Benjamin So was mid-way through a 36-hour shift at a Hong Kong hospital when an elderly couple from Wuhan, China was wheeled into the isolation ward at 3 a.m. After the nurse took their vitals and nasal samples to test for the novel coronavirus, he got to work.
Inside the negative pressure chamber, So, a resident in internal medicine, asked the male patient about his symptoms, listened to his chest and reviewed an x-ray scan of his lungs. Then, he did the same with the female.
Around nine hours later, both tests came back positive. The 72-year-old man and 73-year-old woman became the ninth and tenth confirmed coronavirus cases in Hong Kong.
“I was a little shaken when I found out,” So told TIME.
After he came off shift, he went and quarantined himself. He would rather have done so at the hospital, and many doctors have been calling for on-site accommodation to enable this, but with none available So has holed up in a local hotel.
He may seem overcautious to some (including his hospital, which expected him to report to work as normal the following day). After all, he was wearing full protective gear during his interactions with the patients and nobody outside of mainland China has died from the virus, also known as 2019-nCov.
But the 2003 SARS outbreak killed 360 hospital workers around the world and medical staff accounted for about a fifth of the 299 SARS-related deaths in Hong Kong. So and his colleagues are not in the mood to take any chances.
Read more: A Timeline of How the Wuhan Coronavirus Has Spread—And How the World Has Reacted
There are hundreds of medical workers on the front lines of the fight against the coronavirus in Hong Kong, a semi-autonomous southern enclave separated by a border from mainland China, where the virus has killed at least 210 people and infected more than 9,600. It has also spread to at least a dozen countries, but Hong Kong’s 12 confirmed cases are the second highest outside of mainland China and the local situation threatens to worsen. As many as 95 suspected cases have been reported every day for the past week and more are expected as Hongkongers begin returning home after spending the Lunar New Year up north.
The Hong Kong government says the territory is well equipped to deal with an epidemic and that 1,400 isolation beds can be made available when necessary—a number many medical workers say is exaggerated. But to keep the virus out politicians from across the spectrum, and many hospital staff, have called for the border with mainland China to be fully closed (the government has shut some entry points but kept others open). In recent days, medical workers have threatened to strike until the government responds.
Many are also under intense pressure from their families to resign. “We talk about how ridiculous everything is,” So says, “about whether our life insurance will be valid if we die due to negligence on the part of the hospital.”
Cracks in the system
Joe, a resident specialist in his 30s at another medical facility, has so far only dealt with suspected coronavirus cases. (He asked to go by a pseudonym to protect his identity.) But he’s volunteered to join the so-called “dirty team,” assigned to working with confirmed cases, should they come through to his hospital, next month.
“I don’t have kids,” Joe says. “But my colleagues, a good friend of mine, has two kids. Another colleague who is also going to join the dirty team next week, his wife is going to deliver soon.”
At a recent meeting, Joe’s boss told him: “We must not let the things that happened 17 years ago [during the SARS outbreak] happen again. No matter what, we must protect ourselves and our colleagues.”
In many ways, the coronavirus epidemic has exposed cracks in an under-resourced healthcare system. By one estimate, Hong Kong needs thousands more doctors to bring its health services up to international standards. During flu season, bed occupancy rate at public hospitals can exceed 120%, according to a report by the city’s Hospital Authority. Patients wait on average more than three years for specialist care. The rapidly ageing population further compounds the problem—the medical needs of the elderly are at least 5.5 times that of the rest of the population.
Joe says that the influx of suspected coronavirus cases means that “Non-emergency operations must be canceled. Patients who need the support of high-flow oxygen masks can’t receive it, because that can only be done in isolation wards, which are full. We don’t have the capacity. We can’t deal with this tsunami.”
Read more: How Long Will the Coronavirus Outbreak Last? Experts Are Scrambling to Find Out
At another hospital, a doctor who asked to be identified as S., agreed that resources were an issue.
“We don’t have enough isolation wards,” he says. “What happens is that we have to put about two or three suspected cases in one isolated cubicle. The problem is that one of them could come back testing positive.”
Experts estimate that the outbreak could reach its peak around April or May. As the figures continues to rise, being at the front lines of the outbreak has forced S. to ponder life’s toughest questions. “Whenever I get called to see a patient [suspected to have the virus], I start thinking about life. Should I be here? Should I be writing a will? Last night, I even left a message for my ex. I told her no matter what, I’ll always look after her, that my feelings for her have never changed.”
He adds: “We’ve been trained to deal with other people’s deaths, but we haven’t really been trained to face our own.”
