Report in September 2021

Nyuyen Van Nha

Nguyen Van Tin

Duong Tieu Mai

We would like to report about the situation of Covid-19 in Vietnam (in general) and in Ho Chi Minh city (Vietnam's largest city) (in particular).

The COVID-19 pandemic in Vietnam is part of the ongoing worldwide pandemic of coronavirus disease 2019 (COVID-19). As of 12 September 2021, Vietnam has officially reported 613,375 confirmed cases, 374,578 recoveries, and 15,279 deaths. Ho Chi Minh City is the most-affected locale with 298,549 confirmed cases and 11,992 deaths.

In the 15 months since the epidemic began in January 2020, the country had only registered less than 3,000 cases and 35 deaths. However, by July and August of 2021, the daily number of new cases had risen to approximately 10,000, with thousands of deaths. It could be due to the severe outbreak of the Delta variant, coupled with low vaccination rates, and the stress on the healthcare system (overburdened and unable to handle a huge number of COVID-19 patients).

CONTROL MEASURES

Many cities and provinces continued to strengthen public health and social measures across levels, implementing PM’s Directives No.15, No.16 and 16 plus including stay-at-home order. Ho Chi Minh city continued the PM’s Directive No.16 restrictions with a ”do not move” or “stay-where-you are” orders in place until 15 September - the military and police forces are supporting logistics and food deliveries across the city; mass testing operation is being conducted using a risk-based approach taking the advantage of this social distancing period for early detection of the cases – the ultimate goal is to narrow down very high-risk and high-risk zones and expand lower-risk zone in the City, and gradually control the outbreak situation.

The Ministry of Health in Vietnam introduces the concept of tracking transmission of infected person. The infected person are designated F0, F1 and F3. It stated that: “When a test revealed positive, the patients (named F0) were immediately isolated in health facilities. They must also complete a questionnaire, giving the name of all the people they had recently been in close contact with. People in close contact with the confirmed case, named F1, must undertake testing and government-run quarantine. Those who had close contact with F1 (F2) must be isolated in dedicated accommodation facilities. F3 were individuals in close contact with F2 must self-isolate at home” (10.1016/j.tmaid.2020.101822).

To enhance the risk communication with the people, the Ministry of Health on September 1 announced its 5T message to scale up control measures during the extended social distancing period. The 5T message in Vietnamese stands for: 1) Tuân thủ 5K (compliance with 5K); 2) Test COVID-19 (COVID-19 testing); 3) Tiêm chủng (vaccination); 4) Thực phẩm đủ tại nhà (sufficient food at home); and 5) Thầy, thuốc đến tận gia (healthcare service to the door).

VACCINATION PROGRAMME

Total of 28,213,392 administered vaccination doses was reported by 11 September 2021.

COVID-19 vaccine from AstraZeneca, Gamaleya (Sputnik V), Sinopharm, Pfizer–BioNTech, Moderna and Janssen, Hayat-Vax have been approved by Vietnam Ministry of Health. As of June 2021, the government had secured 120 million doses, including vaccines obtained through the COVAX program. Vietnam currently has four COVID-19 vaccines currently under research. The health ministry has assessed the Nanocovax vaccine produced by Nanogen, which is the most promising.

Table 1. Vaccination (as of 11 September 2021)

TESTING

In Vietnam, both PCR and quick test are used for testing the Covid-19 antigen. Instead of mass testing on every person in the infected area, the authorities using different strategies including targeted testing of higher risk groups as well as random testing of households and inpatients. Testing capacity also can be increased with guidance issued on pooling of lower risk people samples, up to 10 specimens at most.

TREATMENT PLAN

The Vietnamese Ministry of Health implemented a new COVID-19 treatment regimen in July 2021 for the Delta variant. Following the new treatment, all persons with no and mild symptoms will be treated in general ward. Severe and life-threatening conditions necessitate treatment in an intensive care unit. In the new regimen, antiviral drugs proved more effective for COVID-19 patients. Specifically, Lopinavir, Ritonavir and Interferon have been used effectively in Vietnam.

In August 2021, the Ministry of Health approved the use of antiviral drug Remdesivir for COVID-19 treatment and also considering to accept Favipiravir.

From 16 August 2021, Ho Chi Minh City established a 3-levels care pathway: Level 1: Monitoring and care centers (centralized quarantine area and district hospitals) for asymptomatic and mild patients with a stable underlying condition. Level 2: for mild and moderate symptomatic patients. Level 3: for severe and critical cases.

To leave the hospital, patients need to have two consecutive negative samples of COVID- 19 (both pharyngeal and pharyngeal fluid), taken at least 24 hours/test. After leaving the hospital, the patient must continue to isolate at home for another 14 days.

FINANCIAL RELIEF

To supported businesses and people impacted by the COVID-19 outbreak and for disease prevention and control, the state has spent 168.8 trillion VND ($7.34 billion USD) of its budget. Employees who have to postpone their labour contracts, part-time workers who are unemployed but have not received unemployment benefits, enterprises that have no revenue or no financial resources to pay salaries, employers, individual business households and people with meritorious services to the nation are being supported. However, the disbursement of the support package still faces many difficulties and delays due to complicated procedures.

IMPACT OF THE DISEASE

Hundreds of thousands of people are being made unemployed. Incoming tourist are low number. Downturn of stock exchanges. Slowdown of private and national industries. The two months lockdown in Ho Chi Minh City is pushing many businesses and people to the limit when almost all economic activities come to a freeze. The income of workers decreased, especially the immigrant and low-income groups.

School closures from February to until now (September, 2021) impacted an estimated 21.2 million children nationwide. As a matter of fact, Vietnamese students did not go to school during the first semester of 2020–2021 academic year, so schools are slowly adopting online teaching. However, many students live in remote regions with limited internet coverage, or cannot afford devices required for online learning. Meanwhile, compulsory education urgently need to adjust lessons and teaching methods accordingly, especially for grade 1 because this is a turning point for young children in learning.

Fig. 3 and 4. The infected person stays in quarantine at home

Fig. 5 and 6. “Green zone” or “Safe zone” (Designation of a virus-free residential area)

Ho Chi Minh City, Binh Duong and Dong Nai are all hot spots of covid pandemic. Everyone here is fighting the epidemic, is busy struggling with their daily meals and there are children without equipment for online learning. Life almost slows down, it is time for everyone to help each other through the difficulties. What everyone wants most right now is a dose of vaccine because that is the only way to help us get out of the pandemic and look forward to a bright tomorrow.