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Differing medical outcomes

China health workers’ stories reflect unpredictability of illness

Deng Danjing (left) and Xia Sisi, both medical workers in Wuhan, China, got the coronavirus. Only Deng survived.
Deng Danjing (left) and Xia Sisi, both medical workers in Wuhan, China, got the coronavirus. Only Deng survived.Sui-Lee Wee and Vivian Wang Via the New York Times

The young mothers didn’t tell their children they had the coronavirus. Mama was working hard, they said, to save sick people.

Instead, Deng Danjing and Xia Sisi were fighting for their lives in the same hospitals where they worked, weak from fever and gasping for breath. Within a matter of weeks, they had gone from healthy medical professionals on the front lines of the epidemic in Wuhan, China, to coronavirus patients in critical condition.

The world is still struggling to fully understand the new virus, its symptoms, spread and sources. For some, it can feel like a common cold. For others, it is a deadly infection that ravages the lungs and pushes the immune system into overdrive, destroying even healthy cells. The difference between life and death can depend on the patient’s health, age, and access to care — although not always.

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The virus has infected more than 132,000 globally. The vast majority of cases have been mild, with limited symptoms. But the virus’s progression can be quick, at which point the chances of survival plummet. Around 68,000 people have recovered, while nearly 5,000 have died.

The fates of Deng and Xia reflect the nature of a virus that affects everyone differently, at times defying statistical averages and scientific research.

When a mysterious new virus struck the city, the women began working long hours, treating a seemingly endless flood of patients. They took precautions to protect themselves. But they succumbed to the infection. In the hospital, each took a turn for the worse.

One recovered. One did not.

The symptoms came on suddenly.

Xia had ended her night shift Jan. 14 when she was called back to attend to a patient.

Five days later, she started feeling unwell. Exhausted, she took a two-hour nap at home, then checked her temperature: It was 102 degrees. Her chest felt tight.

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A few weeks later, in early February, Deng, the nurse, was preparing to eat dinner at the hospital office when the sight of food left her nauseated. She brushed the feeling aside, figuring she was worn out by work.

After forcing down some food, Deng went home to shower, and then, feeling groggy, took a nap. When she woke up, her temperature was 100 degrees.

Fever is the most common symptom of the coronavirus, seen in nearly 90 percent of patients. About a fifth of people experience shortness of breath, often including a cough and congestion. Many also feel fatigued.

Both women rushed to see doctors. Chest scans showed damage to their lungs, a telltale sign of the coronavirus that is present in at least 85 percent of patients, according to one study.

In particular, Deng’s CT scan showed what the doctor called ground-glass opacities on her lower right lung — hazy spots that indicated fluid or inflammation around her airways.

The hospital had no space, so Deng checked into a hotel to avoid infecting her husband and 5-year-old daughter. She sweated through the night. At one point, her calf twitched. In the morning, she was admitted to the hospital. Her throat was swabbed for a genetic test, which confirmed she had the coronavirus.

Her room in a newly opened staff ward was small, with two cots and a number assigned to each one. Deng was in bed 28. Her roommate was a colleague who had also been diagnosed with the virus.

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At Jiangbei Hospital, 18 miles away, Xia was struggling to breathe. She was placed in an isolation ward and treated by doctors and nurses who wore protective suits and safety goggles. The room was cold.

There is no known cure for Covid-19, the official name for the disease caused by the new coronavirus. So doctors rely on a cocktail of other medicines, mostly antiviral drugs, to alleviate the symptoms.

Deng’s doctor prescribed a regimen of arbidol, an antiviral medicine used to treat the flu in Russia and China; Tamiflu, another flu medicine more popular internationally; and Kaletra, an HIV medicine thought to block the replication of the virus. Deng was taking at least 12 pills a day as well as traditional Chinese medicine.

Despite her optimism, she grew weaker. To feed her, a nurse had to come at 8:30 each morning to hook her up to an intravenous drip with nutrients. Another drip pumped antibodies into her bloodstream, and another antiviral medicine.

Xia, too, was severely ill, but appeared to be slowly fighting the infection. Her fever had subsided after a few days, and she began to breathe more easily after being attached to a ventilator.

In early February, Xia asked her husband, Wu Shilei, also a doctor, whether he thought she could get off oxygen therapy soon.

“Take it easy. Don’t be too anxious,” he replied on WeChat. He told her that the ventilator could possibly be removed by the following week.

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“I keep on thinking about getting better soon,” Xia responded.

By Deng’s fourth day in the hospital, she could no longer pretend to be cheerful.

Her fever jumped to 101.3 degrees. Early in the morning on Feb. 5, she woke from a fitful sleep to find the medicine had done nothing to lower her temperature.

While Xia appeared to be recovering, she was still terrified of dying. Testing can be faulty, and negative results don’t necessarily mean patients are in the clear.

She asked her mother for a promise: Could her parents look after her 2-year-old son if she didn’t make it?

Hoping to dispel her anxiety with humor, her mother, Jiang Wenyan, chided her: “He’s your own son. Don’t you want to raise him yourself?”

Xia also worried about her husband. Over video chat, she urged him to put on protective equipment at the hospital where he worked. “She said she would wait for me to return safely,” he said, “and go to the front line again with me when she recovered.”

Then came the call. Xia’s condition had suddenly deteriorated. In the early hours of Feb. 7, her husband rushed to the emergency room.

Her heart had stopped.

In most cases, the body repairs itself. The immune system produces antibodies to clear the virus, and the patient recovers.

By the end of Deng’s first week in the hospital, her fever had receded. She could eat the food her mother delivered.

On Feb. 15, her throat swab came back negative for the virus. Three days later, she tested negative again. She could go home.

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Deng met her mother briefly at the hospital’s entrance. Then, because Wuhan remained locked down, without taxis or public transportation, she walked home alone.

It was sometime after 3 a.m. on Feb. 7 when Xia was rushed to intensive care. Doctors first intubated her. Then, the president of the hospital frantically summoned several experts from around the city.

Xia’s heart started beating again. But the infection in her lungs was too severe, and they failed. Her brain was starved of oxygen, causing irreversible damage. Soon, her kidneys shut down, and doctors had to put her on round-the-clock dialysis.

Xia slipped into a coma. She died Feb. 23.

Back at Xia’s home, her son, Jiabao — which means priceless treasure — still thinks his mother is working. When the phone rings, he tries to grab it from his grandmother’s hands, shouting, “Mama, Mama.”

Her husband, Wu, doesn’t know what to tell Jiabao. He hasn’t come to terms with her death himself. They had met in medical school and were each other’s first loves. They had planned to grow old together.

“I loved her very much,” he said. “She’s gone now. I don’t know what to do in the future. I can only hold on.”