key: cord-265680-ztk6l2n2
authors: Deng, J; Peng, Z Y; Wen, Z X; Dong, G Q; Xie, M X; Xu, G G
title: High COVID-19 mortality in the UK: Lessons to be learnt from Hubei Province – Are under-detected “silent hypoxia” and subsequently low admission rate to blame?
date: 2020-08-31
journal: QJM
DOI: 10.1093/qjmed/hcaa262
sha: 
doc_id: 265680
cord_uid: ztk6l2n2

nan

and hospitals overwhelmed. Then, 16 FangCangs were built and 15 used to manage about a quarter of all Covid patients in the provincial capital city. These enabled admissions of most mildly or moderately infected patients. There, vital signs were regularly checked and, based on the Chinese National Guideline for Covid, 3 nasal O 2 was supplied to those whose SpO 2 became ≤93% [but not severe enough for ICU admission]. FangCangs' peak bed usage was over 95%.

With centralised isolation and timely treatment to prevent transmission and deterioration of the infection, and with occasional transfers of patients with worsening symptoms to ICU, this drastically decreased the mortality over the entire epidemic in Hubei [ Table 1 ]. After a 76-day lockdown was lifted on 8 April and between May 14 and June 1, Wuhan tested 9,899,828 residents to screen "hidden" SARS-COV-2 infections. That was virtually the entire population of the city tested when including those already tested since the outbreak in January and excluding those who had left the city during the Spring Festival from about 10 January and not returned since the lockdown on 23 January. As a result, no new cases were found, with only https://mc.manuscriptcentral.com/qjm the 68,135 confirmed cases in Table 1 is a highly reliable reflection of the epidemic in Hubei after the initial chaotic statistics in January.

In contrary, the UK had more time to prepare, with a medical system seemingly coped well with the already peaked pandemic. However, by 31 July 2020, it has suffered a population mortality rate that is considerably higher than Hubei has. We should treat the ratio in Table 1 We share the above lessons and experiences learnt from Hubei and would like to provoke discussion to address the paradox seen in the UK and other regions. For example, by the end of July, New York had most Covid deaths in the US with 32,683 fatalities, yet a "Nightingale" hospital costing $52 million treated only 79 virus patients. 9 Without effective and safe drugs and/or vaccines facing imminent Covid resurgences, the Hubei approaches may be worth considering.

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