Debra Li

debra_lidan@163.com

THE sudden increase in child patients with flu or Mycoplasma pneumonia has resulted in overcrowded Chinese hospitals, prompting complaints from parents who endure long waits for their children to actually “see” the doctor.

In recent years, the mask mandate implemented during the COVID-19 pandemic has somewhat deterred common respiratory pathogens, reducing the chances of children coming into contact with these diseases. However, with the removal of the mask mandate, children who previously had limited exposure to such pathogens are now more susceptible, particularly in school settings. Furthermore, in families with multiple children, it is almost inevitable for the infection to spread among siblings.

While the majority of viral respiratory infections are self-limiting and do not require medical intervention, anxious parents often rush their children to hospitals at the first sign of fever. Due to higher expectations for technologically advanced services and a lack of trust in primary health facilities, most parents bypass the option of visiting a community clinic and head directly to a 3A hospital if available in their city.

Although Beijing and Guangzhou have over 50 3A hospitals each, followed by cities like Shanghai, Tianjin, and Chongqing with over 25, many other Chinese cities have none to only a limited number of these “trustworthy” hospitals. Consequently, these hospitals become overwhelmed with patients during flu and respiratory disease seasons. Even in Beijing and Guangzhou, where the population is densely concentrated, taking their kids to see a doctor is still a challenging endeavor for parents.

Primary health care (PHC) is a crucial component of any healthcare system, with a focus on delivering care as close to individuals, families, and communities as possible. In China, PHC is provided by health professionals, including general practitioners, public health nurses, and community pharmacists. According to the World Health Organization, around 90% of Chinese households had access to the nearest PHC site within 15 minutes in 2019.

By contrast, in countries like Britain and the United States, approximately 90% and 75-85% of patients, respectively, seek medical help from the primary care system. In these systems, physicians and nurses not only provide treatment but also offer consultation and referrals to specialists.

In China, community clinics are primarily visited by senior patients with chronic diseases such as diabetes and hypertension, who view them as convenient places to obtain prescription drugs. On the other hand, many young people choose to visit specialists at 3A hospitals for minor symptoms, such as occasional rashes on their skin.

Obviously, there is a need for awareness campaigns to promote basic medical knowledge and instill trust in primary care physicians among the general public. Meanwhile, community clinics should improve their capacity and capabilities to deserve this trust. Recent complaints about community clinics lacking the capability to perform M. pneumonia tests and facing shortages of certain medicines highlight the need for better-equipped facilities.

Then, we need always to keep in mind that prevention is the best treatment for any diseases. While masks are no longer mandate in public areas, small children and senior citizens are still recommended to wear them in crowds during winter and spring to protect against infectious diseases.

Timely flu vaccinations are another effective preventive measure. In Shenzhen, primary and middle school students, along with individuals aged 60 and above, are eligible for free flu shots at community clinics. Schools commonly organize flu shots for students, significantly reducing the occurrence of flu outbreaks on campuses. However, it is worth noting that kindergarten students, typically aged 3 to 6, are not included in the free flu shot program, possibly because this stage of education is not considered compulsory.

Addressing this gap in the system would be a step towards improvement, as local health authorities should at least encourage and remind parents to let their children get timely flu shots, if not providing subsidies.

As parents whose kids unfortunately come down with a fever, relaxing and giving them the time to rest and recover, instead of rushing them to the crowded respiratory disease department, is perhaps a better strategy.

(The author is a Features editor of Shenzhen Daily.)