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

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

"I go to the departments every day, I know the cases, I know there has been no death," said Thwaites, who also heads the Oxford University Clinical Research Unit in Ho Chi Minh City.

"If you had over-reported or uncontrolled community transmission, then we would be seeing cases in our hospital, people coming in with breast infections may not have been diagnosed – it never happened," he said.

So how has Vietnam apparently broken 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 prompt, early response to preventing dissemination, to strict contact tracking and quarantine and effective public communication.

Early Action

Vietnam began preparing for a coronavirus outbreak weeks before the first case was discovered.

At that time, the Chinese authorities and the World Health Organization had both maintained that there was no "clear evidence" for human-to-human transmission. But Vietnam took no chances.

"We were not just waiting for WHO guidelines. We used the data we collected from outside and in (the country to) decide early to take action," said Pham Quang Thai, deputy head of the infection control department at the National Institute of Hygiene and Epidemiology in Hanoi.

  A woman practices social distancing while shopping for groceries from a line at a wet market in Hanoi.
In early January, temperature screening was already in place for passengers arriving from Wuhan at Hanoi International Airport. Travelers found with a fever were isolated and closely monitored, the country's national broadcaster reported at the time.
In mid-January, Deputy Prime Minister Vu Duc Dam ordered public agencies to take "drastic measures" to prevent the disease from spreading to Vietnam, strengthening medical quarantine at border gates, airports and ports.
23. January, Vietnam confirmed its first two coronavirus cases – a Chinese citizen living in Vietnam and his father, who had traveled from Wuhan to visit his son. The day after, Vietnam's aviation authorities canceled all flights to and from Wuhan.
As the country celebrated the lunar New Year holiday, Prime Minister Nguyen Xuan Phuc declared war on the coronavirus. "Fighting this epidemic is like fighting the enemy," he said at an urgent Communist Party meeting on January 27. Three days later, he set up a national steering committee to control the outbreak – the same day the WHO declared coronavirus as a public health emergency of international concern.
1. In February, 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 to Chinese nationals the following day.
During the month, travel restrictions, quarantine and visa suspensions expanded as the corona virus spread across China to countries such as South Korea, Iran and Italy. Vietnam finally suspended entry to all foreigners in late March.
  A Vietnamese Army officer stands next to a sign warning of the closure of Son Loi Municipality in Vinh Phuc Province on February 20.

Vietnam was also proactively locking measures. On February 12, it locked an entire community of 10,000 people north of Hanoi for 20 days during seven coronavirus cases – the first large-scale lockdown known outside China. Schools and universities, scheduled to reopen in February after the Lunar New Year holiday, were ordered to remain closed and only reopened in May.

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

"Their actions in late January and early February were very much ahead of many other countries. And it was enormously helpful … for them to be able to keep control," he said.

Careful Contact Tracking

The crucial early actions effectively curbed the transfer of society and kept Vietnam's confirmed cases at just 16 by February 13. For three weeks there were no new infections – until the second wave hit in March, brought by Vietnamese returning from abroad.

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

"We have a very strong system: 63 provincial CDCs (Centers for Disease Control), more than 700 district-level CDCs, and more than 11,000 municipal health stations. All of them attribute contact tracking," Dr. Pham said with National Institute of Hygiene and Epidemiology.

A confirmed coronavirus patient must provide the health authorities with an exhaustive list of all the people he or she has met for the past 14 days. Messages are placed in newspapers and broadcast on television to inform the public about where and when a coronavirus patient has been, asking people to go to health authorities to test if they have also been there at the same time, Pham said. [19659009] A woman is queuing up to get a trial at a makeshift probation center near Bach Mai Hospital in Hanoi on March 31. "data-src-mini =" // cdn.cnn.com/cnnnext/dam/assets/200529180157-06-vietnam-coroanvirus-small-169.jpg "data-src-xsmall =" // cdn.cnn.com /cnnnext/dam/assets/200529180157-06-vietnam-coroanvirus-medium-plus-169.jpg "data-src-small =" http://cdn.cnn.com/cnnnext/dam/assets/200529180157-06- vietnam-coroanvirus-large-169.jpg "data-src-medium =" // cdn.cnn.com/cnnnext/dam/assets/200529180157-06-vietnam-coroanvirus-exlarge-169.jpg "data-src-large = "// cdn.cnn.com/cnnnext/dam/assets/200529180157-06-vietnam-coroanvirus-super-169.jpg" data-src-full16x9 = "// cdn.cnn.com/cnnnext/dam/assets /200529180157-06-vietnam-coroanvirus-full-169.jpg "data-src-mini1x1 =" // cdn.cnn.com/cnnnext/dam/assets/200529180157-06-vietnam-coroanvirus-small-11.jpg " data-demand-load = "not-loaded" data-eq-pts = "mini: 0, xsmall: 221, small: 308, medium: 461, large: 781" src = "data: image / gif; base64, R0lGODlhEAAJAJEAAAAAAP /////// wAAACH5BAEAAAIALAAAAAAQAAkAAAIKlI + py + 0Po5yUFQA7 "/>

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

"Using contact tracking, we located almost everyone and asked them to stay home and even quarantine, and (if) having any symptoms, they could visit the health stations for free testing," he said.

The authorities also tested more than 15,000 people connected to hospitals, including 1,000 health professionals. [19659020] Vietnam's contact tracking efforts were so close that it not only follows direct contacts from an infected person, but also indirect contacts. "It's one of the unique parts of your answer. I don't think any country has made the quarantine to that level," Thwaites said.

All direct contacts were placed in the government's quarantine in health stations, hotels or military camps. Some indirect contacts were ordered to isolate themselves at home, according to a study by Vietnam's Covid-19 control measures by about 20 public health experts in the country.
  A hairdressing salon that provides a face mask gives a haircut to a customer in Hanoi.

As of May 1, about 70,000 people had been quarantined in the Vietnamese government, while about 140,000 had undergone isolation at home or hotel, the study said.

The study also found that of the country's first 270 Covid-19 patients, 43 percent were asymptomatic cases – which it said highlighted the value of strict contact tracking and quarantine. If the authorities had not proactively sought out people at risk of infection, the virus could have spread to communities days before it was discovered.

Public Communication and Propaganda

From the beginning, the Vietnamese government has communicated clearly with the public about the outbreak.

Dedicated websites, phone hotels and phone apps were set up to update the public on the latest outbreak situations and medical advice. The Ministry of Health also sent regular reminders to the citizens via SMS messages.

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

  A propaganda poster to prevent the spread of the corona virus is seen on a wall while a man smokes a cigarette along a street in Hanoi.

The country's massive propaganda apparatus was also mobilized, raising awareness of the outbreak through speakers, 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 wash their hands and other hygiene measures during the outbreak. Known as the "wash song", it immediately went viral, attracting more than 48 million views on Youtube.

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

"The population respects a lot of infectious diseases than many perhaps more prosperous countries or countries that do not see as much contagious disease – Europe, the United Kingdom and the United States for example," he said.

"The country understands that these things need to be taken seriously and follows government guidelines on how to prevent the infection from spreading."

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