How Vietnam successfully contained the COVID-19 pandemic?

Vietnam Offers Roadmap for Other Developing Countries to contain coronavirus 

When the health care systems of most powerful countries in the world have failed to curb the spread of COVID-19, the South Asian country of Vietnam performed an outstanding work against the pandemic cutting swath through the globe. 

 Although Vietnam reported its first case of COVID-19 on January 23, 2020, it reported only a little more than 300 cases and zero deaths over the following four months. This early success has been attributed to several key factors, including a well-developed public health system, a strong central government, and a proactive containment strategy based on comprehensive testing, tracing, and quarantining. Lessons from Vietnam’s successful early detection and containment strategy are worth examining in detail so other countries may apply them to their own responses.

 Vietnam has taken a targeted approach to testing, scaled up testing in areas with community transmission, and conducted three degrees of contact tracing for each positive case.

 As a result of its detection process, hundreds of thousands of people, including international travelers and those who had close contact with people who tested positive, were placed in quarantine centers run by the government, which greatly reduced transmission at both the household and community levels. Hot spots with demonstrated community transmission were locked down immediately, and the government communicated frequently with citizens to keep them informed and involved in the public health response.

One of the reasons Vietnam was able to act so quickly is that the country experienced SARS in 2003 and human cases of avian influenza between 2004 and 2010. Therefore, Vietnam had both the experience and infrastructure to take appropriate action. As the COVID-19 pandemic continues to unfold and Vietnam relaxes many of its restrictions, monitoring how the case levels change, and studying the reasons for those changes, will be particularly important.

Vietnam has invested heavily in its health care system, with public health expenditures per capita increasing an average rate of 9.0 percent per year between 2000 and 2016. These investments have paid off with rapidly improving health indicators. Between 1990 and 2015, life expectancy rose from 71 years to 75 years, the infant mortality rate fell from 36.9 deaths per 1,000 live births in 1990 to 16.5 deaths in 2018, and the maternal mortality ratio plummeted from 139 deaths per 100,000 live births to 54 deaths. The 2018 immunization rate for measles in children ages 12 to 23 months is over 97 percent.

Vietnam has a history of successfully managing pandemics: it was the first country recognized by the World Health Organization (WHO) to be SARS-free in 2003, and many interventions Vietnam pioneered during the SARS epidemic are being used to respond to COVID-19. Similarly, its experience with epidemic preparedness and response measures may have led to greater willingness among people in the country to comply with a central public health response. In fact, a survey conducted in late March by a public opinion research firm found that 62 percent of people in Vietnam believed the level of government response was the “right amount,” ranking higher than any of the other 45 countries surveyed.

In the wake of the SARS epidemic, Vietnam increased investments in its public health infrastructure, including developing a national public health emergency operations center and a national public health surveillance system.

Vietnam established its national emergency operations center in 2013 and four regional centers in 2016. The centers are staffed by skilled personnel, including alumni of the Field Epidemiology Training Program, a program run by MOH’s Department of Preventive Medicine and supported by US CDC and WHO. The program comprises of three curricula that “trains disease detectives in the field.” In May 2019, there are 23 alumni in Vietnam. This network of emergency operations centers runs exercises and trainings to prepare key stakeholders in government for outbreaks, and it has managed preparedness and response efforts related to measles, Ebola, MERS, and Zika.

Vietnam has long maintained robust systems to collect and aggregate data from public health entities, and it shifted to a nearly real-time, web-based system in 2009. Since 2016, hospitals are required to report notifiable diseases within 24 hours to a central database, ensuring that the Ministry of Health can track epidemiological developments across the country in real time. In collaboration with the US CDC, Vietnam piloted an “event-based” surveillance program in 2016 and scaled it up nationally in 2018 based on positive results. Event-based surveillance empowers members of the public, including teachers, pharmacists, religious leaders, community leaders, and even traditional medicine healers, to report public health events.

 The goal is to identify clusters of people who have similar symptoms that might suggest an outbreak is emerging. As another sign of Vietnam’s focus on epidemic preparedness and response, it was one of the first countries to join the Global Health Security Agenda, a group of 67 countries committed to strengthening global efforts in prevention, detection, and response to infectious disease threats, in 2014.

On May 1, a hundred days into the outbreak, Vietnam had confirmed just 270 cases despite extensive testing, with no community transmission since April 15. To date, no patients have died from COVID-19 in Vietnam. While there is more to learn about the disease and deaths, some experts speculate that Vietnam’s extremely low obesity rate, combined with its young population (the median age in Vietnam is 30.5, only 6.9 percent of the population is over 65, and the median COVID-19 patient age is 29), have contributed to better COVID-19 outcomes. Furthermore, the majority of cases (67 percent as of May 25) in Vietnam were imported from COVID-19 affected countries: first China and then Europe and the United States.

The father of the Vietnamese nation, Ho Chi Minh, once noted that: “The storm is a good opportunity for the pine and the cypress to show their strength and their stability.” Vietnam has so far shown strength and stability in weathering the COVID-19 storm, and offers a successful example of how a developing country can fight a pandemic.

Era Dabla-Norris, Anne-Marie Gulde-Wolf, and Francois Painchaud, IMF Asia and Pacific Department wrote a blog for IMF and explained how Vietnam successfully contain the coronavirus despite having limited resources. The IMF experts has said that developing countries can learn from Vietnam to fight against COVID-19 pandemic.    

"Public buy-in was critical for success. From an early stage, communications about the virus and the strategy were transparent. Details on symptoms, protective measures, and testing sites were communicated through mass media, a government website, public grass-root organizations, posters at hospitals, offices, residential buildings and markets, via text messages on mobile phones, and as voice messages before a phone call could be made.

 The government also launched a contact tracing app in big cities. This well-coordinated multi-media approach strengthened public trust and helped society adhere to protective and containment measures.

While a higher-cost, mass-testing strategy was adopted in most advanced economies to combat the pandemic, Vietnam focused on high-risk and suspected cases and conducted only 350,000 tests, a relatively small share of its population. However, around 1,000 people per confirmed case were tested, the highest ratio in the world.

In parallel, Vietnam used extensive contact tracing, isolation and quarantining, up to third-tier contacts. Groups of people who lived near confirmed cases, sometimes an entire street or village, were swiftly tested and isolated, which helped limit community transmission. Nearly 450,000 people have been quarantined (either at hospitals or state-run facilities or self-isolation). Treatment and quarantine in hospitals were provided free of charge for Vietnamese."

Early containment and use of existing public and military facilities proved to be cost effective. The government estimated the budgetary cost of fighting the pandemic at about 0.2 percent of GDP, with about 60 percent spent on equipment, and the rest on containment activities.

Vietnam successfully limited the spread of COVID-19 so far, but it will not be immune to its economic impact. Weaker domestic and external demand is expected to slow growth significantly from 7 percent in recent years to 2.7 percent in 2020.While its economy has suffered a significant blow due to weakened demand and reduced trade, the effective containment strategy should allow for a quicker rebound.

However, the economic impact is expected to be milder than most countries in the region. Prospects for a recovery look bright as lockdown measures have been lifted, businesses resume operations, and consumers flock to restaurants and shops. There are tentative signs of a domestic recovery, with retail sales and industrial production rebounding from low points seen during the lockdown.

 But sustained and robust growth will also require an economic recovery among Vietnam’s trading partners.

Despite economic losses, the country of around $262 billion gross domestic product (GDP) has determined "to maintain economic stability and a low inflation rate to help businesses, investors, and the people."

"The government has implemented many measures to support the economy, remove difficulties for production and business, such as restructuring bank loans, freezing debt, and reducing or exempting loan interest payments."

The country is implementing assistance packages to support workers, including 62 trillion dong ($2.7 billion) in aid for 20 million workers.

The government is developing new services, especially using information technology for the development of digital government and economy.

                                                                          Khalid Bhatti