When Home and Nation Face Crisis: Everyone Has a Duty to Protect Themselves and Others

Doctor zhou December 10, 2022

With the epidemic at an emergency, an anxious patient's family member contacted me, asking me to try to persuade his elderly father to get vaccinated. The old man has dealt with me for over two years and is very adherent to my advice. His family believed I was the person best able to change his mind, so I tried to talk with the old man online.

The old man's conversation with me was calm and polite. He told me he would not get vaccinated and hoped I could persuade his family to respect his choice. He has had cancer for over five years, plus heart disease and diabetes. His cancer has metastasized to bone, and he suffers day and night from cancer pain; he needs 60 mg of OxyContin every day just to bring the pain to a barely tolerable level. But OxyContin has severe side effects: since starting it, he has suffered severe constipation, and on most days he has to dig stool out with his finger.

In truth, such an elderly man is not a suitable candidate for vaccination. He had previously asked me about euthanasia, but Chinese law does not permit it, so I could not answer him as he wished. Smiling, he told me: if he is infected and becomes a critical patient, and if I can give him some advice and help, using Chinese medicine to carry him through, then he will carry through; otherwise, he asks his family and doctors to give up resuscitating him and not to occupy scarce intensive-care resources.

I respected the old man's wishes and, as he asked, reassured his family. Indeed, for a patient with no quality of life to speak of, death is a release; his declining years have been spent in torment, and this has made him view life and death with equanimity.

Tao Yuanming wrote: "What is there to say of death? Bury the body amid the hills." He also wrote: "Roaming freely in the great transformation, neither delighting nor fearing. What must end, let it end; do not dwell on it overmuch." When a person has lived to a certain age, experienced a certain amount of the world, and bears the pain of illness, they can indeed come to share Tao Yuanming's view and see death as release. The attitude of family and bystanders is just as Tao put it: "Kin may still grieve a little, but others are already singing."

Over three years of the epidemic, how many patients who could not withstand the shock have felt as this old man does? When we panic over the death toll, do we consider that many of the deceased endured before death a suffering worse than death? Modern medicine saves lives while also prolonging suffering. So for some of the departed, passing away after a single infection may indeed be a welcome release. If some frail elderly people long beset by illness already wish to give up their lives, supporting them may, from a humanitarian standpoint, be the more correct course.

Omicron is highly transmissible, less virulent, and has a short incubation period, but one feature is rarely mentioned: it also kills quickly. In the early stage of this wave, when China was still pursuing dynamic zero-COVID, the Beijing municipal government reported the city's deaths. By November 27, four patients had died in Beijing; all four were elderly over 80, long beset by illness, and died about two to four days after onset.

The reason is simple: the deceased were already in very poor shape, with no resistance to infection, and collapsed at the first blow. These elderly people were much like the advanced cancer patient on the phone who refused vaccination: poor health, low quality of life, and the patient himself may not have wished to go on enduring the pain—only the family refused to give up.

These days many people consult me about vaccination, and the great majority of the time I strongly advise them to get vaccinated immediately and be sure to take the booster. But in a case like this old man's, if the patient himself firmly refuses, I will not urge him to vaccinate; I will respect his wishes.

Yet not everyone can face life and death so calmly. After our country's epidemic policy suddenly reversed, my patients and readers have come consulting me like a tide these past few days. They are anxious, worrying both about the elderly at home and about themselves. These worries are not groundless; as far as I know, among the severe patients admitted to Wuhan Jinyintan Hospital, healthy adults in their thirties have already begun to appear.

At the peak, this will happen fairly often. Whenever any country or region has chosen to coexist with the virus, some young people have lost their lives. In the U.S., over two hundred thousand families have lost their main breadwinner; among those who died of Omicron in Hong Kong and Taiwan there were minors as well as young and middle-aged adults. Some had even completed three vaccine doses and had no underlying disease, yet still did not escape. So everyone's worry is understandable, and a certain measure of caution is necessary.

This cautious attitude helps everyone take better responsibility for their own and their family's health. In this period the key is not to stay up late, not to overexert, to exercise moderately as much as possible, and to drink plenty of hot water. If we deplete our bodies, our immunity during infection will be far weaker.

But clearing the shelves of pharmacies to protect yourself and your family is harmful, not helpful. I hear that all over the country people are frantically snapping up antigen tests and medicines, so that now in many places pharmacies cannot even sell cold and diarrhea medicine. This leaves those truly in need without help, while most of what the hoarders stockpile will eventually be wasted.

So I hope that after you have been infected and recovered, you will pass on the medicines you hoarded to relatives, friends, and neighbors around you who need them. Because after one infection, the chance of reinfection in the short term is low. Some people need these medicines to save their lives; how can you bear to hoard them in your own hands and watch others die?

I myself have not bought a single box of antigen tests or any medicine in a rush, and I do not plan to hoard them. About 90% of Omicron cases develop sore throat, thirst, and fever; I plan that, in this extraordinary time, the moment my family shows these symptoms I will immediately treat the symptoms and report to the community. If the community has antigen tests, we'll test; if not, we'll isolate at home. We'll drink plenty of hot water, rest more, and rely on a few simple methods plus our own immunity. After symptoms fully disappear, we'll still rest at home for another two or three days before going out.

For many years, the three of us have not had a flu shot (this is because I judged that influenza poses little threat to us), yet my son has never once taken sick leave for a cold from childhood until now. He is in his final year of high school this year and has taken sick leave only twice in total, both times due to food poisoning at school.

Of course, I do not advocate that others skip the flu vaccine. As someone trained in medicine, I have rich experience dealing with cold-type illnesses and can usually cure a family member's cold while it is still in the bud. Not everyone has this ability, and some families have vulnerable members for whom influenza is very dangerous; so those who should get the flu vaccine should get it. As for the COVID vaccine, my whole family has completed vaccination and taken boosters. To take this new virus lightly is to be irresponsible toward your own and your family's health.

By the way, many people worry about the side effects of COVID vaccines, including some medical and biology professionals who ask me about them. COVID vaccines do have certain side effects, but their incidence is low and the great majority are mild—nowhere near as terrifying as rumors claim (such as causing diabetes or leukemia).

In particular, inactivated vaccines are essentially dead viruses. If our bodies cannot even tolerate a dead virus, how would we survive a live one? Over the coming year, the great majority of Chinese residents will be infected with Omicron; relying on your own immunity without vaccination is very risky, especially for those already frail. So everyone should get vaccinated as soon as possible.

Besides vaccines, we also need some skills to avoid becoming severe patients. How have I managed to keep my family of three free of serious colds for over twenty years? The key is two points: first, urging family members to rest well; second, decisively taking correct measures at the very start of every cold.

From my child's earliest years, I never let him stay up late. Now in his final high-school year, despite the heavy workload, I still supervise him not to stay up too late. At the dinner table I occasionally emphasize that getting into college matters less than health; we accept whichever university he enters, but poor health is not acceptable.

When he was in primary and middle school, I basically urged him to sleep by 9:30, with a latest bedtime of 10:00. This year, in his senior year, with the heavy workload, I still urge him to sleep before 11:00, rise at 6:30, and take a midday nap, ensuring he gets seven and a half to eight and a half hours of sleep.

As for me, I was born able to fall asleep the moment my head hits the pillow; my nighttime and daytime sleep together add up to seven or eight hours. So in flu season, although we do not vaccinate, we are rarely infected.

Incidentally, the popular claim that everyone is susceptible to COVID is not accurate. Some studies show that after COVID broke out, a number of U.S. healthcare workers, despite occupational exposure, were never infected from start to finish—at a time when no vaccine was available. I have also seen many unvaccinated people whose close contacts were all infected, some several times, yet who themselves never caught it.

So a minority of people in the population are immune to COVID, and such people are also usually not easily infected by influenza. Their escape may be related to innate genes, their own immunity, and lifestyle—a regular routine is the most effective way to raise immunity.

Our family probably is not fully immune to influenza, because we occasionally have flu-like symptoms. But the moment I spot flu symptoms in a family member, I immediately act to block the illness from progressing. Whenever someone has sneezing, cough, chills, sore throat, or fatigue, my response is swift. The first thing is to have everyone drink hot water to sweat; if hot water doesn't work, I make ginger-scallion water by boiling scallion and jujube, and make sure they drink until they break into a light sweat.

If ginger-scallion water still doesn't work, I use a hairdryer on hot, blowing from the Dazhui acupoint along the spine down to the coccyx, until they sweat. Usually after this and a good sleep, no symptoms remain and the illness does not progress. My child has rarely had cold symptoms last more than two hours.

Colds are most treatable at the very beginning; if you miss that chance and a severe cold develops, then whether or not you take medicine, and whatever medicine you take, it basically takes about a week to recover. Most cold medicines only relieve symptoms and act as placebos.

TCM has the idea of "treating disease before it arises." The late great TCM master Professor Jiang Chunhua, building on this idea in the last century, proposed the "interception therapy." The so-called interception therapy means taking immediate action at the budding stage of disease to cut off its development. The measures I take are precisely this "interception therapy," developed from the TCM idea of treating disease before it arises; it gets twice the result for half the effort. For over twenty years it has never failed once.

I share this experience of caring for my family in hopes it helps everyone. It is also the fundamental reason I can stay calm at this moment, not hoarding cold medicine or antigen tests. I am quite confident that at a time like this I can protect my family well, without drugs, just as I normally handle a cold.

These days, many people's panic has reached an irrational degree, though it is understandable. For one thing, no one wants to get sick, let alone die; for another, this opening was very sudden. The state pursued zero-COVID for three years; we got used to scanning health codes everywhere, and suddenly not needing any of it is disorienting. The media had previously reported far too much on how terrible COVID and its aftereffects are, and many self-media outlets exaggerated for traffic, all of which affected everyone. Now that the wind has suddenly shifted, many experts come out saying COVID is nothing to fear and there are no aftereffects.

Both extreme sets of statements are untrue and differ from what people see in reality, so they have damaged the overall credibility of our medical establishment. The public now mocks many professionals as puppets on strings and advises experts to stop giving advice. I also hope that in future our academic freedom will be greater, and scholars more factual and more mindful of personal integrity. Then, when the nation faces hardship and people need a real anchor of reassurance, there will be credible expert teams to bring confidence.

Most ordinary people are quite rational; as long as professional discussion does not tilt away from the facts, people can accept professional opinion. Once the national policy opened up, most chronic-disease patients who had previously refused vaccination hurried to get vaccinated. At least among the patients I care for, many did; after consulting me they rushed to get vaccinated, with no side effects.

This is reassuring to me. The antibody levels in these newly vaccinated patients are even much higher than in those of us who were vaccinated earlier, so they receive better protection. Any avoidable death should be avoided; protecting yourself is taking responsibility for yourself, for your family, and for society.

If, in the period ahead, Omicron evolves into a less pathogenic and less lethal variant, the situation may be even more optimistic. So as a born optimist, I tend to believe that in the unseen workings of things, heaven always leaves a way out for people. After the unavoidable happens, we should look at its favorable side and not be swept by negative emotions into living in panic.

Equally, we must avoid living in anger. At breakfast, my wife asked me: now that things have opened up like this, what was the point of the three years of confinement we endured?

I told her: had we opened up in the first year, our death toll might have reached four or five million; in the second year, three or four million; opening now, the toll may be only about a million or so; with luck, if a less lethal variant appears, it may not even reach a million. Objectively, looking at the three years together, our economic loss from three years of confinement was smaller than other countries', and our actual days locked down at home were not many—that is the meaning of those three years.

Humankind has never been free of the grip of plague on this planet. Compared with the great plagues we read about in ancient texts, the present Omicron's impact is very small. Struggling with risk and learning to evade it within risk—isn't this a required course in our lives?

I hope everyone grows through this required course. When home and nation face crisis, we must unite and pull together. At such a moment, everyone has a duty to protect themselves and others. Learn to protect yourself, and also fulfill your civic duty, lending a hand in time when others need help.

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