Multi-disciplinary teams play big role in treatment

Multi-disciplinary teams involving a wide range of departments are playing a prominent role treating severely ill COVID-19 patients during the current outbreak in Shanghai, experts said.

Due to the characteristics of the Omicron variant, most of the severely ill cases are caused by a patient's underlying diseases, and therefore the disciplines covered by the team need to be broader, they said.

"Two years ago, when we participated in treating severe cases, the team was composed of healthcare professionals from critical medicine, respiratory diseases, infectious diseases and those using extracorporeal membrane lung devices," said Gao Yuan, deputy head of the expert team at Renji Hospital's south branch, a designated medical institution to treat COVID-19 cases in Shanghai.

"Now, practitioners from more departments, including emergency treatment, heart disease, surgery, anesthesiology, neurology and kidney disease have joined," said Gao.

As of Wednesday, there were 304 severely ill COVID-19 patients and 48 in critical condition in Shanghai. The city has reported 285 COVID-19 fatalities since the current outbreak started in early March.

Most of them were elderly patients with serious underlying diseases, and most were not vaccinated, according to the city's health authority.

Gao said that at the designated hospital at Renji, the oldest patient currently is 97, and those aged 60 or older account for 80 percent. "What's more, nearly half of them suffer from three or more types of underlying diseases," he said.

More than 40 doctors at the hospital are dedicated to treating ICU patients, and a diversified team of professionals with different expertise work on each shift to ensure that they can deal with patients who have different underlying diseases, said Gao.

Zhang Wenhong, leader of the Shanghai team of experts in the treatment of COVID-19, said the challenges of rescuing vulnerable groups are beginning to emerge.

"When these patients with serious underlying diseases were infected with the virus, their pneumonia symptoms may not be severe, but the treatment of their underlying disease remains a serious challenge," said Zhang, who is also director of the infectious disease department of Shanghai Huashan Hospital.

Shanghai has brought together more than 360 critical care medical experts from in and outside the city to form nine critical care teams stationed at eight designated hospitals to treat these patients, many of whom used to stay at treatment or nursing institutions, he said.

A team composed of 53 experts from 15 disciplines was also established to discuss severe cases in regular virtual meetings to design and adjust personalized treatment plans for each patient.

Experts pointed out that it is important that the original treatment and nursing care for such patients, especially those in their twilight years, were not interrupted. For example, patients suffering from oncology or autoimmune diseases need careful nursing care, and some cancer patients need to continue radiotherapy and chemotherapy.

The daily tally of new COVID-19 infections in Shanghai has continued to fall, with the city reporting 1,292 confirmed cases and 9,330 asymptomatic infections on Wednesday.

To ensure the safe resumption of work and production, the city government has started establishing nucleic acid testing sites across the city. In Qingpu district, around 200 testing sites will be put into use in early May.

The sites will be located in places that allow residents to receive a test within a 15-minute walk from their homes.