After action review of the COVID-19 surveillance system in Quang Ninh Province, Vietnam, in 2020.

Surveillance is the backbone of any response to an infectious disease outbreak, and comprehensive evaluation of surveillance systems is crucial. However, structured evaluations of surveillance systems during the COVID-19 pandemic are scarce. We conducted a after action review (AAR) of the performance of the COVID-19 surveillance system in Quang Ninh Province, Vietnam, during 2020 using the COVID-19-specific AAR methodology developed by the World Health Organization in combination with guidance from the US Centers for Disease Control and Prevention (CDC). We conducted a stakeholder survey, document reviews, and key informant interviews with staff from Quang Ninh CDC's COVID-19 surveillance system. The COVID-19 surveillance system was based on the pre-existing surveillance system in the province. The system's strengths were early preparation for emergency response, strong governance and central coordination, and multidisciplinary collaboration. Stakeholders agreed that the system proved useful and adaptive to the fast-evolving COVID-19 situation but was weakened by overly complex systems, redundant administrative processes, unclear communication channels, and lack of resources. Overall, the surveillance systems in Quang Ninh province proved effective in containing COVID-19 and adaptive in a fast-changing epidemiological context. Several recommendations were made based on identified areas of concern that are of relevance for COVID-19 surveillance systems in Vietnam and similar settings.

Understanding the COVID-19 Infodemic: Analyzing User-Generated Online Information During a COVID-19 Outbreak in Vietnam.

OBJECTIVES: Online misinformation has reached unprecedented levels during the coronavirus disease 2019 (COVID-19) pandemic. This study analyzed the magnitude and sentiment dynamics of misinformation and unverified information about public health interventions during a COVID-19 outbreak in Da Nang, Vietnam, between July and September 2020. METHODS: We analyzed user-generated online information about five public health interventions during the Da Nang outbreak. We compared the volume, source, sentiment polarity, and engagements of online posts before, during, and after the outbreak using negative binomial and logistic regression, and assessed the content validity of the 500 most influential posts. RESULTS: Most of the 54,528 online posts included were generated during the outbreak (n = 46,035; 84.42%) and by online newspapers (n = 32,034; 58.75%). Among the 500 most influential posts, 316 (63.20%) contained genuine information, 10 (2.00%) contained misinformation, 152 (30.40%) were non-factual opinions, and 22 (4.40%) contained unverifiable information. All misinformation posts were made during the outbreak, mostly on social media, and were predominantly negative. Higher levels of engagement were observed for information that was unverifiable (incidence relative risk [IRR] = 2.83; 95% confidence interval [CI], 1.33-0.62), posted during the outbreak (before: IRR = 0.15; 95% CI, 0.07-0.35; after: IRR = 0.46; 95% CI, 0.34-0.63), and with negative sentiment (IRR = 1.84; 95% CI, 1.23-2.75). Negatively toned posts were more likely to be misinformation (odds ratio [OR] = 9.59; 95% CI, 1.20-76.70) or unverified (OR = 5.03; 95% CI, 1.66-15.24). CONCLUSIONS: Misinformation and unverified information during the outbreak showed clustering, with social media being particularly affected. This indepth assessment demonstrates the value of analyzing online "infodemics" to inform public health responses.

Using 'infodemics' to understand public awareness and perception of SARS-CoV-2: A longitudinal analysis of online information about COVID-19 incidence and mortality during a major outbreak in Vietnam, July-September 2020.

BACKGROUND: Trends in the public perception and awareness of COVID-19 over time are poorly understood. We conducted a longitudinal study to analyze characteristics and trends of online information during a major COVID-19 outbreak in Da Nang province, Vietnam in July-August 2020 to understand public awareness and perceptions during an epidemic. METHODS: We collected online information on COVID-19 incidence and mortality from online platforms in Vietnam between 1 July and 15 September, 2020, and assessed their trends over time against the epidemic curve. We explored the associations between engagement, sentiment polarity, and other characteristics of online information with different outbreak phases using Poisson regression and multinomial logistic regression analysis. We assessed the frequency of keywords over time, and conducted a semantic analysis of keywords using word segmentation. RESULTS: We found a close association between collected online information and the evolution of the COVID-19 situation in Vietnam. Online information generated higher engagements during compared to before the outbreak. There was a close relationship between sentiment polarity and posts' topics: the emotional tendencies about COVID-19 mortality were significantly more negative, and more neutral or positive about COVID-19 incidence. Online newspaper reported significantly more information in negative or positive sentiment than online forums or social media. Most topics of public concern followed closely the progression of the COVID-19 situation during the outbreak: development of the global pandemic and vaccination; the unfolding outbreak in Vietnam; and the subsiding of the outbreak after two months. CONCLUSION: This study shows how online information can reflect a public health threat in real time, and provides important insights about public awareness and perception during different outbreak phases. Our findings can help public health decision makers in Vietnam and other low and middle income countries with high internet penetration rates to design more effective communication strategies during critical phases of an epidemic.

Virological characteristics of cases of COVID-19 in northern Viet Nam, January-May 2020.

Background: Viet Nam confirmed its first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on 23 January 2020 among travellers from Wuhan, China, and experienced several clusters of community transmission until September. Viet Nam implemented an aggressive testing, isolation, contact tracing and quarantine strategy in response to all laboratory-confirmed cases. We report the results of SARS-CoV-2 testing during the first half of 2020 in northern Viet Nam. Methods: Between January and May 2020, 15 650 upper respiratory tract specimens were collected from 14 470 suspected cases and contacts in northern Viet Nam. All were tested for SARS-CoV-2 by real-time RT-PCR. Individuals with positive specimens were tested every three days until two tests were negative. Positive specimens from 81 individuals were cultured. Results: Among 14 470 tested individuals, 158 (1.1%) cases of SARS-CoV-2 infection were confirmed; 89 were imported and 69 were associated with community transmission. Most patients (122, 77%) had negative results after two tests, while 11 and 4 still tested positive when sampled a third and fourth time, respectively. SARS-CoV-2 was isolated from 29 of 81 specimens (36%) with a cycle threshold (Ct) value < 30. Seven patients who tested positive again after testing negative had Ct values > 30 and negative cultures. Conclusion: Early, widespread testing for SARS-CoV-2 in northern Viet Nam identified very few cases, which, when combined with other aggressive strategies, may have dramatically contained the epidemic. We observed rapid viral clearance and very few positive results after clearance. Large-scale molecular diagnostic testing is a critical part of early detection and containment of COVID-19 in Viet Nam and will remain necessary until vaccination is widely implemented.