How ‘overreaction’ made Vietnam a virus success | Sunday Observer

How ‘overreaction’ made Vietnam a virus success

17 May, 2020
Vietnam has already started opening up again after weeks of no local cases
Vietnam has already started opening up again after weeks of no local cases

HANOI, May 16. (BBC) - Despite a long border with China and a population of 97 million people, Vietnam has recorded only just over 300 cases of Covid-19 on its soil and not a single death.

Nearly a month has passed since its last community transmission and the country is already starting to open up.

Experts say that unlike other countries now seeing infections and deaths on a huge scale, Vietnam saw a small window to act early on and used it fully.

But though cost-effective, its intrusive and labour intensive approach has its drawbacks and experts say it may be too late for most other countries to learn from its success.

“When you’re dealing with these kinds of unknown novel potentially dangerous pathogens, it’s better to overreact,” says Dr Todd Pollack of Harvard’s Partnership for Health Advancement in Vietnam in Hanoi.

Recognising that its medical system would soon become overwhelmed by even mild spread of the virus, Vietnam instead chose prevention early, and on a massive scale.

By early January, before it had any confirmed cases, Vietnam’s government was initiating “drastic action” to prepare for this mysterious new pneumonia which had at that point killed two people in Wuhan.

When the first virus case was confirmed on 23 January - a man who had travelled from Wuhan to visit his son in Ho Chi Minh City - Vietnam’s emergency plan was in action.

“It very, very quickly acted in ways which seemed to be quite extreme at the time but were subsequently shown to be rather sensible,” says Prof Guy Thwaites, director of Oxford University Clinical Research Unit (OUCRU) in Ho Chi Minh City, which works with the government on its infectious disease programmes.

Vietnam enacted measures other countries would take months to move on, bringing in travel restrictions, closely monitoring and eventually closing the border with China and increasing health checks at borders and other vulnerable places.

Schools were closed for the Lunar New Year holiday at the end of January and remained closed until mid-May. A vast and labour intensive contact tracing operation got under way.

“This is a country that has dealt with a lot of outbreaks in the past,” says Prof  Thwaites, from Sars in 2003 to avian influenza in 2010 and large outbreaks of measles and dengue.

“The government and population are very, very used to dealing with infectious diseases and are respectful of them, probably far more so than wealthier countries. They know how to respond to these things.”

By mid-March, Vietnam was sending everyone who entered the country - and anyone within the country who’d had contact with a confirmed case - to quarantine centres for 14 days.

Costs were mostly covered by the government, though accommodation was not necessarily luxurious. One woman who flew home from Australia - considering Vietnam a safer place to be - told BBC News Vietnamese that on their first night they had “only one mat, no pillows, no blankets” and one fan for the hot room.

Prof Thwaites says quarantine on such a vast scale is key as evidence mounts that as many as half of all infected people are asymptomatic.

Everyone in quarantine was tested, sick or not, and he says it’s clear that 40% of Vietnam’s confirmed cases would have had no idea they had the virus had they not been tested.

“If you have that level[of asymptomatic carriers] the only thing you can do to control it is what Vietnam did,” he says.

“Unless you were locking those people up they would just be wandering around spreading the infection.”

This also helps explain the absence of any deaths.

As most of the returning Vietnamese were students, tourists or business travellers, they tended to be younger and healthier.

They had a better chance of fighting the virus themselves, and were never able to put, for example, elderly relatives at risk, which meant the medical system could focus its resources on the few critical cases.

While Vietnam never had a total national lockdown, it swooped in on emerging clusters.

In February after a handful of cases in Son Loi, north of Hanoi, more than 10,000 people living in the surrounding area were sealed off. The same would happen to 11,000 people in the Ha Loi commune near the capital, and to the staff and patients of a hospital.

No-one would be allowed in or out until two weeks had passed with no confirmed cases.