Vietnam: How this 95 million country kept the coronavirus death toll zero

Motorbike riders with face masks are stuck in traffic during the morning peak hour on May 19 in Hanoi.

For skeptics, Vietnam’s official numbers may seem too good to be true. But Guy Thwaites, an infectious disease doctor who works in one of the main hospitals designated by the Vietnamese government to treat Covid-19 patients, said the numbers correspond to reality on the ground.

“I go to the wards every day, I know the cases, I know there was no death,” said Thwaites, who also heads the clinical research unit of the University of Oxford in Ho Chi Minh City.

“If you’ve had an undeclared or uncontrolled community broadcast, then we’ll see cases in our hospital, people who come with chest infections have perhaps not been diagnosed – this never happened,” he said.

So how does Vietnam appear to have counteracted the global trend and largely escaped the scourge of coronavirus? The answer, according to public health experts, lies in a combination of factors, from the government’s rapid and early response to prevent its spread, to rigorous contact tracking, to quarantine and effective public communication.

Act early

Vietnam began preparing for a coronavirus outbreak weeks before its first case was detected.

At the time, the Chinese authorities and the World Health Organization had both argued that there was no “clear evidence” for human-to-human transmission, but Vietnam was taking no risks.

“We weren’t just waiting for WHO guidelines. We used data collected from outside and from inside (the country for) to decide to act early,” said Pham Quang Thai, deputy director of the infection control department. at the National Institute of Hygiene and Epidemiology in Hanoi.

In early January, temperature screening it was already in place for passengers arriving from Wuhan to Hanoi International Airport. The travelers found with the fever were isolated and carefully monitored, the country’s national broadcaster reported at the time.
In mid-January, Deputy Prime Minister Vu Duc Dam was ordination government agencies to take “drastic measures” to prevent the spread of the disease in Vietnam by strengthening the medical quarantine at border ports, airports and seaports.
On January 23, Vietnam confirmed its first two cases of coronavirus – a Chinese citizen who lives in Vietnam and his father, who had traveled from Wuhan to visit his son. The next day, the Vietnamese aviation authorities canceled all flights to and from Wuhan.
While the country celebrated the Lunar New Year holidays, its prime minister Nguyen Xuan Phuc declared war on the coronavirus. “Fighting this epidemic is like fighting the enemy,” he said She said in an urgent meeting of the Communist Party on January 27th. Three days later, he set up a national steering committee to control the epidemic – the same day as the WHO declared coronavirus is a public health emergency of international concern.
On February 1, Vietnam declared a national epidemic – with only six confirmed cases registered across the country. All flights between Vietnam and China were stopped, followed by the suspension of visas for Chinese citizens the following day.
During the month, travel restrictions, arrival quarantines and visa suspensions expanded in the context of the spread of the coronavirus beyond China in countries such as South Korea, Iran and Italy. Vietnam in the end suspended entry to all foreigners in late March.
An army officer of a Vietnamese people stands next to a sign warning of the blockade in the city of Son Loi in the province of Vinh Phuc on February 20.
Vietnam also quickly took proactive blockade measures. February 12 closed an entire rural community of 10,000 people north of Hanoi for 20 days for seven coronavirus cases – the first known large-scale blockade outside China. Schools and universities, which were due to reopen in February after the Lunar New Year holidays, were ordered remain closed and reopened only in May.

Thwaites, the infectious disease expert in Ho Chi Minh City, said that Vietnam’s speed of response was the main reason for its success.

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“Their actions in late January and early February have been far ahead of many other countries. And this has been of enormous help … for them to be able to maintain control,” he said.

Meticulous tracking of contacts

The first and decisive actions effectively curbed the transmission of the community and kept Vietnam’s confirmed cases at just 16 by 13 February. For three weeks, there were no new infections – until the second wave of blows in March brought about by the return of the Vietnamese from abroad.

Authorities rigorously tracked contacts of confirmed coronavirus patients and placed them in a mandatory two-week quarantine.

“We have a very strong system: 63 provincial CDCs (disease control centers), over 700 CDCs at the district level and over 11,000 common health centers. They all attribute to the search for contacts,” said Dr. Pham with the National Institute. of hygiene and epidemiology.

A confirmed coronavirus patient must provide the health authorities with an exhaustive list of all the people he has met in the past 14 days. The announcements are published in newspapers and broadcast on television to inform the public of where and when a coronavirus patient has been, asking people to turn to health authorities to test if they have also been there at the same time, Pham said.

A woman queues to provide a sample at a makeshift test center near Hanoi's Bach Mai hospital on March 31st.

When Hanoi’s Bach Mai hospital, one of Vietnam’s largest hospitals, became a coronavirus hotspot with dozens of cases in March, authorities imposed a blockade on the facility and tracked down nearly 100,000 hospital-related people, including doctors. , patients, visitors and their close contacts, according to Pham.

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“Using contact tracking, we’ve located almost everyone, and asked them to stay home and self-quarantine, (and that) if they have any symptoms, they can visit the health centers for free tests,” he said.

Even the authorities tested over 15,000 hospital-related people, including 1,000 health workers.

The effort to trace Vietnam contacts has been so meticulous that it goes beyond the direct contacts of an infected person, but also the indirect contacts. “This is one of the unique parts of their response. I don’t think any country has quarantined at that level,” said Thwaites.

All direct contacts were placed in government quarantine in health centers, hotels or military camps. Some indirect contacts have been ordered to insulate themselves at home, according to a she studies control measures for Vietnam’s Covid-19 by around 20 public health experts in the country.
A roadside barber wearing a face mask makes a haircut to a client in Hanoi.

As of May 1, approximately 70,000 people had been quarantined in Vietnam’s government facilities, while approximately 140,000 had been isolated in the home or hotel, according to the study.

The study also found that 43 percent of the first 270 Covid-19 patients in the country were asymptomatic, which highlighted the value of rigorous contact traceability and quarantine. If the authorities had not proactively searched for people with risk of infection, the virus could have spread safely to the community days before it was discovered.

Public communication and propaganda

From the outset, the Vietnamese government has clearly communicated the outbreak to the public.

Dedicated websites, telephone hotlines and telephone apps have been created to update the public on the latest outbreak situations and medical advice. The ministry of health also regularly sent reminders to citizens via SMS messages.

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Pham said on a busy day, national telephone lines alone could receive 20,000 calls, not to mention the hundreds of provincial and district telephone lines.

A propaganda poster about preventing the spread of coronavirus is seen on a wall while a man smokes a cigarette on a Hanoi street.
The country’s massive propaganda apparatus was also mobilized, growing awareness of the outbreak through loudspeakers, street posters, the press and social media. In late February, the ministry of health released a catchy music video based on a Vietnamese pop hit to teach people how to properly wash their hands and other sanitation during the epidemic. Known as the “handwashing song”, it immediately went viral, attracting more than 48 million views on Youtube.

According to Thwaites, Vietnam’s rich experience in managing infectious disease outbreaks, such as the SARS epidemic from 2002 to 2003 and subsequent bird flu, had helped the government and public opinion better prepare for the Covid-19 pandemic. .

“The population is much more respectful of infectious diseases than many perhaps richer countries or countries that do not see as many infectious diseases, for example in Europe, the United Kingdom and the United States,” he said.

“The country understands that these things must be taken seriously and respects the government’s directions on how to prevent the spread of the infection.”

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