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

“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.

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

“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.

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.

“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.

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.

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.

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.

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.”