When I'm on the night shift, all the department heads can't sleep.

More than half an hour after the re-collected sample was sent out, the laboratory called again.

After Xu Wenliang's original sample was re-extracted, the same target still amplified, the curve was clearer than the first time, and the Ct value was still close to the judgment threshold.

The second line of the laboratory has reviewed the operation records and quality control results of the testing instruments, and no obvious signs of contamination have been found inside the laboratory so far.

"Do not issue a formal report on this test result for the time being."

Xu Mingzhe confirmed over the phone, "The original amplification curve, the extraction times and operation records for both extractions have all been retained. The aliquoted specimens from within the hospital will continue to be preserved as required, pending the review opinion from the municipal CDC."

Xu Mingzhe agreed on the other end of the phone and then hung up.

Li Qian added the retest time to the record, picked up another phone, and reported the retest results from the laboratory to the on-call supervisor.

The person in charge of infection control was also woken up by the on-duty officer. After listening to the instructions, he first ordered the fever clinic to continue to maintain the separation between the clean area, the buffer zone, and the isolation observation area. People in each area were not allowed to move between areas on their own, and relevant patients and staff were not allowed to leave the fever clinic without unified arrangements.

The corresponding surveillance footage times for the emergency CT waiting area and the inpatient elevator entrance that Shao Dequan passed through have been determined.

Li Qian reported the two locations and times, and the on-duty officer immediately dialed the radiology department's on-duty phone to notify that the emergency CT machine used that night should postpone receiving the next batch of patients and that the backup examination route should be used first.

The original examination rooms, equipment, and passageways will be reopened after terminal disinfection, ventilation, and infection control assessment.

The on-duty officer contacted security and logistics to separate the entrance for fever patients, the general emergency entrance, and the testing channel. Newly arrived fever patients first underwent initial screening at the designated entrance, while critically ill patients received treatment as usual, and their destinations were registered one by one during the triage process.

When these arrangements were relayed to the emergency room nurses' station, Nurse Zhao was tending to the triage desk.

She instructed the security guards to place the newly delivered mobile isolation barrier between the regular emergency room entrance and the outer triage entrance, and then called the CT room back to confirm which route the next patient needing an urgent examination should take.

"The backup CT scanner can receive the next emergency patient, but the patient's and accompanying nurse's names must be provided in advance," the radiology staff reminded on the phone. "After the temporary route change, don't let family members find it themselves. If someone goes to the wrong place, the backup passage will have to be cleared again."

"Understood. The patient will be accompanied by the accompanying nurse; both names should be provided in advance." Nurse Zhao hung up the radiology department, wrote the backup route at the top of the handover sheet, and then called back to the fever clinic. "Director Qin, the entrances for general resuscitation and fever patients are now separate. If patients need to be transferred out or staff need to be reassigned, please provide their names and destinations in advance. I will personally hand over the backup CT route to the day shift."

Qin Hai responded and hung up the phone.

After 2 a.m., the two landlines finally stopped ringing at the same time.

Li Qian took the opportunity to continue organizing the records of the personnel in the clean area, while Xu Mingzhe kept track of the calls from the laboratory and the local CDC.

Luo Wenbin remained in the observation area. Every half hour, nurses recorded the vital signs and consciousness of three patients, and reported any significant changes to the clean area via internal line.

Xu Wenliang has been given high-flow humidified oxygen therapy, and his blood oxygen level is temporarily maintained at around 94, while his respiratory rate is still close to 30 breaths per minute.

Half an hour later, the bedside blood gas analyzer returned the results of the follow-up test, showing that the oxygenation level had improved compared to before.

The second-line respiratory department still requires continuous monitoring, continued coordination of isolation monitoring beds, and continued standby of equipment and personnel needed for further respiratory support such as endotracheal intubation.

Gao Limin and Shao Dequan remained under observation after undergoing re-examination, and their vital signs were temporarily stable.

When Gao Limin heard from the nurse that the local CDC had arranged for Gu Shoucheng to have a sample taken and undergo medical evaluation, he asked the nurse to tell Gao Yuan not to call the Gu family again.

Shao Dequan, concerned that Chen Xiulan was still on the outside, urged her through the inside line to find a chair to sit on, instead of standing until dawn.

Around 4 PM, the duty manager of Kangning Hotel rushed back to the hotel, retrieved the scanned copy of the contract from the electronic archive, and sent it to the hospital's on-call supervisor.

The contact person on the contract is still Zhou Jian, and an office phone number is also provided. The address listed is a commercial building in the north of the city.

The license plate number of that delivery van is listed in the vehicle registration at the back gate, and the local CDC has taken over the investigation.

The hotel sent two screenshots from the second-floor corridor surveillance camera, one taken after the morning session ended and the other before the afternoon session began.

Both pictures show a man in a gray work shirt pushing a cardboard box containing blue activity bags down the corridor.

Li Qian zoomed in on the images side by side, and based on their clothing and build, they looked very much like the same person, but their exact identity still needs further investigation.

Li Qian numbered the surveillance screenshots, vehicle registration documents, and contracts separately, noting "relationship not yet confirmed" on all three documents, and forwarded them to the local CDC. The on-duty staff also instructed the hotel to retain the complete original video footage of the loading and unloading of cardboard boxes at the back door that day and the departure of all relevant personnel.

As dawn broke, Lin Ye's cell phone alarm clock vibrated in his pocket.

He ignored the 6:30 reminder, walked to a window seat in the cleaning area, and called his mother.

The phone was answered on the second ring.

"Why are you calling at this hour? It's not time for shift change yet, is it?"

"There are still a few patients with fever being screened in the hospital, and I can't leave for the time being after my shift ends. I'm fine here. You and Dad should wear masks when you go out these days and avoid crowded places."

After a moment of silence, the mother said, "I know. You go about your business, and if you can get some sleep, then go. Let us know when you wake up."

"it is good."

After the call ended, Lin Ye set a reminder for 10 a.m.

Just as I was about to put my phone in my pocket, a message from Ma Hao popped up.

Corey told me to report at 7:30 AM through the east entrance of the administration building, and not to go into the emergency room lobby. Are you still in the fever clinic?

Lin Ye replied: [Still in the clean area of ​​the fever clinic. Follow the instructions and don't go into the emergency room.]

At 7:25, Ma Hao completed the registration at the east gate of the administration building.

The on-duty staff checked his schedule and notification information, and kept him in the cleaning office area to temporarily assist the day shift in checking the list of emergency room staff at night, their contact numbers, and the times they entered the relevant areas.

When he called Lin Ye, the temporary office area was not yet ready. Some people were moving printers, and others were bringing in boxes of folders.

"I haven't even seen you in person, but I'm already checking if you went to the fever clinic handover area several times last night," Ma Hao said. "Are you guys going to be unable to finish your shift?"

"Check the access control and handover records together, don't just look at the shift schedule."

"I know, I'm not that stupid," Ma Hao replied quickly. "You can take a nap when you have time; the day shift workers have already started arriving at the hospital."

Zhou Min, the deputy director of the emergency department's day shift, arrived at 7:40 a.m.

She first went to the emergency room nurses' station to receive Nurse Zhao's shift handover, checked the backup CT route and the outer triage entrance, and then listened to Qin Hai's explanation of the nighttime situation at the fever clinic through the internal phone.

Qin Hai transferred to her the list of personnel and activity routes that had not yet been verified overnight. He also explained Xu Wenliang's changes in oxygenation and noted that the city CDC's review results had not yet been reported.

The contact verification of people who have been in contact with each other will continue to be the responsibility of the hospital infection control department and the local disease control center. The current zoning within the hospital will be maintained for now. Whether to expand the isolation area or increase restrictions on the movement of people will depend on the verification results and notification from higher authorities.

After listening, Zhou Min first asked Qin Hai, "Who's going to rest first, you or Lin Ye?"

"After this round of early shift handover is over, Lin Ye will rest first. I'll wait for the inspection report."

"Don't try to hold out until noon." Zhou Min flipped to the last page of the handover log. "After the results from the Municipal CDC come back, I'll take the calls and arrange the follow-up. Xu Mingzhe will hand over the test verification and local liaison to the infectious disease department's day shift, and Luo Wenbin will hand over the monitoring focus of the three patients to the fever clinic's day shift. After that, everyone go and rest. I'll take care of things in the emergency room. Nurse Zhao will leave after she finishes her handover."

The early shift handover went on past 8 a.m.

At 8:03, a call came in from the municipal CDC laboratory to the clean zone.

Li Qian answered the phone. After verifying Xu Wenliang's new sample number, the other party reported word for word: "The initial screening of the novel coronavirus nucleic acid in the re-collected sample showed abnormal amplification of a single target, and a retest has been initiated. No official positive report is available at this time. Please continue to manage this as a suspected case and await the retest results and notification from the local authorities."

Li Qian hung up the phone with the municipal CDC and immediately called back the emergency room nurses' station to report the results to Zhou Min.

Zhou Min reopened the handover log and added "Suspected Case Management" after Xu Wenliang's name. The section for the official review results remained blank.