New Details of Shanghai Nursing Home Covid Deaths Suggest City Is Overwhelmed

[Matt Beasley]

New Details of Shanghai Nursing Home Covid Deaths Suggest City Is Overwhelmed
By Wenxin Fan, Apr. 22, 2022 , WSJ

Late last month, dozens of migrant housemaids and nannies
queued up for new jobs at Donghai Elderly Care Hospital in
Shanghai. No experience or certification was required, just
proof they were vaccinated against Covid-19. People who
scared easily shouldn’t apply, one said she was told by an
employment agent. The ones who stayed entered a hospital in
disarray. Doctors and nurses, stricken with the virus, were
locked in quarantine. Residents were dying after they caught
Covid. New hires were pressed into tasks normally done by
trained workers. One of them, a woman in her 40s in the job
for less than a week, said she and 3 others carried a body to
a room used as a morgue at midnight. They struggled to help a
veteran male orderly zip the body of the swollen woman into a
thick yellow bag and move her. She said she counted half a
dozen bodies in the room.

Shanghai, which has been in near complete lockdown for a
month to contain the current wave of the virus, the worst to
hit China since the pandemic began in Wuhan two years ago,
has reported 450,000 Covid-19 cases since March 1.

Yet for weeks, Shanghai officials reported no deaths in the
entire city from Covid. On April 18, officials finally started
announcing a death count, and now says 36 people have died this
week, mostly elderly.

A Wall St. Journal reconstruction of the Donghai hospital outbreak
provides a more complete picture of the suffering in China’s
financial capital, with at least 40 deaths of Donghai residents
alone as of April 6. The deaths came after Covid spread through
the hospital, sickening hundreds of patients and staff, according
to more than a dozen patient families and health workers, WeChat
messages and hospital documents. The experiences raise questions
about China’s official Covid count and expose vulnerabilities in
its Covid-control strategies.

Despite a high rate of vaccination in China overall, with 88% in
the country vaccinated, millions of elderly people, including most
of Donghai’s residents, remain unvaccinated. In Shanghai, only 62%
of people 60 and over are vaccinated. The rate drops to a minuscule
15% for those over 80. Many are suspicious of the shots, skeptical
of Chinese brands or vaccines in general, while others figured full
vaccination of people around them would be enough of a shield.

It has left them essentially defenseless against Covid, even though
the Omicron variant is less deadly than earlier strains of the virus.
Similar attitudes among elderly residents in Hong Kong contributed to
deaths there in March, when 7,000 people over 60 died.

Nursing homes in the U.S. had widespread infections and deaths at
the beginning of the pandemic, but widespread uptake of vaccines,
plus some immunity for those infected, has limited serious illness
in the recent Omicron wave. In contrast, China has said that its
strict Covid control program, which features frequent compulsory
tests and strict lockdowns, is the best protection for its most
vulnerable citizens. The tactics were successful in containing
previous variants but became less effective in the highly contagious
Omicron wave.

China’s zero tolerance approach to Covid, in which anyone testing
positive and their close contacts must go to quarantine facilities,
has also left hospitals like Donghai scrambling to find trained staff
after more-experienced workers were sent into isolation.

More recently, China has pushed elderly people to get vaccinated,
including by offering cash incentives. While Chinese vaccines have
been shown to be less effective than those made in the West, they
still offer meaningful protection, according to Hong Kong data.

Vulnerable patients
------------------
At Donghai, the virus became so widespread that Chinese authorities
transferred many residents to an overcrowded facility 50 kilometers
away, without the consent of many families. Doctors had warned
hospital officials the move introduced new risks for vulnerable
patients, according to messages in a WeChat group for Donghai
healthcare workers and families of patients.

Some relatives couldn’t locate their parents or grandparents for
days. Others were informed more than a day after their relatives
died, or found out on their own. Many families said they believed
that the disruption of their relative’s care was the biggest reason
they died, based on their health conditions.

A representative of Donghai hospital didn’t respond to requests for
comment. The hospital hasn’t commented or confirmed any deaths
publicly, which were first reported more than three weeks ago by
the Journal.

In a letter of condolence sent to some families in early April,
reviewed by the Journal, Donghai hospital apologized for the deaths
of some residents who were “unvaccinated and had serious chronic
illness.”

The hospital underestimated the speed the virus could spread and
wasn’t professional in containing the outbreak, the letter said,
adding: “It was a bloody lesson.”

China’s National Health Commission and Shanghai’s government didn’t
respond to requests for comment.

Donghai is known as one of Shanghai’s best elderly care hospitals.
Owned by a state-owned food conglomerate, it houses 1,900 residents,
including many former state employees, in roughly a dozen low-rise
buildings southeast of the city center. It reported no Covid-19
infections in 2021. All 731 staff members had received vaccines and
booster shots. In late January, the hospital conducted Covid emergency
drills in which they temporarily locked down the facility within
30 minutes of a simulated Covid exposure. It conducted over 2,000
Covid tests in two hours, the hospital reported in its official blog.

Karl Xue, a Shanghai native who is an interior designer, said operations
were smooth when he visited his 86-year-old mother in late February.
He watched as his mother, a former Russian translator who liked
reading newspaper clippings in bed, walked along the corridors of
Ward 24, the section of the hospital where she lived with dozens of
other residents, with help from a physiologist and a hand bar attached
to the wall.

Visits suspended
-----------------
On March 6, however, a woman coming to see her father was stopped at
the gate. She said she was told the hospital had suspended visits,
citing the emergence of new Covid cases in Shanghai. A few days later,
a staff member tested positive. Hospital officials began sealing off the
site, though unlike the January drill, this time it took over 24 hours.
It couldn’t be determined why.

After lockdown, on March 13, a bus came to take away employees who
had been in contact with the infected staff member, in keeping with
China’s policy of isolating anyone possibly exposed to the virus.
The employees were wrapped in blue disposable hoods and gowns,
supervised by officials in white hazmat suits.

In Ward 7, a few buildings away from Mr. Xue’s mother, patients were
falling ill with Covid. With several positive cases there, officials
moved almost the entire medical staff in the building into quarantine
facilities. Orderlies from other wards were sent in to assist, but the
hospital was running low on staff.

Communications with family members started breaking down. One relative,
the daughter of a woman in Ward 7, said she made hundreds of calls to
the hospital over several days but none of them were answered.

The hospital worked to bring in replacements quickly, including the
migrant maids and nannies. A dozen new hires arrived at Ward 7 by
March 21. Each was allocated a makeshift bed in the corridor to sleep
in and six to a dozen residents to attend to. Nurses who remained on
the job gave them herbal pills approved by China’s government to help
prevent Covid. Within a week, all but 3 from the group of new hires
were infected. One of those who stayed healthy was left feeding as
many as 20 residents. Another new hire said she was so worried about
getting infected that she left her mask on in her sleep. Like many
hospital workers during the original Covid outbreak in Wuhan in 2020,
she wore diapers during the day so she wouldn’t have to take off
protective gear while working. The diapers sometimes soaked through
her pants, she said. By March 29, two dozen bodies were in the hospital
morgue, according to families of the deceased, who cited eyewitnesses.
One of the new-hire orderlies said he was tasked with dressing a male
patient who had died after he was infected with Covid. Another new
orderly said he handled dead bodies for three consecutive days before
he was infected himself, while another said she saw half a dozen
hearses parked at the hospital gate at night.

Mr. Xue’s mother
--------------------
In Ward 24, where Mr. Xue’s mother lived, things had been calmer
than in other wards, which had started moving staff and patients
to Covid isolation facilities. Although family members couldn’t
visit Ward 24, nurses were still cutting residents’ hair and nails.
They shared videos of smiling patients to family members while
assuring them they would keep them posted on any developments.

Mr. Xue, now away from Shanghai, checked with an orderly to make
sure his mother had enough milk and her hearing aids were OK.
The orderly told Mr. Xue that her workload had increased as
several colleagues had left to assist other wards. She also
complained that Mr. Xue’s mother, who had a reputation for being
strong-willed, wouldn’t stay in her room. In WeChat exchanges
between Mr. Xue and his mother on March 28, she sent him cat memes
and complained that the corridor was eerily quiet, and that orderlies
now washed her face too fast. “I’m not at ease,” she told him.
Mr. Xue wrote back that things were much worse outside in the city
at large. A few hours later, a doctor wrote in the Ward 24 WeChat
group, which included families of patients on the ward and their
healthcare workers, that Mr. Xue’s mother, though asymptomatic,
was infected along with 18 other patients. The doctor said he
needed the families’ permission to transfer their infected relatives
to a facility 50 kilometers away called Zhoupu Hospital. Most nurses
in the ward had been infected and he was the only doctor remaining,
he said. Mr. Xue and the other infected patients’ relatives refused,
fearing the move would be too disruptive.

On March 29, Mr. Xue received a message saying that residents
had already been transferred, on orders from the Chinese CDC, which
Donghai’s managers had to obey. “Why the heck did they ask us to
seek approval?” the doctor wrote in the Ward 24 WeChat group.

Family members found messages on Chinese social media about Donghai
residents suffering after the move to Zhoupu, according to the Ward 24
chat records. Some said they couldn’t get in touch with their parents,
and others warned the patients wouldn’t survive the chaos. A nurse
shared in the Ward 24 chat group a hospital notice that said other
Donghai residents who had been forced to stay in a makeshift space
in Zhoupu’s entrance hall would soon be moved into a residential ward.
“The condition is no comparison to Donghai, but at least there’s
progress,” the notice said. “Every hospital is now a mess,” the
nurse wrote. Mr. Xue said his mother didn’t reply when he tried to
reach her on WeChat. He worried about whether she had brought her
hearing aid to the new hospital, imagining her fear without it. He
tried telephoning different wards but couldn’t find her.

On March 30, a nurse picked up the phone. She was in the ward where
his mother had been sent but said she had died the previous night.
Zhoupu formally notified Mr. Xue of his mother’s death on April 1.
He said he was told it wasn’t related to Covid because there were
no symptoms in her lungs. When the person said she might have died
from sudden heart failure or maybe a stroke, Mr. Xue found it hard
to believe based on her previous health, and demanded an autopsy.
Both Zhoupu and Donghai said it wasn’t possible during the outbreak,
he said. Zhoupu declined to comment.

By then, the chat group for Ward 24 relatives was boiling with anger.
A daughter learned her mother suddenly needed a feeding tube after
being transferred to Zhoupu, and demanded to know why. Several chat
group members said that after the transfer, nobody gave their parents
medications they needed to control high blood pressure or diabetes.
In a series of exchanges in the Ward 24 chat group, a nurse said
Donghai needed medical assistance from the outside world. “Otherwise
we’ll all die,” she wrote. Another nurse suggested an appeal to the
central government via a government-run opinion collection website.
“Both the medical workers and the patients are victims,” she said.
Back in Donghai hospital’s Ward 24, around 40 patients remained. One
nurse was left to care for all of them. Two days after the evacuation,
on March 31, a team of doctors, nurses and orderlies came to aid the
ward. Three weeks after his mother’s death, Mr. Xue said Donghai still
hasn’t provided him details of her final hours. He questioned whether
she received proper care during the transfer. “It was Donghai’s
responsibility to keep her safe, even if the pressure came from the
state,” he said.

https://www.wsj.com/articles/shanghai-nursing-home-covid-deaths-11650641053