Yang Shanshan had a nightmare all night. She woke up in the communal lounge area with a splitting headache and a feeling of fullness in her stomach. The whole person sat motionless on the camp bed, so uncomfortable that “I didn’t want to open my eyes.”
She is a depressed patient in Shanghai and is currently under quarantine at the company. This is her seventh day off her medication.
Since March this year, the spread of Omicron has caused clustered epidemics in many parts of my country, among which Jilin Province and Shanghai are the most serious. . On April 17, an expert from the Joint Prevention and Control of the State Council said in an interview that the current epidemic spread index in Shanghai has dropped to 1.23, which is very close to the current round of epidemic control.
Under the prevention and control of the epidemic, some mentally ill patients have encountered a crisis of drug withdrawal. They ask for help in many ways, but due to the suspension of the hospital, the lack of information, and the shortage of transportation capacity, the problem is often not solved in time. As a result, some people experience repeated illnesses and endure strong withdrawal reactions.
In the end, with their own perseverance and the kindness of others, most people got the medicine. But this is not the end of the story, in order to stabilize the condition, they are still doing other efforts.
Crisis Appears
Yang Shanshan’s sense of crisis appeared on March 27th. At noon that day, she found that she had enough medicine for a week at most.
This is her third year of regular medication, two duloxetine enteric-coated capsules and one trazodone tablet per day.
She hastily placed an order at the online pharmacy. Yang Shanshan has bought medicines through this channel several times before, and the delivery is very fast. The delivery has not stopped yet. She also received the pants from the online shopping the night before. She thought that it would be no problem to receive the goods before the medicine was discontinued.
But she hadn’t received a shipping notification all afternoon.
In the evening, Shanghai announced that it would implement a blockade and control with the Huangpu River as the boundary. Zhoupu Town, where Yang Shanshan is located, is located in Pudong, and the closure period is from March 28 to March 31.
The order status has not been updated yet. She left a message to the customer service, hoping to add money and send the fastest express delivery, but she did not get a response. The next day the customer service told her that the delivery had stopped.
At that time, Yang Shanshan didn’t panic. If she strictly follows the doctor’s prescribed dose, she will stop taking the medicine on April 2. According to the notice, Pudong will be unblocked on April 1, which should be in time. “So I was still working normally in those days, and I searched for more channels when I was free.”
3 On March 31, after learning that the lockdown could not be lifted within a short period of time, she became anxious.
In the next few days, she and her boyfriend who was quarantined at the company kept looking for and trying new channels, but it was difficult to advance.
She has registered on the special needs platforms opened by Ele.me and JD. There was no call, and the Internet hospital was also in a state of no service at the time; she saw some netizens say that the medicine was prescribed on a digital medical service platform in the mental and psychological field, and she immediately followed suit, “After paying the money, I saw ‘waiting for collection’. I was really excited when I wrote a few words, but until now, the drug has not been issued.”
She also tried to apply for the medicine dispensing service of the neighborhood committee, but the phone line was always busy. “I didn’t even ask what kind of medicine it was, I just said I couldn’t buy it right now.” Later, only one sentence was left, “then go buy it yourself”.
Yang Shanshan registered a shortage of medicines on a special needs platform, and communicated with customer service for delivery as soon as possible.
Image source: Photo courtesy of respondents
On various online help platforms, “Occasional Healing” found many people in a similar situation to Yang Shanshan.
Wenzhou young man Wang Yuhua is helping his mother who suffers from anxiety to seek medicine. Another identity of the mother is a newly diagnosed breast cancer patient, and she came to Shanghai for the resection operation.
They arrived in Shanghai on March 21st. According to the original plan, the operation was completed in late March, and the follow-up treatment plan was determined with the doctor according to the pathological results and postoperative recovery, and he could return to Wenzhou in early April.
The four medicines that my mother took were prescribed at most for one month each time. Measured over and thought it was more than enough.
The epidemic has disrupted all plans.
On the day of arrival, the contacted hospital suddenly informed that it would not accept out-of-towners for hospitalization. Later, the attending doctor found the operating room in another hospital. Because of the zoning lockdown, her mother could only be discharged from the hospital ahead of schedule and stayed at a relative’s house, while Wang Yuhua was isolated in a hotel for some reason. They have been unable to take out pathological specimens and send them to qualified hospitals for further analysis.
Treatment delays, the separation of mother and child, and the indefinite release of lockdown are all adding to her anxiety. But the medicines are running out. Five or six days before Wang Yuhua posted on Weibo for help, his mother had already reduced the dosage of 3 medicines, and only the one that helped the most sleep remained unchanged.
Ma Wei’s medicine is almost finished. She studied at a university in the suburbs of Shanghai. Nearly 200 people from the school were transferred to the cabin, which inevitably made people panic. Internships and graduate school applications are stacked again. She had an anxiety attack at one point, “can’t breathe, and will keep grabbing herself”.
Recurrence and Withdrawal Response
Previously, Yang Shanshan The condition has been stable for a long time.
The last big fluctuation was more than a year ago. At that time, she was still in college, and she was locked in the school for more than a month because of the epidemic. She stayed in the dormitory every day, and had little communication with others. Later, her sleep became very poor, day and night were reversed, and her emotions were out of control several times.
Therefore, she chose to go to the company for quarantine after receiving the notice of partition closure on March 27. “If you are stuck in the rental house, it will be very suffocating with just me and my boyfriend.”
In the company, Yang Shanshan has experiments to do every day , the work and rest will be more regular, and there is no need to worry about materials. There are still many colleagues who can chat, which helps to stabilize the mood.
Even so, she had a depressive episode.
On April 1, several calls for help were not dialed in a row, plus the emotions accumulated over the past few days from constant exposure to negative information about the epidemic, Looking at her last tablet of trazodone, she instantly collapsed and cried.
The boyfriend took her downstairs immediately, took a walk in the park, and fully vented her emotions. Under his patient comfort, Yang Shanshan slowly calmed down.
Yang Shanshan A small number of dialing records, almost all of which are not connected.
Image source: Photo courtesy of respondents
Under the epidemic, people generally suffer from depression, anxiety and other negative emotions due to worries about infection, restricted mobility, and work suspension. For mentally ill patients, the condition fluctuates easily.
In this case, it is even more important to take the medicine regularly.
Liu Siqi from Changchun suffers from severe depression and moderate anxiety. Due to her traumatic experiences as a child, she has had emotional problems for more than ten years, which were aggravated by some changes last year.
About six months ago, she started treatment. Before the outbreak of the epidemic in Jilin Province, she thought that her condition had improved a lot, so she reduced the medicine on her own.
In mid-March, Liu Siqi’s community began to be closed for management. The pressure kept coming: positives appeared in the community. At first, the distance was not too close. Later, there were also confirmed cases in the same building; food reserves were insufficient. I only got one dish; I caught a cold with my 4-year-old daughter at the same time, and I couldn’t buy medicine. “My daughter has a history of febrile convulsions, and I am especially worried that she has a fever, and she takes care of her all night when she is sick.” Friction is increasing.
Under heavy pressure, the idea of self-injury came up again. She tried to restrain herself.
She took medication more and more frequently, and gradually realized the importance of regular medication. On March 24, she had a big fight with her mother online and lost control of her emotions, shouting and smashing things uncontrollably. From that day on, she took the medication every day until she ran out of it after 12 days.
Image source: Figureworm Creative
Sudden drug withdrawal not only affects the stability of the condition, but may also cause some withdrawal reactions.
Yang Shanshan was forced to adjust her dosage on April 2. At that time, the trazodone had been eaten, and there was not much duloxetine left. If not for a few leftovers in the office drawer, there might be no more. In desperation, she reduced the daily dose from two to one.
Since then, she developed physical symptoms such as headache, palpitations, and insomnia.
The day before getting the medicine is the worst. On the night of April 9, she had sleepless nights until three or four in the morning. I had a nightmare all night and woke up groggy with a splitting headache and a feeling of fullness in my stomach. She sat motionless on a camp cot in the communal lounge area, so uncomfortable she “wouldn’t even want to open her eyes”.
“Occasional cure” has been in contact with a patient with bipolar disorder for the longest time, and it has been more than half a month. Because the required drugs are special, although many volunteers help to find them, there is still no progress.
The patient said that his withdrawal reaction was very serious. “As soon as the eyeballs move, I feel that a nerve is involved, and then my head will “buzz” and I will be instantly dizzy.” Moreover, the mood fluctuates greatly, and he often bursts into tears.
A few days ago, she turned to the medicine left over from 5 years ago, when the doctor’s diagnosis was depression. This medicine had the same main ingredient as the one she needed, and it was made by a different manufacturer.
The medicine has expired for a month, but she still took half a tablet.
The next morning, she noticed that the withdrawal reaction had eased. In recent days, she has been using these leftover medicines to save her life.
She said that she was very satisfied.
Each link may encounter difficulties
For Yang Shanshan, the turning point came on April 9th.
On that day, she dialed a new medical help number, but she did not expect that the operator was another staff member of the neighborhood committee. “The other party’s attitude was very good, and the name of the medicine was registered seriously. When she learned that I was in the company, and our company is Quan Yin, she was very excited and said that the quicker way is for the neighborhood committee to issue a pass, and I go to the Jingwei Center to buy it myself.”
Yang Shanshan just realized that the sentence “then go buy it yourself” a few days ago means. At this point, she had been off her medication for a week.
If the previous staff member could explain a few more words, maybe the problem would not have dragged on for so long.
According to “occasional cure”, there are several ways for patients in Shanghai to buy psychotropic drugs:
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The first is to apply for the medicine dispensing service of the neighborhood committee; the second is to place an order on the online platform and wait for delivery; there are many successful cases where the patient himself holds a pass, or Ask people to bring their ID information and prescriptions to the hospital or a qualified pharmacy to buy medicines.
Maomao, a university student in Beijing, is a volunteer who seeks help from psychotropic drugs. Since March 31, the volunteer team has followed up about 700 mentally ill patients for help.
She told “occasionally cured” that in the first few days, especially during the Qingming Festival, several Jingwei centers did not open clinics, and they preferred the recommended channel at that time. It is to ask the neighborhood committee to dispense the medicine on its behalf. If the neighborhood committee does not cooperate well, try to place an order in the Internet hospital, and then ask the police in the jurisdiction to replace it. Overall, the difficulty is still relatively high.
With the passage of time, more and more patients are able to go to the hospital to prescribe their own medicines.
A volunteer took the residents’ medical record cards to the hospital for centralized dispensing.
Image source: IC photo
Although the process is clear, each link may encounter difficulties.
First of all, hospital openings are constantly changing, and the criteria for accepting patients vary. Some only accept patients with medical records in our hospital, and some district-level Jingwei Centers accept prescriptions from the City Jingwei Center. The time limit for nucleic acid results is also different, some within 24 hours, some within 48 hours, and a few also accept antigen self-test results.
Maomao introduced that they made a list, involving 19 hospitals, including Jingwei centers at all levels, as well as psychiatry departments in general hospitals. Every morning, a group of volunteers are facing the form, calling one by one to confirm whether the clinic is open, which patients are accepted, which drugs are available, and what materials need to be brought.
This is not an easy task. “Because it is difficult to get through the phone, it is impossible for one person to ask all the hospitals, so we can only arrange more people, and whoever asks will be synchronized in real time.” In recent days, due to the shortage of personnel, this verification work was temporarily put on hold.
Maomao looks forward to having an information platform that aggregates and updates these situations in real time. She believes that this is a win-win situation. Patients and volunteers don’t have to spend too much time searching, the hospital can answer fewer calls, and everyone’s efficiency can be improved.
Currently, along with the application, there is a system for “inquiry about the suspension of medical services in some departments of major hospitals”, but only the hospitals and departments that are closed for diagnosis are listed, and there is no detailed information such as nucleic acid requirements, and the update time remains on April 14. The Liberation Daily has also built a query system, and the situation is similar.
Inquiry page about the closure of major hospitals with the application.
Image source: with the application
Another difficulty is travel.
Ma Wei is stuck in this ring. After the drug ran out, she first chose to ask the teacher for help, and the teacher also reported to the school’s psychological center. But she was still unable to leave the school in the end, and the school did not send anyone to help get the medicine.
She had no choice but to search for errands on various online platforms, but now the capacity is tight and the school is relatively biased. Even if the price is increased to the top, there will still be no one for more than ten hours Orders.
Offline dispensing mainly involves the issue of passes and means of transportation.
The pass is subject to the cooperation of the neighborhood committee. “In actual work, there have been cases where the patient himself was rejected by the neighborhood committee, but when we called as volunteers, the other party agreed. In some cases, the communication was not successful in the end, and there was nothing we could do.”
Mobility tools are relatively easy to solve. Yang Shanshan chose to seek help in the community group, and soon four neighbors with cars came to contact her. Mao Mao’s volunteer team will also help patients connect with some vehicle resources.
According to Mao Mao’s observation, most of the patients still take the method of online dispensing, and then ask for errands instead.
If you want to call errands, it is the easiest in the area, second in the area, and the most difficult across the river. “A few days ago, the price we asked for across the river was still 800 or 900 yuan. If we ask again in the next two days, it has risen to 2,000.”
Therefore, they organized centralized drug purchases, helped more than a dozen patients in Pudong find the channel across the river, and shared the transportation costs. Volunteers with the right to cross the river took all the materials, bought them all at the Jingwei Center in Puxi, and sent them across the river. The volunteers in Pudong called errands and distributed them to different patients.
In addition, the medical records and past prescription records of some non-local patients are not around, and the hospitals they often visit do not have online channels for inquiries. The hospital proves its own situation and also needs corresponding guidance.
Getting the medicine is not the end of the story
Yang Shanshan got the medicine on the evening of April 10th. A kind uncle in the community drove to a hospital more than 20 kilometers away to help her get medicine, and then delivered it to the door of her company.
At noon that day, the uncle left without saying hello. By the time Yang Shanshan received the news, he had already arrived at the hospital. An hour later, she received a notification that the registration was successful.
“I can imagine how many people there are in the hospital, and how hard it is for him to queue for so long.”
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Yang Shanshan recorded the entire experience and attached a drug purchase tutorial at the end. Some netizens asked her for her experience, some wanted to prescribe medicine for the depressive elderly at home, and someare experiencing a withdrawal reaction.
Wang Yuhua’s mother also got the medicine on the 7th day when she started to reduce the medicine.
There have been some twists and turns in the middle. Because she had been prescribing medicines in Wenzhou before, it was difficult to get a follow-up prescription in Shanghai. The neighborhood committee of the place where she lived helped to ask the nearby pharmacies, but none of the medicines she needed were available. Later, Wang Yuhua contacted the pharmacy opposite the Jingwei Center through volunteers, passed on the previous prescription records, and asked to run errands instead.
The kind uncle in the community got the medicine for Yang Shanshan.
Image source: Photo courtesy of respondents
At the press conference on epidemic prevention and control on April 12, Wu Ganyu, a first-level inspector of the Shanghai Municipal Health Commission, responded to the problem of “difficulty in dispensing psychotropic drugs”:
Medications for mentally ill patients in Shanghai are divided into registered and non-registered. Those who are registered shall be solved through the existing mechanism of taking and delivering medicines; those who are not registered shall be provided services through the work connection between the Jingwei Center in each district and the community health service center. In areas where conditions permit, the district-level Jingwei Center can seal off the residents of the area. The required medicines are sent to the community health service center, and the community health service center will copy the prescription and dispense the medicine according to the patient’s previous visits and needs by means of specialist doctors or remote guidance.
At the same time, the Jingwei Centers in each district have clarified their specialists and contact numbers.
After returning to normal dosage, Yang Shanshan’s mental state recovered a lot. She is still doing other efforts to benefit her condition, such as reducing her exposure to information about the epidemic, and at most she can browse some texts, videos and audios forwarded by her friends, and never watch or listen to them.
Getting the medicine is not the end of the story. The lockdown is still ongoing, and the state of stress may not be relieved immediately.
Wang Yuhua spends at least 40 minutes on video with her mother every day, trying to divert her attention by talking about small everyday things. The mother seldom confided herself, but Wang Yuhua could sense that sometimes her state would be more tense.
He has been actively asking how to take out his mother’s pathological specimen and send it to the cancer hospital across the river for further analysis. He knew that delays in follow-up treatment were one of the main sources of anxiety for his mother, and he was trying to push it forward.
Before the press release, “Occasional Cure” just learned that under the coordination of the street, Wang Yuhua was finally able to collect pathological specimens. He rode a shared bicycle 17.6 kilometers before reaching the hospital where his mother had surgery.
Liu Siqi from Changchun finally started taking medicine regularly. She felt that her body was still getting used to the new medicine.
The lockdown is about to end for a month, and the supply of materials is getting smoother and smoother, and the anxiety in this regard has eased a lot. But the friction between her and her family continues, and she still breaks down because of it, and sometimes even has some extreme thoughts.
There is one more thing that concerns her. She didn’t want her neighbors to know about her condition. When she asked for help in the community group before, she told it in the tone of a third party.
She hopes that after the lockdown is over, she will not receive the same gaze.
(In order to protect the privacy of the respondents, the characters in the text are all pseudonyms.)
Written by: Chen Yihan
Producer: Li Chen
First image source: IC photo
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