The true terror of the COVID-19 pandemic is in the isolation wards of hospitals. He Shusi talks to patients and medical staff in Wuhan who saw it all.

Medical staff swept up in the horrors of Wuhan have emerged deeply wounded, from seeing the life-and-death struggles in COVID-19 isolation wards.

Zhou Huili was one of them. The 39-year-old head nurse at the Hong Kong-funded Wuhan Asia General Hospital was in charge of 17 isolation beds for novel coronavirus patients who were all in a critical condition.

Zhou's assignment before the plague broke loose in January was head nurse at the hospital's heart disease center. On Jan 20, she was reassigned to the Intensive Care Unit, taking care of the most critically ill.

Many were old, barely breathing and unable to speak. The infection in their lungs would spread to their hearts, and other vital organs, Zhou explained.

"I was trained to treat patients for heart disease. I always used my training to help save lives - even the old people with heart failure. This time, I was desperate." Zhou told China Daily. She felt helpless, even with younger patients, in the face of a virus never seen before.

"Sometimes, I stood by a patient's bed and said a silent prayer for them to survive."

Zhou Huili is a 39-year-old head nurse at the Hong Kong-funded Wuhan Asia General Hospital in the central Chinese city. (PHOTO PROVIDED TO CHINA DAILY)

'Want to be alive'

Zhou saw over 10 patients die, between late January and end of February. In 20 years of nursing, Zhou said she never failed to save a patient during emergency rescue. Losing over 10 patients in a month shook her.

There was a 60-year-old man with a history of good health. He could hardly breathe, and the oxygen in his lungs was dangerously low when he was sent to ICU.

Even with a ventilator, he didn't get better. "We encouraged him to breathe as hard as he could. He tried but it was a struggle. Zhou remembers his face, "exhausted beneath the oxygen mask but determined to fight".

On her rounds one day, Zhou saw something that deeply touched her as the man opened his palm. He couldn't speak but he had written on his palm - Xianghuo, which means "I want to be alive" in Chinese.

"He was the most resolute patient I've ever seen," Zhou said. "I thought no matter how hard it would be, we had to save his life."

She assigned nurses to try to feed him whatever he could take. "If it (the work) was too much for one nurse, I would send two," Zhou said.

He cooperated with the nurses, and struggled to stay alive. Sometimes when Zhou watched him, tears welled up in her eyes.

The medical staff sometimes helped him make video calls with his family. His wife told him: "You can't abandon me". His daughter encouraged him, "Dad, please stay strong", Zhou recalled.

Zhou kept telling him he had many years left. The chance of recovery was good, and the whole country was behind the effort in Wuhan. She'd tell him how many patients had recovered and were discharged every day.

Then he died.

Zhou sobbed as she explained: "Maybe he was too sick to make it, he passed away after three weeks (in hospital)."

Zhou had prepared for the worst when she went into the isolation ward.

Zhou Huili (third left) leads a team of 80 nurses in the ICU for COVID-19 patients. She is the only one infected. (PHOTO PROVIDED TO CHINA DAILY)

Prepare for the worst

On Chinese New Year's Eve, Jan 24, Zhou called her older daughter to the bedroom alone. She recalls she couldn't look her daughter directly into her eyes, because she was on the verge of tears. She told the 14-year-old where she could find the property ownership certificate of their house.

When her daughter showed alarm at the grim tenor of the conversation, Zhou explained: "Nothing, just to keep you informed."

That night, Zhou learned a doctor she knew had died from the virus. "I was shocked and saddened," Zhou said. "As a medical worker, I was scared. I cried in secret for a long time, hiding under my quilt."

Zhou was supposed to have the next day off, the first day of the Year of the Rat. But she went to the hospital. "My mind was filled with the pandemic. The situation wouldn't get any better if I stayed at home. I might as well go to the hospital."

Zhou asked her husband to take their two daughters, one only 15 months old, to stay with her mother-in-law. She didn't want them to be put at risk.

She hasn't seen her family since.

She led a team of some 80 nurses. There was a ton of work and the pressure was enormous. Materials needed distribution. She had to train and manage nurses treating patients, and dealing with death on the wards.

Many nurses had been trained in other fields, and worked in other departments. Now, all attention was turned to COVID-19. The nurses came full of questions for Zhou about medical procedures for this novel virus.

From late January to early February, the number of coronavirus patients in Wuhan surged by some 20,000. Emergency rooms were full. Thousands of those thrown into panic showed real symptoms.

"It was like there's no end in sight. We didn't know when the outbreak could be brought under control. There was desperation," Zhou said.

Zhou remembered a doctor of her department asked her to take a photo of him before entering the isolation ward. "He said it might be his last photo in protective clothing. We didn't know whether we would be infected and what would happen to us," she recalled.

Zhou Huili takes care of a patient on the isolation bed. She oversees 17 beds in the ICU during the pandemic. (PHOTO PROVIDED TO CHINA DAILY)

Secretly infected

What Zhou didn't expect was that the virus found her first. On Feb 2, Zhou found herself feeling weak and short of breath. Prompted by another nurse, she had a computed tomography (CT) on her lung.

A nurse told her, the diagnosis was suspected viral pneumonia. "The nurse handed me the report, crying," Zhou recalled. "I had to be strong in front of my subordinate. So I told her I was alright, and not to worry about it."

The nurse left. Zhou found a quiet corner, squatted down and cried. "I called a nurse friend and said, 'I can't die. My daughter just passed her first birthday.'"

Despite the bleak outlook that descended with the diagnosis, Zhou was tested negative for the virus. She went home for a week, and took drugs to contain the deterioration of her lung. She worked from home. Too much needed to be done.

On Feb 9, Zhou did another CT. Her situation shows no deterioration, but no improvement as well. She got back to work.

Zhou lived at the hospital, working from 7 am to midnight, in protective gear up to five hours a day.

In late February, the outbreak in Wuhan began slowing down. New daily cases are fewer than 500, compared with a few thousand at the peak.

Zhou and her team got through the toughest times, with no one infected. But it wasn't over.

On Feb 26, Zhou felt a pain in her chest. She had been coughing. Another CT scan showed the abnormality in her lung getting worse. She was put into isolation.

Zhou Huili attends to a COVID-19 patient, and nurses on her team watch and learn. (PHOTO PROVIDED TO CHINA DAILY)

She had seen the worst. Patients died but many others recovered. She faced her crisis with renewed optimism.

Zhou always approved requests for time off from nurses who felt ill. But as the head nurse, she felt that option was closed to her.

From Feb 26 to March 24, Zhou spent 13 days in hospital, then 14 days in a quarantine camp. She didn't tell her family, and doesn't plan to.

Zhou didn't want them to worry about her. Her mother-in-law was prone to depression. Only a few close friends, her boss and a few nurses knew she had been infected.

If her family asked for video calls, she would say she was too busy.

Zhou stayed strong. Her final diagnosis didn't come until March 6. She was positive for the antibody to the virus, after about half a dozen earlier tests proved negative to the virus.

On March 3, China updated its diagnosis standard, stipulating that the antibody of the virus also indicated infection with COVID-19.

Zhou had clung to the belief that she was just a suspected case. That helped her to stay positive.

Zhou noted one of her classmates at nursing school, her close friend, also had the virus. "She told me, if we were too scared to get through this, what's the point for us attending nursing school?" Zhou said her friend, a nurse at Hubei General Hospital, kept her spirits up.

Staying at home alone, Zhou completed quarantine on April 7. She then returned to work, and plans to draft a thesis on her experience.

"I told my daughter, that at my age, I am no longer doing the work for a living. If my experience can contribute, even a little, to patients, it will be enough."

Zhou said she thinks many things seem less important. "Those tasty foods, amusing activities, good-looking stuff, are not that important for me right now."

"It's more important to stay healthy, breathe normally, with family and colleagues around," Zhou stressed. "I will cherish everything I have."

Yu Mingfeng, a 34-year-old nurse at the ICU of Wuhan Asia Heart Hospital, gets an apple — representing their wish for her staying healthy — from doctors sent to Wuhan from Beijing, when she was discharged from hospital on Feb 13. (PHOTO PROVIDED TO CHINA DAILY)

Caught off guard

By early March, more than 3,000 Chinese medical workers had been infected. Many caught the virus because of inadequate protection.

At the start, people knew little about the transmissibility of the virus. Lack of knowledge helped spread the infection. Yu Mingfeng, a 34-year-old nurse at the ICU of Wuhan Asia Heart Hospital, was one.

She was confirmed infected on Jan 22. Before that, she wore only the lowest level of protection in the ICU - a surgical mask.

"At first I thought I just had a cold," Yu told China Daily. People knew little about the virus, and didn't expect it to spread the way it has.

"I got muddled and terrified the moment I knew the diagnosis," said Yu, the mother of a 4-year-old daughter. Her first concern was whether she had infected her family and colleagues.

Luckily, Yu's infection was discovered before the onset of fever, which signals that the virus has become highly infectious. No one close to Yu came down with the infection.

There's no specific medicine for the novel coronavirus so far. Yu stresses the importance of a positive mental state, which can help natural immunity fight the disease.

Yu recalled one of her roommates in the isolation ward, in her 40s, who came close to panic when she noticed doctors cutting back on her medication.

"I told her it's a sign of recovery," Yu said. "I encouraged her to stay positive, and trust the doctors." The woman was relieved, as she knew Yu was a nurse.

"The encouragement and companionship helped us defeat the virus."

Yu had praise for the Beijing medical team who took care of her. "They came all the way to Wuhan," Yu said. "Some told me that they could hardly understand patients with Hubei accents. They had trouble acclimatizing to the cold, moist climate of Wuhan in the winter."

A nurse from Beijing posted a note on the wall inside Yu's ward: "Staying optimistic is the beginning of any treatment. Your recovery is our happiness.

Let's fight together!"

Yu was cleared of the infection and discharged from hospital on Feb 13. She has been quarantined at home since then. She has almost recovered now and waiting for confirmation to return to work.

Those desperate moments seeing horror and death, and the pearlescent memory where selfless medical workers give all they could to save lives, have knitted the picture of an unforgettable Chinese New Year for those in Wuhan.

Their lives will never be the same.

Contact the writer at heshusi@chinadailyhk.com