Insufficient quantity
Compared to other countries, the number of fever clinics is
substantially insufficient to triage patients and prevent nosocomial
infection in China. For example, Singapore that has a population of 5.7
million, sets up a total of approximately 900 public health preparedness
clinics (similar to fever clinics in China). All of them were activated
to fight the COVID-19. By contrast, Wuhan, once the epicenter of the
pandemic in China, has only 61 fever clinics to serve over nine million
residents (as of January 20, 2020), which is far from meeting the public
needs. For instance, on February 3, the peak number of outpatient visits
in fever clinics across Wuhan reached 12,568, which severely exceeded
the maximum load of fever clinics 8. Insufficient
quantity of fever clinics led to a sizable proportion of suspected cases
who were not examined, diagnosed or isolated, which therefore increased
the risk of widespread of SARS-CoV-2 in hospitals and communities.
Lack of infectious disease professionals in fever clinics is another
major problem in this pandemic. Given the high risk of exposure to
SARS-CoV-2, healthcare providers in fever clinics are required to be
skilled and experienced in infectious disease or related specialties.
However, since fever clinics were substantially overloaded, physicians
and nurses from other departments who did not receive formal training or
expertise in infectious diseases had to be deployed for support, thus
having considerably high risk of being infected. It was even the first
time for some healthcare professionals to put on and take off protective
equipment when on duty in fever clinics, especially in rural and remote
areas in China 9. The shortage of adequately skilled
professionals therefore compromised the anticipated function of fever
clinics against the COVID-19 outbreak.