Wan Jun had never thought that he would one day be in charge of the building and operations of a makeshift hospital inside a stadium.

As the vice-president of the Renmin Hospital of Wuhan University, Wan was initially overwhelmed by the task. 

At that time, no one – from patients to medical staff – has enough faith and confidence about building the makeshift hospital.

But in the end the mission was a great success. The 16 makeshift hospitals in Wuhan – expeditiously converted from stadiums and exhibition centers – proved pivotal in China's decisive fight against the novel coronavirus outbreak. 

Infection exploded, hospitals overwhelmed

The situation was dire in early February. 

On Feb 2, China reported more than 17,000 new cases of the novel coronavirus pneumonia, 30 percent in Wuhan alone, a metropolis with a population of 11 million in Center China's Hubei province.

At that time, all designated hospitals in the city were packed with patients. As a result, many diagnosed mild patients couldn't get treated at the hospitals and had to self-isolate at home. Risks were high and real for families and communities given that it was a highly contagious disease, so far without a vaccine.

How to break the dilemma between surging numbers of patients and overwhelmed hospitals? The makeshift hospital offered a workable alternative.

"Makeshift hospitals are built for the treatment of a large number of confirmed mild patients," said Wang Chen, vice-president of the Chinese Academy of Engineering and president of the Chinese Academy of Medical Sciences, "The makeshift hospital is not a perfect choice, but given the harsh reality of the novel coronavirus prevention and control, it is a pragmatic one.”

The site of such a hospital must meet two criteria, according to Wang Jian, director of the Medical Management Center under China's National Health Commission. It should be spacious enough to hold a large number of patients for quarantine and treatment. And it must be far away from residential areas and have good ventilation.

On the evening of Feb 3, the Hongshan Stadium in Wuchang district of Wuhan was picked as one of the sites to be converted into a makeshift hospital and Wan Jun was put in charge of the operation. 

But how to proceed? Wan Jun had no clear idea at that moment. What he did know for certain was that he had an almost impossible deadline as his makeshift hospital would open to patients in just two days.

Through all the challenges

A batch of 28 cured patients were discharged from the makeshift hospital at Hongshan Stadium in Wuhan, Central China's Hubei province, on Feb 11, 2020. [Photo/provided to en.nhc.gov.cn]

The transformation started at full swing, setting a target of 1,000 hospital beds in the stadium.

For Wan, the first thorny issue was how to place the beds. Placing them side by side poses two potential threats: it could lead to cross infection and if one patient got irritable or even aggressive, it would be prone to escalation and make it hard to control all the patients. 

"There should be some distance between the beds and a certain partition between the bedheads," Wan said.

The distance was easy, but where to find so many partitions right in the middle of Spring Festival holiday when almost all factories were closed and migrant workers were at their hometowns for family reunion? Wan was stymied.

Shortly thereafter a construction worker approached Wan, offering an alternative solution: the city's plastic roadblocks – just outside on the road, plain and many – would make decent partitions once cleaned and disinfected. 

One challenge down, there emerged another. To fix the ventilation system in the stadium was another priority. 

"One main difference between a stadium and an infectious disease ward is that the former has positive air pressure while the latter has to be negative." said Zhang Ya'nan, a senior engineer with Central-South Architectural Design Institute.

The ventilation's top priority, Zhang added, was to ensure the health and safety of medical staff and patients.

Thus the polluted area had to be under negative pressure and the clean area under positive pressure, so that the air in the polluted area will not be directly discharged outdoors. 

A renovated ventilation system in the ward area, equipped with a high-efficiency filter, would ensure no contamination to the outside.

All along the way there were so many other problems. 

February in Wuhan is still winter, and it could be very cold inside the big stadium-turned makeshift hospital. “How can patients rest well when it's so cold?" Wan Jun asked himself. And promptly electric blankets were added to the beds.

The stadium now had so many beds but not enough restrooms. So, mobile toilets were installed. However, the communal usage could be a problem in itself as health authorities had just found that the disease might be transmitted via human excrement. 

Now what? The final solution: a sanitation force was arranged to take away the toilet waste every day with designated vehicles for centralized disinfection.

From a rainy start to full operation

A medical worker measures a patient's body temperature at the makeshift hospital at Hongshan Stadium in Wuhan, Central China's Hubei province, on Feb 28, 2020. [Photo/provided to en.nhc.gov.cn]

There was a drizzle on Feb 5, the designated deadline for Wan Jun. Three P3 mobile laboratories dispatched from Beijing and Guangdong province were stationed outside the Wuchang Makeshift Hospital, ready to receive clinical samples and conduct nucleic acid testing.

By 5 pm that afternoon, Wan Jun was still crisscrossing inside the refurbished stadium for a final inspection of the hospital. Around him were hundreds of medical personal – from four national emergency medical rescue teams as well as four local medical teams – fully prepared to receive the first patients. 

All rescue team members sent to the makeshift hospital are outstanding professionals in their respective hospital, said Wan Jun, adding that they are the main force for patient treatment.

It wasn't until 11:40 pm, near midnight, when the day's drizzling had gathered into a heavy shower, that the first patients arrived. 

It was the city's first makeshift hospital. As of 7:30 am the next day, it was providing medical treatment for 328 patients who tested positive for the virus but showed no severe symptoms.

The makeshift hospital was equipped with medical inspection equipment for biochemical detection, radiological detection and etiology detection, which can monitor the situation of patients at any time.

Multiple washbasins with warm water were later installed in the ward. A temporary library was even set up for the patients.

On Feb 11, six days after its opening, 28 patients who had fully recovered were discharged from the Wuchang Makeshift Hospital. Wan issued a certificate for each of them.

The ultimate shelter

An 11-year-old patient draws a picture for the medical workers to show her gratitude at the makeshift hospital at Hongshan Stadium in Wuhan, Central China's Hubei province, on March 8, 2020. [Photo/provided to en.nhc.gov.cn]

Ma Xiaowei, minister of the National Health Commission, said at a press conference on Feb 28 that by that date Wuhan had built 16 makeshift hospitals with more than 13,000 beds, and treated more than 12,000 patients. One out of four patients in Wuhan received treatment in the makeshift hospitals. 

As an emergency measure to solve the dilemma of inadequate beds for surging numbers of patients, China's makeshift hospitals played a pivotal role in its war against the novel pneumonia.

Earlier this month, after all the patients had either recovered or relocated to designated facilities, the 16 makeshift hospitals in Wuhan gradually concluded their operations. The hospital under Wan Jun's care, the first in the city, was also the last to close, after bidding farewell on March 10 to the last 49 recovered patients.

For many of those in dire need of help, these facilities were truly their lives' shelters.