China, patients now have to fill out an extensive questionnaire about where they have been to during the past few days and whether they have been in contact with anyone with COVID-19 before they can enter the hospital. Due to such inconvenience, many patients avoided going to the hospital as often. (Amy Ouyang/MEDILL)

By Amy Ouyang
Medill Reports

Wearing two layers of surgical masks and holding a bag full of her medical records for the past six months, Shuhua Liu filled out the COVID-19 questionnaire in front of Peking University People’s Hospital in Shenzhen, the last step before she could enter the hospital after half a year.

“I haven’t been to the hospital since January when the coronavirus started to spread in China,” Shuhua Liu said. “In fact, I was supposed to visit the hospital at least twice a month to check my blood sugar level and see if any current medication needs to be changed.”

Being diagnosed with diabetes for 18 years, Liu, now 78, said that 2020 was by far the most difficult year for her. Her chronic diseases added more stress on top of the constant anxiety over the coronavirus outbreak.

“Similar to everyone else, I had to worry about the spread of the deadly virus,” Liu said. “But more than that, I am constantly struggling because I should go see my doctors at some points while the outbreak makes such visits seem rather impossible.”

Liu was not alone in her reluctance to visit the hospital. As the virus started to spread in China, many hospitals shifted online. They started to provide virtual routine care to patients in need. Nevertheless, worries about the shortage of medical resources still prevented some patients from getting proper treatment.

“Especially at the beginning of the outbreak when nobody knew how deadly the virus was or how to best protect ourselves from it, going to the hospital seemed to be an adventure for me,” Liu said. “You are not only putting yourself at risk but also your entire family.”

Shan Qin, another patient with Type II diabetes, said that he was particularly worried about exhausting medical resources when such were already lacking.

“I always heard the news on TV that many hospitals are lacking medical supplies and medical staff,” Qin said. “I thought to myself that I shouldn’t add any more burden to the already overloaded system. So I refrained from going to the hospital or registering for virtual appointments as much as I could.”

According to Dr. Qian Xie at Peking University People’s Hospital in Shenzhen, many of her patients stopped seeing her as soon as the pandemic started. The number of visits from patients with diabetes dropped significantly in January and February. But it started to slightly increase as China successfully contained the virus.

The number of patients visiting hospitals in China gradually starts to rebound to the pre-pandemic level. (Amy Ouyang/MEDILL)

“I almost didn’t receive any of my former patients,” Xie said. “I have noticed that recently, the number started to rise again. And that is a good sign.”

Xie said she was extremely worried about her patients’ well-being. She said missing even a few check-ins with doctors can be detrimental for patients with severe conditions.

“Patients with diabetes have to visit us rather frequently. We have to adjust the quantity and the type of the medication according to their reactions to them,” Xie said. “We need to constantly monitor their blood sugar level to ensure that the current medication is right for them.”

The COVID-19 outbreak didn’t only affect the physical health of patients with chronic diseases. Many of them also suffered from mental health issues, ranging from minor anxiety to severe depression.

According to a recent study published in June, in an online survey targeted at healthcare professionals, 80% reported their patients’ mental health worsened during the COVID-19 outbreak. Xie said that she also noticed this trend among her patients and tried to alleviate their stress on top of providing medical care.

“Many of my patients told me that they were increasingly anxious when the pandemic hit most of China,” Xie said. “For elderly patients with chronic diseases especially, their mental state is just as important. I tried to chat with them frequently to assure them that they are receiving proper care.”

However, Xie admitted that she could only check in with a few patients with whom she has a more close and personal relationship. The majority of her patients, however, are left to themselves to find counsel elsewhere. She suggested that a more rigorous system should be put in place to make sure patients are also in a good mental state.

“If there is an official system set up which provides patients with psychological consultation, many patients would not have suffered as much,” Xie said.

Amy Ouyang is a social justice reporter at Medill. You can follow her on Twitter at @Hanyue_Ouyang.