KERRY GOULSTON, THANH NGUYEN AND OLIVER FRANKEL. Vietnam’s success in containing Covid-19Apr 22, 2020
Relative to most other countries, including Australia, Vietnam seems to be faring extremely well in the shadow of the current coronavirus pandemic, and has recently earned praise from the WHO. Vietnam had only 275 confirmed cases of Covid-19, and thankfully no deaths from the virus, as at 17 April 2020.
While no-one should be under any misapprehension that the Covid-19 pandemic remains a huge threat to public health globally, and even countries which have had initial success in containing the virus have suffered second waves, Vietnam’s public health record has to date been remarkable, and the contributors to that success are worth noting.
Why Vietnam’s Covid-19 record is so impressive
Vietnam’s population, at just over 97 million, is roughly 3.8 times that of Australia, yet as at 17 April, Vietnam’s confirmed cases of Covid-19 represented only 4% those of Australia. With a population of just over half that of Vietnam, South Korea, which has been held up as a beacon of good practice in this pandemic, had 10,635 confirmed cases at that date, and 230 Covid-19 related deaths.
Still considering itself a relatively poor country, Vietnam’s GDP per capita stands at just under US$3,000 (ranked 150th in the world), compared to Australia’s roughly US$58,000 (ranked 15th).
Healthcare resources in Vietnam are thin on the ground, partly due to the country’s low GDP per capita, with only 20 ambulances in Hanoi, a city of some 8.1 million residents and an estimated further 2 million visitors, where hospitals are greatly overcrowded, with often 2 patients to a bed and patients’ relatives sometimes camping out in the hospital grounds (particularly if they live far away) and having to conduct much of the non-medical care and feeding for their hospitalised loved ones. This notwithstanding, the general standard of hospital medical care is very good.
The country shares a very long (over 1,400 km) border with China, the original epicentre of the coronavirus pandemic, and there is a very long history of wars between these two countries (most recently a short conflict in 1979) – much longer than the French and American wars against Vietnam.
How Vietnam has managed to keep the spread of Covid-19 so low
It is of course hard to know at this early stage what has contributed most to Vietnam’s success in containing the coronavirus, but the following have all been factors and are listed here in no particular order:
Early government response, including widespread testing:
Vietnam responded to Covid-19 early and proactively. Having experienced the deadly SARS epidemic in early 2003, which originated in China in late 2002, and sharing a long border with China, the Vietnamese government was determined not to underestimate the Covid-19 pandemic. In mid-January, soon after cases in China started being reported, a National Steering Committee for Covid-19 Prevention and Control was established under the auspices of Vietnam’s Deputy Prime Minister (Vu Duc Dam), and it immediately implemented a national response plan. This included closure of schools, religious sites, entertainment places and public transport. Widespread testing was introduced early, far more so than most other Southeast Asian nations.
Simple but effective wartime rhetoric and community solidarity:
Prime Minister Nguyen Xuan Phuc enlisted wartime rhetoric by describing Vietnam’s efforts to contain the virus as the “spring general offensive of 2020” – a reference to the crucial 1968 “Tet Offensive” carried out by the Viet Cong during the Vietnam War. The PM has urged local officials to keep the spirit of “fighting the pandemic like enemies” to protect people’s lives and health. The attitude of key health authorities, including for example Hanoi’s critically important ambulance service, has been to prepare for the worst and hope for the best. Community solidarity has been vital.
Despite its low number of confirmed cases, Vietnam entered nationwide lockdown on 1 April – as a preventative measure rather a response to an already out-of-control situation. The nationwide lockdown expired on 15 April, but in certain parts of the country still considered to have high risks in terms of the pandemic, including the major cities of Hanoi, Danang and Ho Chi Minh City (Saigon), the lockdown has been extended until 22 or 30 April. In areas still locked down, people are allowed to leave home only for food, medicine and other essential items, and when outside home are required to wear masks, maintain at least 2 metres social distance from one another and not gather more than 2 together in public places.
Mass quarantining and self-isolation:
Mass quarantining began on 16 March. Since then, tens of thousands of people entering the country have been put into compulsory quarantine, in vast military-style camps. Anyone confirmed to have the virus or with possible symptoms, and all of their contacts, have been compulsorily isolated or required to self-isolate. Communities, streets or buildings where cases had been confirmed were also quarantined. On or around 31 March, the Vietnamese government said on its website it was proceeding “with the principle every household, village, commune, district and province went into self-isolation”.
After 30 positive cases were identified on 28 March at Hanoi’s Bach Mai Hospital, one of Vietnam’s largest hospitals, not only was mass quarantine immediately instituted but a nation-wide campaign was carried out to trace more than 40.000 visitors to the hospital between March 10 and 27.
Isolation from other countries:
By 25 March, international flights into Vietnam ceased altogether.
Early closure of schools:
All Vietnamese schools have been closed since January 16, even though no cases had been reported at that time.
The use of mobile technology:
Technology has played a key role in the monitoring of suspected and confirmed infected patients in Vietnam. A mobile app, NCOVI, allows people to proactively declare their health status on a daily basis. Another mobile app, SmartCity, allows Hanoi people to track infected, quarantined, and recovered cases.
Widespread and routine wearing of masks:
In Vietnam’s biggest cities, including Hanoi, a high proportion of residents traditionally and routinely wear a face mask, to protect against pollution. Since the advent of Covid-19, everyone now wears a face mask. On 10 March, a Vietnamese man was handed a 9-month prison sentence for aggressively refusing to wear a mask. Official signs in Ho Chi Minh City warn that those not wearing a face mask who are found to have infected another person could face up to 12 years in prison.
Possible benefits of a young population:
Although we have not seen this point mentioned as a contributor to Vietnam’s success in fighting Covid-19, we note that the country has a relatively young population, with a median age of only 30.5 years, compared to Australia’s 38.7, the USA’s 38.1, Spain’s 42.7 and Italy’s 45.5. We mention this because coronavirus appears to have affected older age groups much more severely than the young.
On 8 April, Vietnam’s Planning and Investment Ministry estimated that 3.5 million workers had lost their jobs and 19% of businesses had suspended or reduced their activities due to the pandemic.
Kerry Goulston, Vice-Chairman of the Hoc Mai Foundation (Australia-Vietnam Medical Foundation), was Associate Dean, Northern Clinical School of Sydney University, from 1993 to 2001.
Thanh Nguyen is Director of Hanoi Emergency Center 115, which is responsible for ambulance and pre-hospital services for the entire Hanoi region, comprising 10 million people.
Oliver Frankel is a former corporate finance and M&A lawyer, who also worked in finance, investment and management. Some years ago, he joined a group of Australian doctors and nurses teaching medical english to Vietnamese doctors in Hanoi, under the auspices of the Hocmai Foundation.