sharon sanders
Editor-in-Chief & President
Aged rural areas under the cold winter of the epidemic: more old people have died, and more than 10,000 coffins have been sold
2023-01-06 08:22:06 Source: China Business News
First Financial News, "My father is 74 years old and suffers from asthma. He lives alone. As a son, he should be with him, but because the workers around him are all positive, he is afraid that the virus will be transmitted to his father. There are many whole families with positive symptoms in the neighboring village. I am worried that all the township health centers and county hospitals will not be able to buy medicines." A returning man from Banqiao Village, Chenxi County, Huaihua, Hunan Province left a message on a public welfare project called "Fever Relief and Relief Action in Rural Areas".
The "Fever Relief and Relief Action in Rural Areas" was launched on December 14, 2022. The project team collects information on rural help-seeking in various places on social platforms, connects with pharmaceutical companies and local village doctors or volunteers, and completes private self-help. At present, the news that urban medical resources are running out is widely concerned, while the voices of the elderly in rural areas are even more difficult to be heard.
A reporter from China Business News interviewed many help-seekers and found that the elderly in rural areas generally stay behind closed doors. They have not been infected before, and their understanding of the new crown virus is not clear. They have only recently started to wear masks. Because of information lag, it is difficult for them to stock up on fever medicine faster than urban residents. As the silent majority, their distress messages are mostly sent by their descendants who are far away or have returned home early.
According to the seventh national census data, as of November 1, 2020, my country's rural population is about 510 million, a decrease of 164 million compared with 10 years ago. The proportions of people aged 60, 65 and over in rural areas are 23.81% and 17.72% respectively, which are 7.99 and 6.61 percentage points higher than those in urban areas respectively. Based on this calculation, there are about 120 million people over 60 years old in rural areas, and about 100 million people over 65 years old. 90.37 million.
Regardless of whether they are facing basic diseases or the new crown virus, the elderly are a vulnerable group, and the elderly in rural areas must face the lack of medical care and medicine. What will happen to them this winter?
Medical shortage
"I can't buy medicine, and I'm asleep at home. I don't know if I'm positive or not, and I haven't done nucleic acid." Villager Lao Wu is 60 years old. There are more than 1,800 people in his village in northern Shaanxi. There are 400 people, accounting for about a quarter.
Before the epidemic was released, he did not dare to buy cold medicine for fear of being sent to the shelter. After the epidemic was released, he went to the health center and found that he could not buy the medicine. At the beginning of December 2022, Lao Wu had a fever, and the village doctor came to give him an infusion. Lao Wu has arthritis, and the clinic has no heating, so he can't go to the clinic for injections. The medicines he bought online were not delivered smoothly at one time.
Afterwards, the grandson and his wife also had a fever, and they each had three days of infusion, and Lao Wu lost one day less than them, "because there must always be someone to take care of the house." After about ten days, Lao Wu's family was basically asymptomatic. Later, the patients in the village basically received one or two tablets of ibuprofen, some from the government and some from private volunteers, but the clinics and hospitals still couldn’t buy antipyretics. “If you run out of (ibuprofen) There’s nothing you can do if you don’t see it getting better, just be patient, just get better slowly.”
After New Year's Day, 90% of the people in the village are sick, and there are still many people seeking treatment for colds in the clinic, but it is less than a month ago.
Before the promulgation of the "New Ten Measures", many rural clinics and health centers basically did not admit and treat fever patients, so the reserves of fever and cold medicines were limited, and some areas were basically zero; after the policy shifted, the number of fever cases in rural areas increased significantly, and the supply of related medicines It is difficult to keep up with the purchase reserve for a while. Village and town health centers (hospitals) respond to the needs of patients through alternative medicines, traditional Chinese medicines, and infusions. However, since the previous positive cases were directly taken away and quarantined, many grassroots doctors in rural areas were unprepared for the new crown treatment plan, and the phenomenon of "whatever you use" is more common.
When rural medical resources are in short supply, public welfare projects such as the "Fever Relief and Relief Action in Rural Areas" have begun to intervene in private self-help. However, according to Zheng Hongbin, one of the initiators of the "Rural Fever Relief and Relief Action", some villages and towns are more cautious in their attitude towards private assistance. On the one hand, they hope that medical resources will be in place as soon as possible, and on the other hand, they do not want the media and non-governmental organizations to intervene too much.
Liu Guifen, a doctor at the People's Hospital of Xishui County, Huanggang City, told reporters: "Our hospital has 1,200 beds, and now we have added 1,800. Many beds have been added in the corridors, and one vacant one will come in. Mild cases basically go to the hospital. If you don’t come, the people in the hospital are all elderly people, most of whom suffer from high blood pressure, diabetes, emphysema, etc. Doctors at the county hospital’s director level will go to the villages to investigate and transfer critically ill patients to the county hospital in time.”
Starting from the evening of December 23, 2022, Xishui County People's Hospital notified all departments to accept patients with fever, and then each floor was full, and the newly admitted patients were basically combined with pneumonia infection. From 8 am to 8 pm. According to the "East Hubei Evening News" report, since mid-December 2022, Xishui County People's Hospital has seen a sharp increase in fever patients, with a peak of nearly 500 visits per day at most. The hospital has transferred more than 20 administrative management and logistics departments with medical background. Frontline personnel support.
Liu Guifen recalled that around December 25, 2022, the busiest day was when doctors accompanied patients to transfer to large hospitals in Wuhan, and the beds still had to wait. But after New Year's Day, there are not as many patients as before, and there is no need to wait too long for a bed in a hospital in Wuhan. "There may be a new peak in the flow of people around the Spring Festival. In the past, the Spring Festival was busier than usual."
As soon as the firecrackers go off, you know that another old man has left
Although there is a lack of medical treatment and medicine, Lao Wu has never heard of severe cases and a large number of dead elderly people in the village. Most people treat it as a relatively serious cold. But in other places, the situation is quite different.
Lao Kong, a 76-year-old man from Huanggang, Hubei, felt that more elderly people died in the village recently. "Some elderly people in their 80s and 90s left at home and were not sent to the hospital. The best coffin in this county used to sell for 5,000 yuan. A pair of yuan has been sold for more than 10,000 in the past two weeks."
There are more than 200 households with more than 1,000 people in the urban-rural interface of a certain place in Huanggang where Lao Kong lives. There are one or two elderly people in each household, and the overall aging ratio is more than 20%. On December 17 last year, he suffered from high blood pressure, coronary heart disease, stroke and other underlying diseases. He started to have a fever and a cold, and he overcame the difficulty after taking medicine. As a retired civil servant, he is a group of people with better local medical care conditions, and has urban employee insurance and chronic disease medical insurance. But even so, the community did not establish a file on his health, and the community did not investigate him under the impact of the epidemic.
Recently, several firecrackers were set off in the community. As soon as the firecrackers went off, he knew that another old man had left.
Having been engaged in rural work for many years, Lao Kong has a deep feeling for the gap between medical care and pensions in rural areas. "The old people with the 'five guarantees' who have no children and no daughters are paid by the government to see a doctor and provide for the elderly. Elderly people who have rich children or have retirement wages can also take care of themselves. But the middle group has serious illnesses and their children work outside the country. The economic conditions are average. The elderly in rural areas are in the worst situation, the rural pension of more than 100 yuan per month cannot cover their lives, and even if the county hospital can reimburse 60%, the rest is still a heavy burden for the elderly in rural areas, and they cannot afford serious illnesses.”
According to Lao Kong, the local rural elderly can usually go to the community or rural hospitals to buy medicines and see some minor or chronic diseases; it is not uncommon for serious illnesses to be left unattended. After the stroke, Lao Kong went to the nursing home run by the local Disabled Persons’ Federation for rehabilitation. He saw that some rural elderly people there had a miserable life.
According to the results of the seventh census, Huanggang City has a population of 918,500 people aged 65 and over, accounting for 15.61%, and has entered an aging society. As of 2021, the city's urbanization rate will be less than 50%, ranking third from the bottom in the province.
Why do some elderly people regard the new crown as a big cold, while others die because of it? And why some elderly people in rural areas did not seek medical treatment for severe illness?
The above-mentioned medical staff introduced, "The new crown infection has many symptoms. Some elderly people with poor cardiopulmonary function may have severe lung infections." She said, "Some older people may be infected from the heart. I have accepted this fact and feel that I can't be cured. But there are also some elderly people in their 90s, whose blood oxygen has dropped to 70 or 80, and their family members are still relatively willing to rescue them." According to several consecutive editions of the "New Crown Diagnosis and Treatment Plan", blood Patients whose oxygen saturation is lower than 93% are critically ill and need assisted breathing therapy.
Jiao Yahui, director of the Department of Medical Affairs of the National Health Commission, said recently that as the Spring Festival is approaching, with the increase in the flow of people, the urban epidemic may spread to rural areas, increasing the pressure on rural epidemic prevention and control. It is necessary to plan in advance, on the one hand, to allow the medicine to be distributed; on the other hand, it is necessary to transfer the critically ill patients in rural areas, especially the elderly critically ill patients.
Rural Doctors: Growing Old with the Countryside
Guo Hongwei is a village doctor in Xishui County. Among the more than 4,000 people in the village, there are 600-700 elderly people over 65 years old. The town health center he belongs to has four family doctor teams, each corresponding to three or four villages, and each village has two family doctors.
Xishui County is located at the southern foot of the Dabie Mountains. It is a county with a large traditional agriculture and a large population. It is also a large county for exporting labor services. Every year, more than 200,000 people, nearly a quarter of whom work outside the country. The local aging trend is deepening.
On December 22, 2022, when China Business News interviewed Guo Hongwei, his cough worsened. "It's probably positive, and he needs to rest for a few days." He is 64 years old, and the consultation work in the next few days will be handed over to another "young" village doctor - also nearly 60 years old.
Qin Hai, a village doctor in Baoding, Hebei Province, started practicing in the 1980s, "catching up with the barefoot doctors." A few years ago, he was admitted as a practicing (assistant) doctor.
At the beginning of December 2022, Qin Hai experienced the busiest time. He would be woken up by the patient's knock on the door at 5 o'clock in the morning. Ten patients often come to the hospital for treatment.
There are more than 80 elderly people over the age of 65 in the village, and Qin Hai has an account of their underlying diseases and commonly used medicines. Today, there are more and more old people in the village, fewer and fewer newborns, Qin Hai is also entering his twilight years, and there are very few colleagues around him who have worked for decades like him.
Some young village doctors chose to leave.
Li Tongqiang from Harbin used to be a village doctor, but because of "personal development reasons", he chose to leave this team in 2019 in his 40s to open his own Chinese medicine clinic in the urban-rural junction. "The workload of rural doctors is very heavy. In addition to treating diseases, they also undertake local public health affairs. The income level is linked to the covered population. The overall source of income is very limited." He told reporters.
From Qin Hai’s point of view, the 1980s and 1990s were the highlight of his career. At that time, rural doctors were respected, and people always came to give gifts during the festivals. After that, the bricklayers and carpenters in the village began to be popular, and the income of village doctors declined. They were willing to do this. There are fewer and fewer young people practicing, so many village doctors will be rehired when they reach retirement age.
According to the "Statistical Bulletin on the Development of my country's Health Care" issued by the National Health Commission every year, the number of administrative villages and village clinics in my country has been decreasing year by year, and the number of rural doctors is gradually shrinking, with a decrease of 146,000 in the past two years.
Holders of village doctor qualification certificates can be registered to engage in prevention, health care and general medical services in village medical and health institutions; holders of licensed (assistant) doctors can practice in township hospitals or village clinics. As of the end of 2021, the total number of the two is about 1.17 million, and each person corresponds to about 80 rural elderly people over the age of 65 on average.
Therefore, the number of rural doctors has decreased, firstly because of the decrease in rural population; secondly, some rural doctors have been upgraded to become licensed (assistant) physicians, which does not mean that they do not consult in rural areas, and the number of village doctors per thousand rural residents is nearly It's actually been improving for a decade.
As of the end of 2021, the central government has invested a total of 1.43 billion yuan to train 590,000 grassroots health personnel, including 380,000 rural doctors.
In October 2022, the National Health and Medical Commission responded to the "Proposal on Strengthening the Construction of Rural Doctor Teams to Boost Rural Revitalization". Village doctors on duty can participate in endowment insurance for government agencies and institutions, basic endowment insurance for enterprise employees or urban and rural areas according to different identities according to regulations. Basic pension insurance for residents. For elderly leaving-post village doctors, most localities increase pension benefits by issuing fixed subsidies or providing seniority subsidies based on the length of service. In terms of medical security, the national medical insurance system has been continuously improved, and village doctors can participate in basic medical insurance according to regulations and enjoy corresponding benefits.
Rural Nursing Homes: "Defend if you can"
Hu Xia is the director of a nursing home in rural eastern Hubei. On December 21, 2022, Hu Xia told China Business News that there were two positive elderly people in the hospital, and their family members had just sent things to the hospital, which may have brought the virus in. The two elderly people were quarantined, and Hu Xia still had 50 to 100 copies of various cold and fever medicines in her hand, "Defend if you can." But on New Year's Day, the whole hospital is basically full of sunshine.
This elderly care institution combining health and wellness has more than 300 beds, equipped with three general practitioners and one physiotherapist, and currently treats more than 160 elderly people. Their average age is over 80 years old, and the oldest is 102 years old. They are basically paralyzed elderly who cannot take care of themselves. Myocardial infarction and cerebral infarction occur from time to time. If the elderly are in an emergency, they will first rescue them and send them to the County People's Hospital, which is a ten-minute drive away.
However, during the large-scale outbreak of the epidemic, the ambulance to the county hospital had to wait longer, sometimes forty or fifty minutes, sometimes three hours. "Our medical methods can only detect that the elderly have a lung infection, and further treatment needs to be sent to the hospital, but now emergency resources are tight, and sometimes family members need to drive the elderly to the hospital by themselves."
Longer wait times are also for funeral home vehicles. Hu Xia’s nursing home has recently sent out more than 20 elderly people, some went to the hospital, some were taken home, and some passed away. “Most of the people who died were elderly with poor heart and lung function. Afterwards, the condition worsened, and some family members had no choice but to give up."
In the first half of last year, the Research Institute on Aging of Fudan University released a survey report on 539 nursing homes across the country. The report shows that in terms of epidemic prevention and control, 60% of the interviewed elderly care institutions currently lack professionals, and the vaccination rate of the elderly in institutions is significantly lower than that of the elderly at home; 40% of the institutions have varying degrees of shortage of living materials during the closed management period ; 8.24% of the institutions said that there is often or always a shortage of epidemic prevention materials, 35.52% of the institutions have a shortage of some urgently needed medical supplies (such as catheters), and 60% of the institutions have a shortage of medicines, especially for rare diseases and psychiatric diseases. drug.
In addition, 66.05% of the interviewed institutions said that the average annual operating income after 2020 will drop significantly compared with that before the epidemic, of which 78.37% of the institutions have a decline rate of no more than 40%; 68.83% of the institutions reflect that the overall workload of employees during the epidemic has increased. This has led to a shortage of manpower in the organization, and 60.48% of the organizations experienced staff resignation during the epidemic, resulting in a shortage of human resources.
Hu Xia’s nursing home is also facing difficulties. The local Sinopharm Group and the civil affairs department have been in touch with her before, but the number of seriously ill elderly people in the nursing home is gradually increasing, and Sinopharm’s drug resources are also becoming tight. She can only find other channels to find medicines. "Now more than 200,000 yuan has been spent to store various Chinese and Western medicines. Due to the different underlying diseases of the elderly and some medicines that cannot be taken at the same time, we still need to go to Wuhan and other places to purchase multiple medicines."
Another real problem nursing homes face is the shortage of nurses (not nurses) who can help doctors treat them. Similar to the village doctor group, the elderly nursing staff in rural areas are generally older. Most of the staff in the nursing home where Hu Xia works are rural women in their 50s with low education.
Like almost all nursing homes across the country, this nursing home has been closed and semi-closed for three years due to the epidemic. Even though the whole country has been liberalized, and the whole county and nursing homes have been covered with sunshine, the nursing homes are still strictly guarded, fearing that the outside world will bring more infections.
For safety reasons, Hu Xia took in the new elderly cautiously. And some elderly people were taken back by their families because their families could not afford the hospitalization expenses. "We have some paralyzed old people here, who are tens of thousands in arrears. Their children are working outside, but they have no income this year, so we can't rush them."
56-year-old Hu Xia currently has a monthly retirement salary of 5,000 yuan. She has chosen a nursing home for herself in this nursing home. However, most of the elderly in rural areas can only receive pensions ranging from tens to hundreds of dollars per month, and the burden on their children is heavy.
"The Chinese tradition is 'Water flows downward'. Between the elderly and children, most people must choose to take care of the children, and these paralyzed elderly can only be left to us to take care of. Some elderly people are not willing to live in the first month, but after a month You have adapted to life here." Hu Xia said, "It would be great if all the elderly, whether they have children or not, can enjoy their old age with the support of the government like the 'Five Guarantees'."
zhttps://www.cqcb.com/shishijingwei/2023-01-06/5136710_pc.html
2023-01-06 08:22:06 Source: China Business News
First Financial News, "My father is 74 years old and suffers from asthma. He lives alone. As a son, he should be with him, but because the workers around him are all positive, he is afraid that the virus will be transmitted to his father. There are many whole families with positive symptoms in the neighboring village. I am worried that all the township health centers and county hospitals will not be able to buy medicines." A returning man from Banqiao Village, Chenxi County, Huaihua, Hunan Province left a message on a public welfare project called "Fever Relief and Relief Action in Rural Areas".
The "Fever Relief and Relief Action in Rural Areas" was launched on December 14, 2022. The project team collects information on rural help-seeking in various places on social platforms, connects with pharmaceutical companies and local village doctors or volunteers, and completes private self-help. At present, the news that urban medical resources are running out is widely concerned, while the voices of the elderly in rural areas are even more difficult to be heard.
A reporter from China Business News interviewed many help-seekers and found that the elderly in rural areas generally stay behind closed doors. They have not been infected before, and their understanding of the new crown virus is not clear. They have only recently started to wear masks. Because of information lag, it is difficult for them to stock up on fever medicine faster than urban residents. As the silent majority, their distress messages are mostly sent by their descendants who are far away or have returned home early.
According to the seventh national census data, as of November 1, 2020, my country's rural population is about 510 million, a decrease of 164 million compared with 10 years ago. The proportions of people aged 60, 65 and over in rural areas are 23.81% and 17.72% respectively, which are 7.99 and 6.61 percentage points higher than those in urban areas respectively. Based on this calculation, there are about 120 million people over 60 years old in rural areas, and about 100 million people over 65 years old. 90.37 million.
Regardless of whether they are facing basic diseases or the new crown virus, the elderly are a vulnerable group, and the elderly in rural areas must face the lack of medical care and medicine. What will happen to them this winter?
Medical shortage
"I can't buy medicine, and I'm asleep at home. I don't know if I'm positive or not, and I haven't done nucleic acid." Villager Lao Wu is 60 years old. There are more than 1,800 people in his village in northern Shaanxi. There are 400 people, accounting for about a quarter.
Before the epidemic was released, he did not dare to buy cold medicine for fear of being sent to the shelter. After the epidemic was released, he went to the health center and found that he could not buy the medicine. At the beginning of December 2022, Lao Wu had a fever, and the village doctor came to give him an infusion. Lao Wu has arthritis, and the clinic has no heating, so he can't go to the clinic for injections. The medicines he bought online were not delivered smoothly at one time.
Afterwards, the grandson and his wife also had a fever, and they each had three days of infusion, and Lao Wu lost one day less than them, "because there must always be someone to take care of the house." After about ten days, Lao Wu's family was basically asymptomatic. Later, the patients in the village basically received one or two tablets of ibuprofen, some from the government and some from private volunteers, but the clinics and hospitals still couldn’t buy antipyretics. “If you run out of (ibuprofen) There’s nothing you can do if you don’t see it getting better, just be patient, just get better slowly.”
After New Year's Day, 90% of the people in the village are sick, and there are still many people seeking treatment for colds in the clinic, but it is less than a month ago.
Before the promulgation of the "New Ten Measures", many rural clinics and health centers basically did not admit and treat fever patients, so the reserves of fever and cold medicines were limited, and some areas were basically zero; after the policy shifted, the number of fever cases in rural areas increased significantly, and the supply of related medicines It is difficult to keep up with the purchase reserve for a while. Village and town health centers (hospitals) respond to the needs of patients through alternative medicines, traditional Chinese medicines, and infusions. However, since the previous positive cases were directly taken away and quarantined, many grassroots doctors in rural areas were unprepared for the new crown treatment plan, and the phenomenon of "whatever you use" is more common.
When rural medical resources are in short supply, public welfare projects such as the "Fever Relief and Relief Action in Rural Areas" have begun to intervene in private self-help. However, according to Zheng Hongbin, one of the initiators of the "Rural Fever Relief and Relief Action", some villages and towns are more cautious in their attitude towards private assistance. On the one hand, they hope that medical resources will be in place as soon as possible, and on the other hand, they do not want the media and non-governmental organizations to intervene too much.
Liu Guifen, a doctor at the People's Hospital of Xishui County, Huanggang City, told reporters: "Our hospital has 1,200 beds, and now we have added 1,800. Many beds have been added in the corridors, and one vacant one will come in. Mild cases basically go to the hospital. If you don’t come, the people in the hospital are all elderly people, most of whom suffer from high blood pressure, diabetes, emphysema, etc. Doctors at the county hospital’s director level will go to the villages to investigate and transfer critically ill patients to the county hospital in time.”
Starting from the evening of December 23, 2022, Xishui County People's Hospital notified all departments to accept patients with fever, and then each floor was full, and the newly admitted patients were basically combined with pneumonia infection. From 8 am to 8 pm. According to the "East Hubei Evening News" report, since mid-December 2022, Xishui County People's Hospital has seen a sharp increase in fever patients, with a peak of nearly 500 visits per day at most. The hospital has transferred more than 20 administrative management and logistics departments with medical background. Frontline personnel support.
Liu Guifen recalled that around December 25, 2022, the busiest day was when doctors accompanied patients to transfer to large hospitals in Wuhan, and the beds still had to wait. But after New Year's Day, there are not as many patients as before, and there is no need to wait too long for a bed in a hospital in Wuhan. "There may be a new peak in the flow of people around the Spring Festival. In the past, the Spring Festival was busier than usual."
As soon as the firecrackers go off, you know that another old man has left
Although there is a lack of medical treatment and medicine, Lao Wu has never heard of severe cases and a large number of dead elderly people in the village. Most people treat it as a relatively serious cold. But in other places, the situation is quite different.
Lao Kong, a 76-year-old man from Huanggang, Hubei, felt that more elderly people died in the village recently. "Some elderly people in their 80s and 90s left at home and were not sent to the hospital. The best coffin in this county used to sell for 5,000 yuan. A pair of yuan has been sold for more than 10,000 in the past two weeks."
There are more than 200 households with more than 1,000 people in the urban-rural interface of a certain place in Huanggang where Lao Kong lives. There are one or two elderly people in each household, and the overall aging ratio is more than 20%. On December 17 last year, he suffered from high blood pressure, coronary heart disease, stroke and other underlying diseases. He started to have a fever and a cold, and he overcame the difficulty after taking medicine. As a retired civil servant, he is a group of people with better local medical care conditions, and has urban employee insurance and chronic disease medical insurance. But even so, the community did not establish a file on his health, and the community did not investigate him under the impact of the epidemic.
Recently, several firecrackers were set off in the community. As soon as the firecrackers went off, he knew that another old man had left.
Having been engaged in rural work for many years, Lao Kong has a deep feeling for the gap between medical care and pensions in rural areas. "The old people with the 'five guarantees' who have no children and no daughters are paid by the government to see a doctor and provide for the elderly. Elderly people who have rich children or have retirement wages can also take care of themselves. But the middle group has serious illnesses and their children work outside the country. The economic conditions are average. The elderly in rural areas are in the worst situation, the rural pension of more than 100 yuan per month cannot cover their lives, and even if the county hospital can reimburse 60%, the rest is still a heavy burden for the elderly in rural areas, and they cannot afford serious illnesses.”
According to Lao Kong, the local rural elderly can usually go to the community or rural hospitals to buy medicines and see some minor or chronic diseases; it is not uncommon for serious illnesses to be left unattended. After the stroke, Lao Kong went to the nursing home run by the local Disabled Persons’ Federation for rehabilitation. He saw that some rural elderly people there had a miserable life.
According to the results of the seventh census, Huanggang City has a population of 918,500 people aged 65 and over, accounting for 15.61%, and has entered an aging society. As of 2021, the city's urbanization rate will be less than 50%, ranking third from the bottom in the province.
Why do some elderly people regard the new crown as a big cold, while others die because of it? And why some elderly people in rural areas did not seek medical treatment for severe illness?
The above-mentioned medical staff introduced, "The new crown infection has many symptoms. Some elderly people with poor cardiopulmonary function may have severe lung infections." She said, "Some older people may be infected from the heart. I have accepted this fact and feel that I can't be cured. But there are also some elderly people in their 90s, whose blood oxygen has dropped to 70 or 80, and their family members are still relatively willing to rescue them." According to several consecutive editions of the "New Crown Diagnosis and Treatment Plan", blood Patients whose oxygen saturation is lower than 93% are critically ill and need assisted breathing therapy.
Jiao Yahui, director of the Department of Medical Affairs of the National Health Commission, said recently that as the Spring Festival is approaching, with the increase in the flow of people, the urban epidemic may spread to rural areas, increasing the pressure on rural epidemic prevention and control. It is necessary to plan in advance, on the one hand, to allow the medicine to be distributed; on the other hand, it is necessary to transfer the critically ill patients in rural areas, especially the elderly critically ill patients.
Rural Doctors: Growing Old with the Countryside
Guo Hongwei is a village doctor in Xishui County. Among the more than 4,000 people in the village, there are 600-700 elderly people over 65 years old. The town health center he belongs to has four family doctor teams, each corresponding to three or four villages, and each village has two family doctors.
Xishui County is located at the southern foot of the Dabie Mountains. It is a county with a large traditional agriculture and a large population. It is also a large county for exporting labor services. Every year, more than 200,000 people, nearly a quarter of whom work outside the country. The local aging trend is deepening.
On December 22, 2022, when China Business News interviewed Guo Hongwei, his cough worsened. "It's probably positive, and he needs to rest for a few days." He is 64 years old, and the consultation work in the next few days will be handed over to another "young" village doctor - also nearly 60 years old.
Qin Hai, a village doctor in Baoding, Hebei Province, started practicing in the 1980s, "catching up with the barefoot doctors." A few years ago, he was admitted as a practicing (assistant) doctor.
At the beginning of December 2022, Qin Hai experienced the busiest time. He would be woken up by the patient's knock on the door at 5 o'clock in the morning. Ten patients often come to the hospital for treatment.
There are more than 80 elderly people over the age of 65 in the village, and Qin Hai has an account of their underlying diseases and commonly used medicines. Today, there are more and more old people in the village, fewer and fewer newborns, Qin Hai is also entering his twilight years, and there are very few colleagues around him who have worked for decades like him.
Some young village doctors chose to leave.
Li Tongqiang from Harbin used to be a village doctor, but because of "personal development reasons", he chose to leave this team in 2019 in his 40s to open his own Chinese medicine clinic in the urban-rural junction. "The workload of rural doctors is very heavy. In addition to treating diseases, they also undertake local public health affairs. The income level is linked to the covered population. The overall source of income is very limited." He told reporters.
From Qin Hai’s point of view, the 1980s and 1990s were the highlight of his career. At that time, rural doctors were respected, and people always came to give gifts during the festivals. After that, the bricklayers and carpenters in the village began to be popular, and the income of village doctors declined. They were willing to do this. There are fewer and fewer young people practicing, so many village doctors will be rehired when they reach retirement age.
According to the "Statistical Bulletin on the Development of my country's Health Care" issued by the National Health Commission every year, the number of administrative villages and village clinics in my country has been decreasing year by year, and the number of rural doctors is gradually shrinking, with a decrease of 146,000 in the past two years.
Holders of village doctor qualification certificates can be registered to engage in prevention, health care and general medical services in village medical and health institutions; holders of licensed (assistant) doctors can practice in township hospitals or village clinics. As of the end of 2021, the total number of the two is about 1.17 million, and each person corresponds to about 80 rural elderly people over the age of 65 on average.
Therefore, the number of rural doctors has decreased, firstly because of the decrease in rural population; secondly, some rural doctors have been upgraded to become licensed (assistant) physicians, which does not mean that they do not consult in rural areas, and the number of village doctors per thousand rural residents is nearly It's actually been improving for a decade.
As of the end of 2021, the central government has invested a total of 1.43 billion yuan to train 590,000 grassroots health personnel, including 380,000 rural doctors.
In October 2022, the National Health and Medical Commission responded to the "Proposal on Strengthening the Construction of Rural Doctor Teams to Boost Rural Revitalization". Village doctors on duty can participate in endowment insurance for government agencies and institutions, basic endowment insurance for enterprise employees or urban and rural areas according to different identities according to regulations. Basic pension insurance for residents. For elderly leaving-post village doctors, most localities increase pension benefits by issuing fixed subsidies or providing seniority subsidies based on the length of service. In terms of medical security, the national medical insurance system has been continuously improved, and village doctors can participate in basic medical insurance according to regulations and enjoy corresponding benefits.
Rural Nursing Homes: "Defend if you can"
Hu Xia is the director of a nursing home in rural eastern Hubei. On December 21, 2022, Hu Xia told China Business News that there were two positive elderly people in the hospital, and their family members had just sent things to the hospital, which may have brought the virus in. The two elderly people were quarantined, and Hu Xia still had 50 to 100 copies of various cold and fever medicines in her hand, "Defend if you can." But on New Year's Day, the whole hospital is basically full of sunshine.
This elderly care institution combining health and wellness has more than 300 beds, equipped with three general practitioners and one physiotherapist, and currently treats more than 160 elderly people. Their average age is over 80 years old, and the oldest is 102 years old. They are basically paralyzed elderly who cannot take care of themselves. Myocardial infarction and cerebral infarction occur from time to time. If the elderly are in an emergency, they will first rescue them and send them to the County People's Hospital, which is a ten-minute drive away.
However, during the large-scale outbreak of the epidemic, the ambulance to the county hospital had to wait longer, sometimes forty or fifty minutes, sometimes three hours. "Our medical methods can only detect that the elderly have a lung infection, and further treatment needs to be sent to the hospital, but now emergency resources are tight, and sometimes family members need to drive the elderly to the hospital by themselves."
Longer wait times are also for funeral home vehicles. Hu Xia’s nursing home has recently sent out more than 20 elderly people, some went to the hospital, some were taken home, and some passed away. “Most of the people who died were elderly with poor heart and lung function. Afterwards, the condition worsened, and some family members had no choice but to give up."
In the first half of last year, the Research Institute on Aging of Fudan University released a survey report on 539 nursing homes across the country. The report shows that in terms of epidemic prevention and control, 60% of the interviewed elderly care institutions currently lack professionals, and the vaccination rate of the elderly in institutions is significantly lower than that of the elderly at home; 40% of the institutions have varying degrees of shortage of living materials during the closed management period ; 8.24% of the institutions said that there is often or always a shortage of epidemic prevention materials, 35.52% of the institutions have a shortage of some urgently needed medical supplies (such as catheters), and 60% of the institutions have a shortage of medicines, especially for rare diseases and psychiatric diseases. drug.
In addition, 66.05% of the interviewed institutions said that the average annual operating income after 2020 will drop significantly compared with that before the epidemic, of which 78.37% of the institutions have a decline rate of no more than 40%; 68.83% of the institutions reflect that the overall workload of employees during the epidemic has increased. This has led to a shortage of manpower in the organization, and 60.48% of the organizations experienced staff resignation during the epidemic, resulting in a shortage of human resources.
Hu Xia’s nursing home is also facing difficulties. The local Sinopharm Group and the civil affairs department have been in touch with her before, but the number of seriously ill elderly people in the nursing home is gradually increasing, and Sinopharm’s drug resources are also becoming tight. She can only find other channels to find medicines. "Now more than 200,000 yuan has been spent to store various Chinese and Western medicines. Due to the different underlying diseases of the elderly and some medicines that cannot be taken at the same time, we still need to go to Wuhan and other places to purchase multiple medicines."
Another real problem nursing homes face is the shortage of nurses (not nurses) who can help doctors treat them. Similar to the village doctor group, the elderly nursing staff in rural areas are generally older. Most of the staff in the nursing home where Hu Xia works are rural women in their 50s with low education.
Like almost all nursing homes across the country, this nursing home has been closed and semi-closed for three years due to the epidemic. Even though the whole country has been liberalized, and the whole county and nursing homes have been covered with sunshine, the nursing homes are still strictly guarded, fearing that the outside world will bring more infections.
For safety reasons, Hu Xia took in the new elderly cautiously. And some elderly people were taken back by their families because their families could not afford the hospitalization expenses. "We have some paralyzed old people here, who are tens of thousands in arrears. Their children are working outside, but they have no income this year, so we can't rush them."
56-year-old Hu Xia currently has a monthly retirement salary of 5,000 yuan. She has chosen a nursing home for herself in this nursing home. However, most of the elderly in rural areas can only receive pensions ranging from tens to hundreds of dollars per month, and the burden on their children is heavy.
"The Chinese tradition is 'Water flows downward'. Between the elderly and children, most people must choose to take care of the children, and these paralyzed elderly can only be left to us to take care of. Some elderly people are not willing to live in the first month, but after a month You have adapted to life here." Hu Xia said, "It would be great if all the elderly, whether they have children or not, can enjoy their old age with the support of the government like the 'Five Guarantees'."
zhttps://www.cqcb.com/shishijingwei/2023-01-06/5136710_pc.html