Triage system easing treatment in Shanghai

Medical institutions are making all-out efforts to treat patients with severe symptoms amid the ongoing upswing in COVID-19 infections by taking dedicated measures, including introducing more intensive care beds and implementing the triage treatment protocol.

Shanghai has built a triage system to facilitate referrals between its municipal, district and community medical institutions, the city's health commission said.

Since Dec 19, when Shanghai opened 2,594 fever clinics in its community medical centers and village clinics, the triage system has greatly improved the efficiency of the city's medical services, the commission said.

In just four days, fever diagnosis and treatment at the community centers went from making up less than 5 percent of the city's total to about 50 percent, it said. Last week, the percentage increased to nearly 70 percent in the city's Minhang district.

Shanghai's efforts have relieved the strain on hospitals so that their medical resources can be better used to serve patients in greater need. The proportion and number of fever diagnosis in the city's major hospitals have been declining as a result of the triage system's implementation.

According to Chen Erzhen, vice-president of Shanghai's Ruijin Hospital affiliated to Shanghai Jiao Tong University's School of Medicine, the hospital has seen the number of patients visiting its fever clinic halved between Dec 27 and 29, down from 600 to around 300.

At the same time, most hospitals in Shanghai have increased their online medical services for patients with less pressing medical problems, which coupled with the implementation of the triage system has allowed the city's tertiary hospitals to concentrate on treating severe cases.

"With the increase in the number of people infected with COVID-19, the peak of severe cases has gradually appeared," Chen said.

On Dec 29, the number of patients visiting the emergency room at Ruijin Hospital nearly doubled from the previous week to hit 1,500. About 80 percent of them were infected with COVID-19, with nearly half being elderly people with underlying diseases, Chen said.

"We are concentrating on the treatment of critically ill patients," he said.

The implementation of the triage protocol has also been carried out in cities such as Beijing and Zhengzhou, capital of Henan province, where community health services have been recently enhanced to alleviate the pressure mounting on major hospitals. In provinces such as Guizhou and Qinghai, medical experts have also gathered online to offer medical advice and diagnoses for patients with less pressing problems.

Across China, similar systems are being implemented. Jiao Yahui, director of the Department of Medical Affairs at the National Health Commission, said that China has established a daily dispatch system to coordinate medical resources across the country every day.

The total number of beds in China's first- and second-tier hospitals is around 5.6 million, and the recent bed utilization rate is hovering at around 60 percent.

As for major tertiary medical institutions, concentrating on the treatment of critically ill patients is the top priority.

In Wuhan, capital of Hubei province, the People's Hospital affiliated to Wuhan University has transformed itself into a "super clinic". It has reserved 5,198 beds, including 466 for the critically ill, to treat COVID-19 patients under the guidance of a 36-member team of respiratory experts.

The hospital has promised to try it best to admit and treat any patient, according to Wan Honghui, Party secretary of the hospital.

"We won't turn down any patient, nor will we give up on any life," Wan said.

LIN SHUJUAN in Shanghai