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Li Wenliang (; 12 October 1986 – 7 February 2020) was a Chinese
ophthalmologist Ophthalmology ( ) is a surgical subspecialty within medicine that deals with the diagnosis and treatment of eye disorders. An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a med ...
who warned his colleagues about early
COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was identified in Wuhan, China, in December 2019. The disease quick ...
infections in
Wuhan Wuhan (, ; ; ) is the capital of Hubei Province in the People's Republic of China. It is the largest city in Hubei and the most populous city in Central China, with a population of over eleven million, the ninth-most populous Chinese city a ...
. On 30 December 2019, Wuhan CDC issued emergency warnings to local hospitals about a number of mysterious "pneumonia" cases discovered in the city in the previous week. On the same day, Li, who worked at the Central Hospital of Wuhan, received an internal diagnostic report of a suspected
severe acute respiratory syndrome Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by the severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1), the first identified strain of the SARS coronavirus species, ''sev ...
(SARS) patient from other doctors which he in turn shared with his
Wuhan University Wuhan University (WHU; ) is a public research university in Wuhan, Hubei. The university is sponsored by the Ministry of Education. Wuhan university was founded as one of the four elite universities in the early republican period of China and ...
alumni through a
WeChat WeChat () is a Chinese instant messaging, social media, and mobile payment app developed by Tencent. First released in 2011, it became the world's largest standalone mobile app in 2018, with over 1 billion monthly active users. WeChat has b ...
group. He was dubbed a
whistleblower A whistleblower (also written as whistle-blower or whistle blower) is a person, often an employee, who reveals information about activity within a private or public organization that is deemed illegal, immoral, illicit, unsafe or fraudulent. Whi ...
when that shared report later circulated publicly despite his requesting confidentiality from those with whom he shared the information. Rumors of a deadly SARS outbreak subsequently spread on Chinese social media platforms; Wuhan police summoned and admonished him and seven other doctors on 3 January for "making false comments on the Internet about unconfirmed SARS outbreak." The outbreak was later confirmed not to be SARS, but rather a new coronavirus,
SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19 (coronavirus disease 2019), the respiratory illness responsible for the ongoing COVID-19 pandemic. The virus previously had a ...
. Li returned to work and later contracted
COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was identified in Wuhan, China, in December 2019. The disease quick ...
, the disease caused by the virus, from a patient who was not known to be infected. He died from the disease on 7 February 2020, at age 33. A subsequent Chinese official inquiry exonerated him; Wuhan police formally apologized to his family and revoked his admonishment on 19 March. In April 2020, Li was posthumously awarded the May Fourth Medal by the government. By early June 2020, five more doctors from the Wuhan hospital had died from COVID-19.


Early life

Li Wenliang was born on 12 October 1986 in a
Manchu The Manchus (; ) are a Tungusic East Asian ethnic group native to Manchuria in Northeast Asia. They are an officially recognized ethnic minority in China and the people from whom Manchuria derives its name. The Later Jin (1616–1636) an ...
family in
Beizhen Beizhen () is a city in west-central Liaoning province of Northeast China. It is under the administration of Jinzhou City. History In 1123, the Jin Dynasty set Guangning County () in nowadays Beizhen. In Ming Dynasty, the town of Guangning becam ...
,
Jinzhou Jinzhou (, ), formerly Chinchow, is a coastal prefecture-level city in central-west Liaoning province, China. It is a geographically strategic city located in the Liaoxi Corridor, which connects most of the land transports between North Chin ...
, Liaoning. His parents were former
state enterprise A state-owned enterprise (SOE) is a government entity which is established or nationalised by the ''national government'' or ''provincial government'' by an executive order or an act of legislation in order to earn profit for the government ...
workers and both lost their jobs in the 'wave of laid-offs' in the 1990s. He attended Beizhen High School () and graduated in 2004 with an excellent academic record. He attended Wuhan University School of Medicine as a clinical medicine student in a seven-year combined bachelor's and master's degree program. He joined the
Chinese Communist Party The Chinese Communist Party (CCP), officially the Communist Party of China (CPC), is the founding and sole ruling party of the People's Republic of China (PRC). Under the leadership of Mao Zedong, the CCP emerged victorious in the Chinese Ci ...
(CCP) in his second year. His mentor praised him as a diligent and honest student. His college classmates said he was a
basketball Basketball is a team sport in which two teams, most commonly of five players each, opposing one another on a rectangular Basketball court, court, compete with the primary objective of #Shooting, shooting a basketball (ball), basketball (appr ...
fan.


Career

After graduation in 2011, Li worked at the Xiamen Eye Center of
Xiamen University Xiamen University (; Southern Min: ''Ē-mn̂g-toā-o̍h''), colloquially known as Xia Da (; Southern Min: ''Hā-tāi''), is a national public research university in Xiamen, Fujian, China. Founded in 1921 by Tan Kah Kee, a Chinese patriotic ex ...
for three years. In 2014, Li became an
ophthalmologist Ophthalmology ( ) is a surgical subspecialty within medicine that deals with the diagnosis and treatment of eye disorders. An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a med ...
at Wuhan Central Hospital in Wuhan.


Role in COVID-19 pandemic

In late December, doctors in Wuhan were puzzled by many "pneumonia" cases of unknown cause. On 30 December 2019, the Wuhan CDC sent out an internal memo to all Wuhan hospitals to be alerted and started an investigation into the exact cause of the pneumonia. The alert and subsequent news reports were immediately published on ProMED (a program of the
International Society for Infectious Diseases The International Society for Infectious Diseases (ISID), established in 1986, is a nonprofit organization that monitors infectious diseases on a global scale. It also offers grants and fellowships, publishes a journal, and runs online learning p ...
). On the same day, Li saw a patient's report which showed a positive result with a high
confidence level In frequentist statistics, a confidence interval (CI) is a range of estimates for an unknown parameter. A confidence interval is computed at a designated ''confidence level''; the 95% confidence level is most common, but other levels, such as ...
for SARS coronavirus tests. The report had originated from Ai Fen, director of the emergency department at Wuhan Central hospital, who became alarmed after receiving laboratory results of a patient whom she had examined who exhibited symptoms akin to influenza resistant to conventional treatment methods. The report contained the phrase "SARS coronavirus." Ai had circled the word "SARS" and sent it to a doctor at another hospital in Wuhan. From there it spread throughout medical circles in the city, where it reached Li. At 17:43, he wrote in a private
WeChat WeChat () is a Chinese instant messaging, social media, and mobile payment app developed by Tencent. First released in 2011, it became the world's largest standalone mobile app in 2018, with over 1 billion monthly active users. WeChat has b ...
group of his medical school classmates: "7 confirmed cases of SARS were reported o hospitalfrom
Huanan Seafood Market The Wuhan Huanan Seafood Wholesale Market (), simply known as the Huanan Seafood Market (''Huanan'' means 'South China'), was a live animal and seafood market in Jianghan District, Wuhan City, the capital of Hubei Province in Central China. ...
." He also posted the patient's examination report and CT scan image. At 18:42, he added "the latest news is, it has been confirmed that they are coronavirus infections, but the exact virus strain is being subtyped." Li asked the WeChat group members to inform their families and friends to take protective measures whilst requesting discretion from those he shared the information with; he was upset when the discussion gained a wider audience than he had hoped. After screenshots of his WeChat messages were shared on Chinese Internet and gained more attention, the supervision department of his hospital summoned him for a talk, blaming him for leaking the information. On 3 January 2020, police from the Wuhan Public Security Bureau investigating the case interrogated Li, issued a formal written warning and censuring him for "publishing untrue statements about seven confirmed SARS cases at the Huanan Seafood Market." He was made to sign a letter of admonition promising not to do it again. The police warned him that any recalcitrant behavior would result in a prosecution. Li returned to work at the hospital and contracted the virus on 8 January. On 31 January, he published his experience in the police station with the letter of admonition on social media. His post went viral and users questioned why the doctors who gave earlier warnings were silenced by the authorities.


Reaction

The existence of Li's personal blog where he documented his discoveries was reported by the Italian newspaper
La Stampa ''La Stampa'' (meaning ''The Press'' in English) is an Italian daily newspaper published in Turin, Italy. It is distributed in Italy and other European nations. It is one of the oldest newspapers in Italy. History and profile The paper was fou ...
on 1 February. Li later responded that he did not know whether he was one of the so-called "rumor mongers," but that he had been admonished for claiming a SARS outbreak, which at that time was unconfirmed. The police punishment of Li for "rumor mongering" was aired on
China Central Television China Central Television (CCTV) is a Chinese state- and political party-owned broadcaster controlled by the Chinese Communist Party (CCP). Its 50 different channels broadcast a variety of programing to more than one billion viewers in six lan ...
, signaling central government endorsement for the reprimand, according to two reporters for the ''
South China Morning Post The ''South China Morning Post'' (''SCMP''), with its Sunday edition, the ''Sunday Morning Post'', is a Hong Kong-based English-language newspaper owned by Alibaba Group. Founded in 1903 by Tse Tsan-tai and Alfred Cunningham, it has remained ...
''. On 4 February, the Chinese
Supreme People's Court The Supreme People's Court of the People's Republic of China (SPC; ) is the highest court of the People's Republic of China. It hears appeals of cases from the high people's courts and is the trial court for cases about matters of nation ...
said that the eight Wuhan citizens should not have been punished as what they said was not entirely false. It wrote on social media: "It might have been a fortunate thing if the public had believed the 'rumors' then and started to wear masks and carry out sanitization measures, and avoid the wild animal market." Li told ''
Caixin Caixin Media () is a Chinese news website based in Beijing known for investigative journalism. Caixin means "New Fortune" in Chinese. Structure The founder and publisher is Hu Shuli, a former Knight Fellow in journalism at Stanford Universi ...
'' that he had been worried the hospital would punish him for "spreading rumors," but felt relieved after the top court publicly criticized the police, and said, "I think there should be more than one voice in a healthy society, and I don't approve of using public power for excessive interference." On December 31, 2019, Yijun Luo, then deputy director of the
Centers for Disease Control The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
of the Ministry of Health and Welfare of Taiwan, was browsing the Internet when he discovered that an Internet user had posted a warning message from Dr. Wenliang Li about a new SARS-like virus, which alerted him. After researching the message, Luo Yijun considered it highly credible and initiated a series of epidemic prevention procedures, and at a press conference on April 16, 2020, Luo Yijun expressed his gratitude to Dr. Li Wenliang.


Illness and death


COVID-19 infection

On 8 January, Li contracted COVID-19 unwittingly while treating an infected patient at his hospital. The patient suffered from acute angle-closure
glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for aqueous humor, fluid withi ...
and developed a fever the next day that Li then suspected was coronavirus-related. Li developed a fever and cough two days later which soon became severe. Doctor Yu Chengbo, a
Zhejiang Zhejiang ( or , ; , also romanized as Chekiang) is an eastern, coastal province of the People's Republic of China. Its capital and largest city is Hangzhou, and other notable cities include Ningbo and Wenzhou. Zhejiang is bordered by Ji ...
medical expert sent to Wuhan, told media that the glaucoma patient whom Li saw on 8 January was a storekeeper at
Huanan Seafood Market The Wuhan Huanan Seafood Wholesale Market (), simply known as the Huanan Seafood Market (''Huanan'' means 'South China'), was a live animal and seafood market in Jianghan District, Wuhan City, the capital of Hubei Province in Central China. ...
with a high
viral load Viral load, also known as viral burden, is a numerical expression of the quantity of virus in a given volume of fluid, including biological and environmental specimens. It is not to be confused with viral titre or viral titer, which depends on the ...
, which could have exacerbated Li's infection. On 12 January, Li was admitted to intensive care at Houhu Hospital District, Wuhan Central Hospital, where he was quarantined and treated. He tested positive for the virus on 30 January and formally diagnosed with the virus infection on 1 February. While hospitalized, Li posted a message online vowing to return to the front lines after his recovery.


Death

On 6 February, while Li was on the phone with a friend, he told the friend that his
oxygen saturation Oxygen saturation (symbol SO2) is a relative measure of the concentration of oxygen that is dissolved or carried in a given medium as a proportion of the maximal concentration that can be dissolved in that medium at the given temperature. It ca ...
had dropped to 85%.
Extracorporeal membrane oxygenation Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequa ...
(ECMO) was reportedly used to keep him alive. According to ''China Newsweek'', his heartbeat stopped at 21:30. In social media posts, the Chinese state media reported that Li had died, but the posts were soon deleted. Later, Wuhan Central Hospital released a statement contradicting reports of his death: "In the process of fighting the coronavirus, the eye doctor from our hospital Li Wenliang was unfortunately infected. He is now in critical condition and we are doing our best to rescue him." The hospital formally announced that Li had died at 2:58 a.m. on 7 February 2020. During the confusion, more than 17 million people were watching the live stream for updates on his status.


Aftermath

By early June 2020, five other doctors had died from COVID-19 in the Wuhan hospital, now called "whistleblower hospital". Hu Weifeng, a
urologist Urology (from Greek οὖρον ''ouron'' "urine" and '' -logia'' "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary-tract system and the reproductive org ...
and a coworker of Li, was the sixth doctor of the hospital to die from the virus on 2 June 2020, after four months of hospitalization. The hashtag #WeWantFreedomOfSpeech () gained over 2 million views and over 5,500 posts within 5 hours before it was removed by censors, as were other related hashtags and posts. Wuhan citizens placed flowers and blew whistles at Wuhan Central Hospital, where Li worked and died, as a tribute to him. On the Internet, people spontaneously launched the activity themed "I blew a whistle for Wuhan tonight," where everyone kept all the lights off in their homes for five minutes, and later blew whistles and waved glitter outside of their windows for five minutes to mourn Li. Many people left messages in response to Li's last post on Sina Weibo, some lamenting his death and expressing anger at the authorities. He was also proclaimed an "ordinary hero." The
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level o ...
posted on Twitter saying that it was "deeply saddened by the passing of Dr Li Wenliang" and "we all need to celebrate work that he did on #2019nCoV." Although there was no official apology from the city of Wuhan for reprimanding Li, the Wuhan municipal government and the Health Commission of Hubei made statements of tribute to Li and condolences to his family. Beyond Wuhan, the National Health Commission did likewise. China's highest anti-corruption body, the
National Supervisory Commission National Supervisory Commission of the People's Republic of China is the highest anti-corruption agency of the People's Republic of China, at the same administrative ranking as Supreme People's Court and Supreme People's Procuratorate. Its oper ...
, has initiated a "comprehensive investigation" into the issues involving Li. Qin Qianhong, a law professor at
Wuhan University Wuhan University (WHU; ) is a public research university in Wuhan, Hubei. The university is sponsored by the Ministry of Education. Wuhan university was founded as one of the four elite universities in the early republican period of China and ...
expressed his concern that, unless properly managed, public anger over Li's death could explode in a similar way as the death of
Hu Yaobang Hu Yaobang (; 20 November 1915 – 15 April 1989) was a high-ranking official of the People's Republic of China. He held the top office of the Chinese Communist Party (CCP) from 1981 to 1987, first as Chairman from 1981 to 1982, then as Gen ...
. A group of Chinese academics, led by Tang Yiming – head of the school of Chinese classics at
Central China Normal University Central China Normal University (CCNU) or Huazhong Normal University (), located in Luonan Subdistrict, Hongshan District in Wuhan, the capital of Hubei Province, is a comprehensive university directly under the administration of the Chinese Mini ...
in Wuhan – published an open letter urging the government to both protect free speech and apologize for Li's death. The letter emphasized the right to free speech, ostensibly guaranteed by the
Chinese constitution The Constitution of the People's Republic of China is the supreme law of the People's Republic of China. It was adopted by the 5th National People's Congress on December 4, 1982, with further revisions about every five years. It is the fou ...
. Tang said that the viral outbreak was a man-made disaster, and that China ought to learn from Li Wenliang. Tang also wrote he felt that senior intellectuals and academics must speak up for the Chinese people and for their own consciences. "We all should reflect on ourselves," he wrote, "and the officials should rue their mistakes even more." The letter alleges that Li Wenliang "is also a victim of speech suppression." Jie Qiao, Academician of the Chinese Academy of Engineering and President of Peking University Third Hospital in Beijing called Li a "whistle-blower dedicating his young life in the front line." On 7 February 2020, Taiwanese author Yan Zeya () expressed doubt on the ''
Liberty Times The ''Liberty Times'' is a national newspaper published in Taiwan. Founded by Lin Rong-San, it is published by the Liberty Times Group, which also publishes '' Taipei Times'', an English language newspaper . The newspaper was first published on ...
'' about whether Li should be called a whistleblower, citing his lack of general objection to the government and lack of willingness to expose its dark side. On 9 February 2020, hundreds of people in New York commemorated Li in a tribute at
Central Park Central Park is an urban park in New York City located between the Upper West and Upper East Sides of Manhattan. It is the fifth-largest park in the city, covering . It is the most visited urban park in the United States, with an estimated ...
. The U.S. Senate honored Li by passing a resolution calling for transparency and cooperation from the Government of the People's Republic of China and the Communist Party of China.


Recognition by the Chinese government

In April, Li was officially honored by the Chinese government as a "martyr," which is the highest honor the government can bestow on a citizen who dies serving China. According to the state-run
Xinhua News Agency Xinhua News Agency (English pronunciation: )J. C. Wells: Longman Pronunciation Dictionary, 3rd ed., for both British and American English, or New China News Agency, is the official state news agency of the People's Republic of China. Xinhua ...
, he was honored together with 13 other "martyrs," mostly physicians, who died from COVID-19. Chinese Internet users have left more than 870,000 comments under Li's last post on social website Sina Weibo since his death. On 3 March, ''
International Journal of Infectious Diseases The International Society for Infectious Diseases (ISID), established in 1986, is a nonprofit organization that monitors infectious diseases on a global scale. It also offers grants and fellowships, publishes a journal, and runs online learning pl ...
'' published an article, wrote "Dr Li Wenliang's example as an astute clinician should inspire all of us to be vigilant, bold and courageous in reporting unusual clinical presentations." Italian author Francesca Cavallo wrote a children's book titled ''Dr. Li and the crown-wearing virus'', featuring Li's story, to help educate children on COVID-19. ''
Fortune Fortune may refer to: General * Fortuna or Fortune, the Roman goddess of luck * Luck * Wealth * Fortune, a prediction made in fortune-telling * Fortune, in a fortune cookie Arts and entertainment Film and television * ''The Fortune'' (1931 film) ...
'' magazine ranked Li as No.1 of the "World's 25 Greatest Leaders: Heroes of the pandemic." On 4 May, Matt Pottinger, deputy national security adviser of US, hailed Li during a speech in Mandarin.


Personal life

When Li began showing symptoms of COVID-19, he booked a hotel room to avoid the possibility of infecting his family, before being hospitalized on 12 January. Despite this precaution, his parents became infected with
SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19 (coronavirus disease 2019), the respiratory illness responsible for the ongoing COVID-19 pandemic. The virus previously had a ...
, but later recovered. Li and his wife, Fu Xuejie (), had one son, and were expecting their second child at the time of his death. In June 2020, his widow gave birth to a second son.Anger in China as doctor who died of Covid-19 omitted from citizen awards
. ''The Guardian'', 9 September 2020


References


External links

* {{DEFAULTSORT:Li, Wenliang 1986 births 2020 deaths Deaths from the COVID-19 pandemic in China Chinese ophthalmologists Chinese whistleblowers Manchu people People from Jinzhou Physicians from Liaoning Wuhan University School of Medicine alumni