ABSTRACT
BackgroundVietnam has emerged as one of the worlds leading success stories in responding to COVID-19. After prolonged zero-low transmission, a summer outbreak of unknown source at Da Nang caused the countrys first COVID-19 deaths, but was quickly suppressed. Vietnam recently reopened its borders to international travelers. Understanding the attendant risks and how to minimize them is crucial as Vietnam moves into this new phase. MethodsWe create an agent-based model of COVID-19 in Vietnam, using regional testing data and a detailed linelist of the 1,014 COVID-19 cases, including 35 deaths, identified across Vietnam. We investigate the Da Nang outbreak, and quantify the risk of another outbreak under different assumptions about behavioral/policy responses and ongoing testing. ResultsThe Da Nang outbreak, although rapidly contained once detected, nevertheless caused significant community transmission before it was detected; higher symptomatic testing could have mitigated this. If testing levels do not increase, the adoption of past policies in response to newly-detected cases may reduce the size of potential outbreaks but will not prevent them. Compared to a baseline symptomatic testing rate of 10%, we estimate half as many infections under a 20% testing rate, and a quarter as many with 40-50% testing rates, over the four months following border reopenings. ConclusionsVietnams success in controlling COVID-19 is largely attributable to its rapid response to detected outbreaks, but the speed of response could be improved even further with higher levels of symptomatic testing.
ABSTRACT
@#Introduction: Hospitals are a key source of information for the early identification of emerging disease outbreaks and acute public health events for risk assessment, decision-making and public health response. The objective of this study was to identify potential facilitators and barriers for event reporting from the curative sector to the preventive medicine sector in Viet Nam. Methods: In 2016, we conducted 18 semi-structured, in-depth interviews, as well as nine focus group discussions, with representatives from the curative and preventive medicine sectors in four provinces. We transcribed the interviews and focus group discussions and used thematic analysis to identify the factors that appeared to affect public health event reporting. Results: We identified five major themes. First, the lack of a legal framework to guide reporting meant hospital staff relied on internal procedures that varied from hospital to hospital, which sometimes delayed reporting. Second, participants stated the importance of an enabling environment, such as leadership support and having focal points for reporting, to facilitate reporting. Third, participants described the potential benefits of reporting, such as support provided during outbreaks and information received about local outbreaks. Fourth, some challenges prohibited timely reporting such as not perceiving reporting to be the task of the curative sector and hesitancy to report without laboratory confirmation. Finally, limited resources and specialist capacities in remote areas hindered timely detection and reporting of unusual events. Discussion: This study identified potential opportunities to promote the detection and reporting of unusual events from health-care workers to the public health sector, and thus to improve the overall health security system in Viet Nam.The influenza virus is a respiratory pathogen that is transmitted through respiratory droplets.1 During seasonal influenza epidemics, high attack rates cause a significant public health burden.2 The infection is usually self-limited in young adults but can lead to severe infections in people in high-risk groups, including elderly people (> 65 years old), pregnant women, children aged 6–59 months and adults with chronic illnesses.3
ABSTRACT
@#This article describes Viet Nam Ministry of Health’s (VMoH) activities to prepare for and respond to the threat Zika virus (ZIKV), including the adaptation of existing surveillance systems to encompass ZIKV surveillance.
