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Zhong Nanshan: Doctors care about patients, not diseases

(People's Daily Online)    13:56, April 09, 2020

“Doctors care about patients, not diseases. The question we should often think about is what are the medical problems that haven’t been solved yet and how can we solve them,” renowned Chinese respiratory expert Zhong Nanshan said on April 4 during an exclusive interview, Zhongguo Jijian Jiancha Bao (China Discipline Inspection and Supervision Daily) reported Tuesday.

Zhong Nanshan receive interview with Zhongguo Jijian Jiancha Bao on April 4. (Photo/Zhang Rui)

Zhong, who is also an academician with the Chinese Academy of Engineering (CAE), is the head of the high-level expert team put together and sent to Wuhan by China’s National Health Commission (NHC) to guide epidemic response work and conduct on-site investigations.

Zhong was born in in 1936 in Nanjing, capital of east China’s Jiangsu province. He graduated from Peking University Health Science Center (then the state-run Beijing Medical School) in 1960, and was one of the first batch of students sponsored by the Chinese government to study abroad after the implementation of the reform and opening-up policy.

In 2013, Zhong took part in the country’s fight against the Severe Acute Respiratory Syndrome (SARS) epidemic. This year, when the novel coronavirus outbreak hit China, the 84-year-old expert once again went to the front line of the battle like an iron warrior.

During the recent three-day Qingming Festival national holiday from April 4 to 6, Zhong continued to work tirelessly in his office in the Yuexiu campus of Guangzhou Medical University in Guangzhou, capital of south China’s Guangdong province.

His recent interview with Zhongguo Jijian Jiancha Bao gave a great deal of insight into his work, ideas, beliefs, and some of the reasons why the man is so highly respected in China.

Going to the front: “I went to Wuhan with an urgent desire to learn more about the disease.”

On Jan. 18, Zhong went to Wuhan, capital of central China’s Hubei province and also the previous epicenter of the novel coronavirus disease (COVID-19), on short notice.

“On the afternoon of Jan. 18, I got the notice about going to Wuhan and joined the NHC’s high-level expert team that same night. I was made head of the team and was told to take part in discussions the next day. I realized then that the situation was probably serious. I went to Wuhan with an urgent desire to learn more about the disease,” Zhong said.

Zhong reported the epidemic situation on behalf of the expert team on the morning of Jan. 20, when he confirmed human-to-human transmission of the novel coronavirus and cases of medical workers becoming infected. These were two very important signs, as they signified that the disease would spread quickly, Zhong pointed out.

“In the face of a new infectious disease, the first priority is to think about how to prevent it,” Zhong said, stressing that for all public health incidents, the first priority is to keep the situation within the upper stream of those incidents, and that efforts must be made to prevent it from spreading out.

Fighting COVID-19: “We need to prevent more infections and reduce deaths. What can be more important for a doctor than this?”

Under the leadership of the Central Committee of the Communist Party of China (CPC), China has formulated the correct epidemic prevention and control strategies, Zhong said.

During the initial stage of the outbreak, China locked down Wuhan in order to cut off the spread of the virus and launched mass prevention and treatment measures across the country, Zhong said, noting that those measures were later upgraded to joint prevention and control efforts.

The joint prevention and control efforts highlight four key points: early discovery, early reporting, early isolation, and early treatment, Zhong explained, adding that these efforts have proven effective in China.

China has been making efforts to summarize the ways the disease works while paying close attention to medical treatment, Zhong pointed out, adding that the clinical manifestations and effective drugs China discovered during its fight against COVID-19 serve as a good reference for the world to follow.

After painstaking efforts, China has made important phased achievements in prevention and control of the epidemic, and these results were hard-won, according to Zhong.

However, the disease is spreading rapidly overseas and the country is coming under mounting pressure from imported COVID-19 cases, Zhong noted, pointing out that by April 3, China had reported more than 700 imported cases of COVID-19, and the figure continues to rise.

China should promptly adjust and improve its epidemic prevention and control measures and focus its efforts on preventing imported cases and a recurrence of the outbreak in the country, Zhong said.

When asked about the greatest pressure he faced during the fight against the epidemic, Zhong said throughout his career as a doctor, the greatest pressure has always come from a patient’s death.

“Since I started my career as a doctor, the greatest pressure for me has always come from whether I am successful in saving patients’ lives. If I manage to save and cure a patient, then everything else is easier to deal with. But if I fail to save the life, it’s the most stressful moment for me,” Zhong revealed.

“The same is true with the present fight against COVID-19. We need to prevent more infections and reduce deaths. What can be more important for a doctor than this?”

Making progress: “Historical experience has told us that a vaccine is the final answer to prevention and control of an epidemic.”

“We have carried out clinical tests for chloroquine and the Lianhua Qingwen Capsule, which have so far both proven to have positive effects. Chloroquine can shorten the course of the disease and reduce viral load, while Lianhua Qingwen Capsule can significantly reduce the time needed for alleviation of symptoms,” Zhong disclosed.

“It’s essential to develop vaccines for the COVID-19,” Zhong said, noting that COVID-19 is more contagious than SARS, which is why some countries are now reporting more than 10,000 confirmed cases a day.

“Historical experience has told us that the vaccine is the final answer to prevention and control of an epidemic,” Zhong said, adding that vaccines for COVID-19 are urgently needed.

Scientific research: “Basic scientific research should serve clinical practice.”

“Clinical treatment must always have an extremely important position in anti-epidemic efforts, and basic scientific research should serve clinical practice,” said Zhong.

Zhong disclosed that his research team collected the clinical characteristics of 1,099 COVID-19 cases and published its findings in the New England Journal of Medicine soon after the outbreak of the epidemic.

“It was the first time that data on more than 1,000 COVID-19 patients across the country was gathered. The paper is also by far the most cited research on the epidemic in the world,” Zhong added.

“We found in the research that about half of the COVID-19 patients didn’t have fever when they were admitted to hospital, and some patients who had high laboratory indexes quickly became severe cases. Such basic research findings have played a very good guiding role in curing and treating the disease around the world,” Zhong said.

Family tradition: “My father didn’t talk much. He said one should make sure what he says is based on evidence.”

Zhong says his career choice can be largely attributed to his family environment.

Zhong’s father was a paediatrician. His mother graduated in advanced nursing from Peking Union Medical College (then China Union Medical University) and served as vice president of Sun Yat-sen University Cancer Center (then tumor hospital in south China).

“In the 1940s and 1950s, many neighbors often brought their children to my home for medical diagnosis and treatment. After they were cured, the neighbors were very happy and my father felt a sense of achievement,” Zhong said.

“My parents talked a lot about medicine at home, which had quite a big influence on me. It helped develop my interest in the subject,” Zhong added.

The greatest influence his father had on him was the idea that one should always seek truth from facts, according to Zhong. “My father didn’t talk much. He said that one should make sure what he says is based on evidence.”

According to Zhong, his family members understand his work and have always supported his career.

“I’ve made some achievements in my work. The support from my family is very important,” Zhong said.

Life: “How the Steel Was Tempered had a very big influence on me. The patriotism in the book has influenced a whole generation.”

During his time in the University of Edinburgh, some of Zhong’s studies won widespread recognition from his teachers and research fellows. One of his teachers tried to persuade him to stay, but Zhong decided to return to his motherland when his studies had ended.

“Our country gave us the opportunity to study abroad when it was in a very difficult situation financially, so I never thought about not returning home. I thought I had to come back to help with our country’s scientific research after finishing my studies abroad,” Zhong said.

“I haven’t had much time to read novels since I began to work, but I read a lot of novels when I was in primary and secondary school. How the Steel Was Tempered had a very big influence on me. The patriotism and the idea of ‘one for all and all for one’ in the book has influenced a whole generation,” Zhong said.

“Just like my father said, you can feel your life has been worthwhile if you leave something valuable in the world,” Zhong said.

Medicine is a practical discipline, said Zhong, revealing that many of his ideas, inspiration in work, and research questions came from clinical practice.

“I’m not used to finding research questions from literature,” Zhong said. 

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