武汉最初7例会诊记录首次曝光！“疫情上报第一人”公开回应质疑
近日，“疫情上报第一人”、 湖北省中西医结合医院呼吸内科主任张继先报告的最初7名新冠肺炎病例首次会诊记录，第一次曝光！
时隔三个多月，张继先在接受CGTN采访时首次打开档案柜，展示了最初7名新冠肺炎病例首次会诊记录，及多部门专家对这些不明病例的初次诊断意见，重现去年12月27日首次拉响警报的关键时刻。
图源：CGTN视频
那么，报告中到底都写了些什么？武汉有关部门又是如何应对最初的这些“不明原因肺炎病例”？戳视频观看↓↓↓
What was written in the profiles of the first seven COVID-19 patients in central China's Wuhan? How did the authorities in Wuhan first deal with the medical report of COVID-19 cases? CGTN interviewed Dr. Zhang Jixian, the first doctor to alert the medical system on the novel coronavirus.
Zhang Jixian said she had not expected the disease to be so infectious or serious, while noting that local authorities reacted promptly after receiving her report.
在张继先展示的一份会诊记录中，该患者入院时间为2019年12月27日，专家会诊时间为12月29日，会诊主持人是张继先和湖北省中西医结合医院夏文广院长，参加的有10个部门的人。
图源：CGTN视频
Zhang, director of the department of respiratory and critical care medicine at the Hubei Provincial Hospital of Integrated Chinese & Western Medicine, showed records of a medical consultation on December 29, 2019, of seven COVID-19 patients the hospital treated at the early stage of the outbreak in an interview with CGTN on April 18.
在会诊记录中，描述了武汉最初7例新冠肺炎病例之一的病情简介：
“发热10天伴加重3天入院，双肺有呼吸音粗，左下肺有湿罗音，双下肢不肿。”
图源：CGTN视频
“入院后给予抗感染（抗病毒、抗细菌）对症治疗。肺部CT显示双肺多发感染性病变，有毛玻璃影。甲流乙流抗体阴性，呼吸道五项病原学检查也是阴性……”
图源：CGTN视频
张继先介绍，这个病例是第4个病例，是华南海鲜市场卖冻品的商户。他是最重的一个，也最具有典型代表。除这个病例外，其他6人有类似症状，所以大家一起讨论。
会诊记录后面的总结显示：
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继续积极治疗，对症处理；
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鉴于我院检验科的检验条件有限，无法明确感染源，建议在报区疾控部门基础上，继续报武汉市、湖北省疾控部门，组织专家会诊；
因7名患者均为近两日入院，此患者最重，有代表性，且群集性发病。其中5名患者症状较重，可能危及生命。建议上级医院或专科医院诊治。进一步明确感染源，针对性治疗。
图源：CGTN视频
According to the record, a vendor at the Huanan Seafood Market who was sent to the hospital on December 27, 2019 showed the severest symptoms among the seven. CT results showed infecting lesions and ground-glass opacity in his lungs.
All the seven patients were admitted around December 27 and showed features of cluster transmissions. Five of the seven were in critical condition with possible threat to life, read the consultation conclusion.
The hospital could not define the source of infection due to limited conditions, and suggested the district, the Wuhan and Hubei provincial CDC to organize more expert consultations on the cases, the conclusion said.
张继先表示，上报区疾控中心后，他们的反应还是挺迅速的。
12月27日中午上报，区疾控中心当天下午就来做流行病学调查，同时也采集了病人的血液和咽拭子，检测病原体。
图源：CGTN视频
29日会诊上报后，区疾控中心又来了，同样采集病人的血液并问病史。张继先说：“我觉得他们反应还是挺及时的。”
图源：CGTN视频
According to the timeline of China's reaction to the COVID-19 outbreak, on December 27, 2019, Zhang first reported three suspicious cases she had treated to the district disease control and prevention center.
"I reported to the district at noon, and they came to conduct an epidemiological survey that afternoon and collected patients' blood samples and throat swabs," Zhang told CGTN.
The result of the consultation on December 29 was also reported to the district, who sent experts to the hospital again that day collecting patients' blood and asking questions about patients' medical history.
"They reacted quite quickly," Zhang noted.
而在疫情之初，张继先也没有想到，三个多月之后，疫情会在全球范围内发展得如此严重。
“当初我觉得它可能是传染病，但是真的没有想到像现在这样，传染性这么强，流行范围这么广，病情这么严重。”
图源：CGTN视频
在采访中，记者还问到了很多人的质疑：既然专家已经说了有可能有人传人的危险，那么是不是应该更早地告诉大众呢？
图源：CGTN视频
张继先表示，对疾病的认识都有一个过程。在事情没完全弄清楚的时候，不能够说得太多。
图源：CGTN视频
“如果是做科研，结论出来之前我怎么跟大众说？这个事情应该有科学谨慎的态度。”
图源：CGTN视频
As to questions over why experts and authorities did not notify the public that the disease could spread from person to person, Zhang said that a process is required to learn about a disease and experts could not say too much to the public before they understood the issue.
"If I am a scientist, how should I inform the public before I reach any conclusion? We should have a rigorous attitude," she said.
那么，这些病例是怎么被发现的？又有哪些特殊的地方？新华社前不久也在武汉采访了张继先，听她讲述那“特殊时刻”的发现。
张继先回忆称，最早是去年12月26日，门诊接诊了一位老太太，有发烧、咳嗽气喘、呼吸困难等症状。
图源：新华社视频
和她一起来看病还有她的老伴和儿子，老伴是因为乏力前来就诊的，当时并没有发烧。
图源：新华社视频
On Dec. 26, an elderly couple from a nearby community visited the Hubei Provincial Hospital of Integrated Chinese and Western Medicine. Their symptoms included fever, coughing and tiredness, which "looked like flu or common pneumonia," recalled Zhang, director of the hospital's respiratory and critical care medicine department.
两位老人都生病了，所以张继先就赶紧让他们的儿子来医院接受检查，他儿子说自己没有什么特殊症状，不是很愿意来。
“在我的坚持下，老两口的儿子也来医院做了检查，一看CT，肺部也有类似症状，但是症状不重。哪有一家子三个人得一样的病？说明这病可能有传染性，他们三人的CT情况，也给我一种感觉：这不是一般病毒。”
图源：新华社视频
Zhang's experience during the 2003 SARS outbreak, when she worked as a medical expert investigating suspected patients in Wuhan, made her sensitive to signs of an epidemic. After reading the CT images of the elderly couple, she summoned their son, demanding a CT scan of him too.
"At first their son refused to be examined. He showed no symptoms or discomfort, and believed we were trying to cheat money out of him," said Zhang.
It was Zhang's insistence that brought her the second piece of evidence: the son's lungs showed the same abnormities as those of his parents.
"It is unlikely that all three members of a family caught the same disease at the same time unless it is an infectious disease," Zhang told Xinhua.
张继先在接受新华社《瞭望新闻周刊》采访时说：
“接下来的几天里，一直到2019年12月29日，我们科室又陆续收治4个病人，且和上述一家三口有类似症状。一开始我们也不知道这4人之间有什么关系，便把他们放到一个区域治疗，结果发现他们相互认识，都是华南海鲜市场的，有的是摊主，有的在里面打工，来医院之前他们还在同一家门诊打过针，看过病。”
“我一看，肯定不对，同一个地方有4人发病，肯定有问题。医院也怕搞错，就在当日下午2点钟左右，召集呼吸科、院感办等院里多个部门的专家对7个病例逐一讨论，讨论完更觉得我们之前的判断是对的：这种病和我们以前知道的病都不一样，而且有人传人的迹象。于是当天再次上报，区里、市里、省里一层层上报。”
图源：新华社视频
这就是我们前面看到的7名病例的会诊病历。
The arrivals of another four patients with similar lung images in the next few days further alarmed the hospital, which on Dec. 29 convened a panel of 10 experts to discuss the seven cases. Their conclusion that the situation was extraordinary, plus information of two similar cases in other hospitals, prompted the hospital to report directly to the municipal and provincial health authorities.
对这7名病人，最初是怎么安置的呢？
张继先表示：“在收治那一家三口住院时，我们在呼吸科病房隔出一块与其他区域相对独立的地方，建立了有9张病床的隔离病房，并且要求科里的医护人员一定要加强防护。”
“因为我们知道它至少是个病毒，会传染，就像甲流乙流一样，有传染性。但甲流乙流引起的肺炎比这个要轻些。一般的病毒感染都要做防护，现在这个病重，肯定更要做好防护。戴口罩是必须的，要勤洗手；那些病人用的东西，都是专用的，不能拿出来，包括病人的生活垃圾、医疗垃圾，不能跟别的病人搞混了。”
Back then, knowledge of the virus was scarce. Zhang cordoned off an area in the department's ward to hospitalize the patients. She then demanded medics in the ward to beef up self-protection.
“2019年12月29日晚上，传染病定点医院——武汉市金银潭医院业务副院长黄朝林和ICU主任吴文娟火速抵达湖北省中西医结合医院，逐一查看了7例病患。
当晚11点多，就转走了其中6位病人前往金银潭医院进行治疗。有1人留在我们医院治疗，并于今年1月7日治愈出院，就是前面说的一家三口中的那位儿子。
当晚，黄朝林就和我们医院领导商量，向上面提出建议，要关停华南海鲜市场。”
图源：新华社视频
根据新华社记者以时间顺序进行梳理的《中国发布新冠肺炎疫情信息、推进疫情防控国际合作纪事》，2019年12月底，湖北省武汉市疾控中心监测发现不明原因肺炎病例。
12月30日，武汉市卫生健康委向辖区医疗机构发布《关于做好不明原因肺炎救治工作的紧急通知》。
12月31日，国家卫生健康委员会凌晨作出安排部署。派出工作组、专家组赶赴武汉市，指导做好疫情处置工作，开展现场调查。
图源：新华社视频
同日，武汉市卫生健康委在官方网站发布《关于当前我市肺炎疫情的情况通报》，发现27例病例。提示公众尽量避免到封闭、空气不流通的公众场合和人多集中地方，外出可佩戴口罩。
图源：武汉市卫生健康委网站截图
当日起，武汉市卫生健康委依法发布疫情信息。
According to an official timeline released on April 6 on China's response to COVID-19, the Wuhan Municipal Health Commission on Dec. 30 sent out an urgent notification to medical institutions under its jurisdiction about an outbreak of pneumonia of unknown cause in the city.
The National Health Commission (NHC) dispatched a working group and an expert team in the wee hours of Dec. 31 to Wuhan to guide epidemic response and conduct on-site investigations.
Also on the same day, the Wuhan Municipal Health Commission released its first briefing about the outbreak of pneumonia of unknown cause on its website, in which it confirmed 27 cases and told the public not to go to enclosed public places or gather. The public was also advised to wear face masks when going out.
作为第一个为湖北乃至全国拉响疫情警报的医生，张继先在2月4日被湖北省卫健委记大功奖励。
不过，张继先本人在接受新华社《瞭望新闻周刊》采访时却认为大家给她的评价太高了：
图源：新华社视频
我是一名医生，就应该这么做。职业敏感让我做了应该做的事情。
I was just doing what a doctor was supposed to do, driven by professionalism.
综合来源：CGTN、环球时报、央视新闻、新华社、新华社《瞭望新闻周刊》
