This is a guest post by Todd Pollack (i), Guy Thwaites (ii), Maia Rabaa (ii), Marc Choisy (ii), Rogier van Doorn (ii), Le Van chảy (ii), Duong Huy Luong (iiia), Dang quang quẻ Tan (iiib), Tran dai Quang (iiib), Phung Cong Dinh (iv), gàn Duy Nghia (v), Tran Anh Tu (v), La Ngoc quang đãng (vi), Nguyen Cong Khanh (v), Dang Duc Anh (v), Tran Nhu Duong (v), sang trọng Minh Le (vii), thai Pham quang đãng (v), Vu Duong (viii), & Exemplars in Global Health (see institutional affiliations1).
Notice: This article was published earlier in the COVID-19 pandemic, based on the latest published data at that time.You can find the most up-to-date data for all countries in our Coronavirus Data Explorer.
A previous version of this article covered the COVID-19 pandemic in Vietnam from January khổng lồ June 2020.
As of December 31, 2020, Vietnam had reported 1,465 laboratory confirmed cases of COVID-19 và 35 deaths.2 This success has been attributed khổng lồ several key factors, including a well-developed public health system, a decisive central government, and a proactive containment strategy based on comprehensive testing, tracing, and quarantining.
Detect:Vietnam has taken a targeted approach to testing, scaling it up in areas with community transmission. Contact tracing is comprehensive, with three degrees of contacts traced for each positive case.
Contain:As a result of its detection process, hundreds of thousands of people, including international travelers and those who had close liên hệ with people who tested positive, were placed in quarantine centers run by the government, greatly reducing both household và community transmission. Hot spots with demonstrated community transmission, including da Nang during its outbreak in July and August 2020, were locked down immediately, và the government communicated frequently with citizens lớn keep them informed & involved in the public health response.
One of the reasons Vietnam was able to lớn act so quickly and keep the case count so low is that the country experienced a severe acute respiratory syndrome (SARS) epidemic in 2003 and human cases of avian influenza between 2004 & 2010. As a result, Vietnam had both the experience và infrastructure lớn take appropriate action. Vietnam makes many key containment decisions in a matter of days, which may take weeks for governments in other countries to make. Although Vietnam is a highly centralized country, a number of key decisions were made at the local level, which also contributed khổng lồ the swift response.
Vietnam’s Deputy Prime Minister Vũ Đức Đam joined Exemplars and our partners to mô tả perspective on Vietnam’s success against COVID-19.
Since the 1980s, Vietnam, a country of nearly 100 million people, has undergone a significant economic transformation. The adoption of economic reforms known as the Doi Moi policies in the mid-1980s turned a centrally planned economy into a socialist-oriented market economy, setting Vietnam on a path lớn its current middle-income status.
Vietnam has invested heavily in its health care system, with public health expenditures per capita increasing an average rate of 9 percent per year between 2000 and 2016.3 These investments have paid off with rapidly improving health indicators. For example, infant mortality và maternal mortality decreased by more than half between 1990 & 2018.4
Vietnam has a history of successfully managing pandemics: it was the second country after đài loan trung quốc to face SARS and, after 63 cases và five deaths, it was the first country declared SARS-free by the World Health Organization (WHO).5 Many interventions pioneered by Vietnam during the SARS epidemic are being used to respond khổng lồ COVID-19. Similarly, its experience with epidemic preparedness and response measures may have led to greater willingness among people in the country lớn comply with a central public health response.
In the wake of the SARS epidemic, Vietnam increased investments in its public health infrastructure, developing a national public health emergency operations center và a national public health surveillance system.6 The national center & four regional centers run exercises & trainings khổng lồ prepare key stakeholders in government for outbreaks, và they have managed preparedness and response efforts for measles, Ebola, Middle East respiratory syndrome (MERS), and Zika. Throughout the COVID-19 pandemic, the government has continued to lớn incorporate new lessons & regularly conducts intra-action & after-action reviews.7
Vietnam has long maintained robust systems to lớn collect & aggregate public data, và in 2009 it shifted to a nearly real-time, web-based system. Since 2016, hospitals are required khổng lồ report notifiable diseases within 24 hours khổng lồ a central database, ensuring that the Ministry of Health can track epidemiological developments across the country.8In collaboration with the US Centers for Disease Control và Prevention (CDC), Vietnam implemented an innovative “event-based” surveillance program in 2018. Event-based surveillance empowers members of the public, including teachers, pharmacists, religious leaders, and even traditional medicine healers, lớn report public health events. The goal is lớn identify clusters of people who have similar symptoms that might suggest an outbreak is emerging.9
Vietnam’s first case of COVID-19 was reported on January 23, 2020. A week later, Vietnam formed a national steering committee that initially met every two days to coordinate the country’s “whole of government” strategy.10In Vinh Phuc, a northern province about an hour’s drive from Hanoi, provincial leaders locked down Son Loi commune, isolated patients & their close contacts in quarantine camps for at least 14 days, và activated community-wide screening at the first evidence of community spread.11
A second wave of cases, imported from new hot spots in Europe và the United States, was discovered on March 6. Within a day after the first case of the second wave was detected, the government had tracked & isolated about 200 close contacts of those infected.12
As of May 1, a hundred days into the outbreak, Vietnam had confirmed just 270 cases, despite extensive testing, and with no community transmission since April 15.13Vietnam began loosening restrictions in May, including resuming domestic travel across the country.
On July 25, Vietnam marked 99 days without any community transmission, until an outbreak occurred in the đô thị of da Nang, a đô thị with a population of more than 1 million that receives about 8 million tourists annually. Da Nang was especially crowded in July because people were eager to lớn travel after a tense spring, & the government promoted domestic tourism as a way lớn compensate for the economic losses from international tourism. What started as nosocomial transmission quickly spilled over into the community, và during the last week of July new incident cases increased by about 30 percent, the fastest growth rate since the beginning of the epidemic.14
Between July 25 & September 8, 551 locally transmittedcases were reported from 15 cities và provinces across the country, with domain authority Nang and nearby Quang phái nam Province most affected. Approximately 98 percent of cases were either related to lớn major hospitals in da Nang or had a history of visiting domain authority Nang. (From July 1 to July 27, it was estimated that more than 1.5 million people returned from da Nang khổng lồ other provinces of Vietnam, of which 41,000 had visited da Nang Hospital.) A temporary hospital for treatment of suspected and mild cases was built, và two other hospitals were designated for COVID-19 treatment & put under the direction of a special committee from the Ministry of Health.15
To bring the outbreak under control, Vietnam turned to the same strategies that had been successful in ending earlier outbreaks: targeted lockdowns, travel bans, business closures, mass quarantines, và widespread testing. As of September 10, 61,968 people were being monitored, 998 were quarantined in health care facilities, 15,619 were quarantined in centralized facilities, & 45,351 were self-quarantined at home.16
Since containing the da Nang outbreak, Vietnam has continued reopening plans, although the country borders have remained closed except for specific circumstances, và the 14-day centralized quarantine policy continues to apply to lớn most incoming Vietnamese & international travelers.
In late January 2020, the Ministry of Science & Technology met with virologists to lớn encourage the development of diagnostic tests. Starting in early February, publicly funded institutions in Vietnam developed at least four locally made COVID-19 tests that were validated by the Ministry of Defense and the National Institute of Hygiene & Epidemiology. Subsequently, private companies including Viet A and Thai Duong offered capacity khổng lồ manufacture the test kits. Most confirmation laboratories where these tests are analyzed use in-house versions of WHO protocol, allowing tests khổng lồ be widely administered without long wait times.
Development timelines of diagnostic thử nghiệm kits:February 7, 2020: test kit developed by Hanoi University of Science and Technology. Testing method: RT-LAMP (reverse transcription loop-mediated isothermal amplification). Cost: US$15. Testing time: 70 minutes.March 3, 2020: kiểm tra kit developed by Vietnam Academy of Science and Technology. Testing method: real-time RT-PCR (reverse transcription polymerase chain reaction). Cost: less than US$21. Testing time: 80 minutes from receiving a sample.
Testing capacity also ramped up quickly, from just two testing sites nationwide in late January to lớn 120 by May. As of October 22, 137 laboratories were capable of testing by RT-PCR, with a maximum daily capacity of 51,000 tests.20 Of these laboratories, 62 are designated as screening laboratories and 75 as confirmatory laboratories.Plans are underway khổng lồ further expand laboratory testing to lớn include use of GeneXpert machines within the lung hospital system.21
Given its low case numbers, the country decided on a strategy of using testing lớn identify clusters và prevent wider transmission. When community transmission was detected (even just one case), the government reacted quickly with liên hệ tracing, commune-level lockdowns, and widespread local testing lớn ensure no cases were missed. However, the number of tests administered increased during the domain authority Nang outbreak. Between July 23 và September 24, more than 700,000 tests were conducted, và those who had visited high-risk areas in domain authority Nang (as identified by the Ministry of Health) were required to fill out a health declaration khung via mobile app và notify local health authorities for sample collection and testing.22 From September 3 to lớn September 10, a third of all households in da Nang—72,492 households—were tested, along with 13,776 students và staff taking part in graduation exams. All were negative.23
One noteworthy aspect of Vietnam’s approach is that it identified và quarantined suspected cases based on their epidemiological risk of infection (if they had liên hệ with a confirmed case or traveled khổng lồ a COVID-19 affected country), not whether they exhibited symptoms. The high proportion of cases that never develop symptoms (43 percent) suggests that this approach may have been a key contributor lớn limiting community transmission at an early stage.25
For SARS, a strategy of identifying and isolating symptomatic people was effective because the vi khuẩn was infectious only after symptoms started. With SARS-CoV-2, however, such a strategy would be inadequate, since infectiousness can occur before the onset or in the absence of symptoms.
From January 23 lớn May 1, 2020, over 200,000 people spent time in a quarantine facility,26 but the numbers increased dramatically after the da Nang outbreak. To enable contract tracing of the more than 1.5 million people linked khổng lồ the domain authority Nang outbreak, the government mobilized resources lớn localities with poor health systems.27 Ho đưa ra Minh thành phố conducted contact tracing of everyone from da Nang and stratified them into groups. People with respiratory symptoms or those exposed to the three epicenter hospitals in da Nang were placed in a centralized quarantine facility và tested; others were isolated at trang chủ and monitored by local commune health staff.
As of December 31, 2020, a total of 10,242,896 people had been placed under quarantine: 211,983 in health care facilities, 4,296,302 in centralized quarantine facilities, and 5,734,611 at home.29
On March 10, the Ministry of Health worked with telecom companies to launch NCOVI, an ứng dụng that helps citizens create a “neighborhood watch system” that complements official contact tracing efforts và may have helped to slow transmission of the disease, although the app has drawn criticism from some privacy advocates. NCOVI includes a bản đồ of detected cases & clusters of infections và allows users to lớn declare their own health status, report suspected cases, and watch real-time movement of people placed under quarantine.31 In mid-April, Vietnamese cybersecurity firm Bkav launched Bluezone, a Bluetooth-enabled mobile app that notifies users if they have been within approximately 6 feet (2 meters) of a confirmed case within 14 days. When users are notified of exposure, they are encouraged to liên hệ public health officials immediately.32 The Ministry of Information & Communications aimed to reach 60 percent of the population with the app và worked with network operators khổng lồ promote it. By August 20, the application had exceeded trăng tròn million downloads.33
Preventing transmission khổng lồ health care workers, và from health care workers khổng lồ the community, is another important containment strategy. During the SARS outbreak in 2003–2004, dozens of Vietnamese health care workers were infected; apart from the index patient, everyone in Vietnam who died from SARS was a doctor or a nurse.34 Over the past ten years, however, Vietnam has significantly improved hospital infection control by investing in organizational systems, building physical facilities, buying equipment and supplies, and training health workers.
In preparation for the COVID-19 pandemic, Vietnam further strengthened hospital procedures to prevent infection in health care settings. On February 19, 2020, the Ministry of Health issued national Guidelines for Infection Prevention & Control for COVID-19 Acute Respiratory Disease in Healthcare Establishments. This document provides comprehensive guidance lớn hospitals on screening, admission & isolation of confirmed or suspected COVID-19 cases, establishment of isolation areas in hospitals, use of personal protective equipment (PPE), cleaning và disinfection of environmental surfaces, waste management, collection, preservation, packing & transport of patient samples, prevention of laboratory-acquired infection of COVID-19, handling of remains of confirmed or suspected COVID-19 cases, và guidance for COVID-19 prevention for family members và visitors.
Regardless, da Nang General Hospital was the epicenter of the da Nang outbreak, with at least 251 cases reported among patients, caregivers, và staff. In August, the hospital was locked down.35
Vietnam implemented mass quarantines in suspected hot spots based on evolving epidemiological evidence over time (see Table 1).Vietnam entered a nationwide lockdown on April 1. Initially, the lockdown was phối for 15 days, but it was extended to lớn 21 days in 28 out of 63 provinces. During the da Nang outbreak in August, 10 provinces were locked down.
|Son Loi Commune (Vinh Phuc Province)||February 13 –March 4||10,000 people||At the time, there were 16 cases of COVID-19 in the country, with 6 in Son Loi.36|
|Truc Bac Street (Hanoi)||March 6–20||190 people||Patient 17 (the first confirmed case of the second wave) lived on this street; 66 households were on lockdown.37|
|Phan Thiet Streets (Binh Thuan)||March 13–April 3||150 people||On two streets (Hoang Van Thu & Ngo Sy Lien) where the patient 38 lived, 29 households were on lockdown.38|
|Van Lam 3 Village (Phuoc phái mạnh Commune, Thuan nam giới District, Ninh Thuan Province)||March 17–April 14||5,000 people||Two COVID-19 infections, patient 61 và patient 67, led to total lockdown in this area, in which movement restrictions were put in place for all residents, and all 16 entrances khổng lồ the village were closed off và monitored.39|
|Thua Loi Village (Ben Tre Province)||March 23–April 20||1,600 people||Isolation measures enacted on 480 households after a resident, 17-year-old patient 123, was infected with the virus.40|
|Bach Mai Hospital (Hanoi)||March 28–April 11||4,000—5,000 people||Locked down after 45 people connected to lớn the hospital tested positive for COVID-19. Over 15,000 people who had been associated with the hospital were tested for the virus, và 40,000 people who had come in tương tác with the hospital sometime before the lockdown were tracked down.41|
|Ha Loi Village (Me Linh District, Hanoi Province)||April 7–May 6||10,000 people||Sealed off during lockdown, with the last detected community cases (apart from Ha Giang patient 268).|
|Dong Van District (Ha Giang Province)||April 22–23||7,600 people||The lockdown was put in place before obtaining the kiểm tra results for suspected cases, & was released the day after when the tests were found negative, exemplifying how quickly the authorities reacted.|
Even before the first cases in the country were confirmed, Vietnam took early steps to lớn implement closures, require masks, and limit mobility for citizens & international travelers. Most other countries waited to make these types of decisions until numbers were much higher.
Inbound passengers from Wuhan, China, received additional screening before Vietnam’s first case was reported. Visas for Chinese tourists were no longer issued as of January 30, 2020, just a week after the first case was confirmed. At the kết thúc of the ten-day Lunar New Year holiday on January 31—and with only five confirmed in-country cases—the government mandated that all schools nationwide remain closed. Masks were recommended in early February, before WHO or most countries did so, & were made mandatory nationwide in mid-March.
Flights to and from trung quốc were suspended on February 1 and trains were canceled shortly thereafter, on February 5. These restrictions were implemented when cases were in the single digits. Flights from the Schengen Area—26 countries in Europe—and the United Kingdom were suspended on March 15 (after the second wave of cases, traced to people who had been traveling in Europe), and all visa issuance was discontinued on March 18.
In early February, Vietnam began its practice of placing international arrivals from COVID-19 affected countries in large government-run quarantine centers for 14 days. Vietnam began using the centers for Vietnamese arrivals from china on February 4 & expanded the practice to Vietnamese arrivals from South Korea on March 1. Beginning on March 20–22, all international arrivals were placed in the quarantine centers. International flights were also diverted away from airports still used for domestic travel. For most of the past year, all international incoming commercial flights have been stopped & only people with special permission are allowed khổng lồ enter the country from abroad; all travelers must quarantine for 14 days.
While leaders in many countries downplayed the threat of COVID-19, the Vietnamese government communicated in clear, strong terms about the dangers of the illness even before the first case was reported. On January 9, the Ministry of Health first warned citizens of the threat; since then, the government has communicated frequently with the public, adding a short prevention statement to lớn every phone hotline placed in the country, texting people directly, and taking advantage of Vietnam’s high use of social media—there are 64 million active Facebook users in Vietnam & 80 percent of smartphone users in Vietnam have the local social media app, Zalo, installed.43
In late February, the National Institute of Occupational Safety and Health released “Ghen teo Vy,” meaning “jealous coronavirus,” a well-known pop tuy vậy given new lyrics & turned into a handwashing public service announcement.44 The institute asked Khac Hung to rewrite the lyrics & dancer quang đãng Dang to lớn choreograph dance moves; the release ultimately spearheaded a dance challenge on TikTok.45 The #Onhavanvui (#StayHomeIsFun)campaign on TikTok has had more than 8 billion views.46 During the domain authority Nang outbreak, Vietnamese celebrities và social media users shared “stay strong” posts khổng lồ show their support. Across the city, buildings shone with “I love da Nang” light displays.47
Throughout these communications, the government stayed on message. At first, it consistently used the motto: “Fighting the epidemic is like fighting against the enemy.”48Later, the government branded each citizen’s responsibility as “5K” (Nam Khong): (1) face mask; (2) hygiene; (3) safe distance; (4) gathering; (5) health declaration. Toward the over of 2020, with tư vấn from WHO, the Ministry of Health launched the Safe Coexistence with COVID-19 communications initiative, including a long-term online campaign, Normalize the New Normal, jointly launched by the United Nations và other international organizations in November.49
The government was on the lookout for misinformation from the very beginning. A 2018 cybersecurity law already gave the government substantial authority in this area, but on April 14, Vietnam passed a specific decree outlining fines for people who use social truyền thông to “share false, untruthful, distorted, or slanderous information.” The police have pursued more than 200 cases since then.50 This ordinance has generated opposition from Amnesty International và others. However, according to lớn data from YouGov, as of December 21, 91 percent of the Vietnamese people believe the government is responding “very” or “somewhat” well.51
The pandemic is projected to lớn cost Vietnam nearly 200,000 billion dong (US$ 9.4 billion) in revenue, according to Prime Minister Nguyen Xuan Phuc. The country’s tourism sector was among the hardest hit as borders remain closed lớn international tourists. In typical years, Vietnam welcomes 21 million international arrivals.52 The shops và hotels in themost upscalestreets of Hanoi và Ho đưa ra Minh city remain empty.53 Fruit exports fell by half between April và June 2020, with freight operators demanding two khổng lồ four times the normal prices.54
Overall, however, Vietnam is weathering the economic crisis better than many other countries. It is one of the few countries in the world currently experiencing positive GDP growth (noting that Vietnam had a high baseline GDP growth before the pandemic). The manufacturing sector was growing again by June, after five months of decline.55
Early in the pandemic, local producers were able to capitalize on exports of PPE. France, which was severely hit by the virus, importedhundreds of millions of cloth masks from Vietnam in May. The US government purchased 4.5 million made-in-Vietnam PPE suits. In August, global demand dropped as countries around the world gradually collected themselves, leading Vietnamese mask exports khổng lồ decline by a third.56
In recent months, international flights have been opened for foreign workers, such as engineers from South Korea’s LG, who are needed khổng lồ keep the economy functioning.57 Some international investors are pushing for the country lớn shorten the time for compulsory isolation for foreign workers.
Vietnam’s response khổng lồ COVID-19 has been exceptional, và although some of its success derives from the country’s unique context, many lessons from Vietnam are widely applicable, including the following:Investment in a public health infrastructure (e.g., emergency operations centers & surveillance systems) enables countries to have a head start in managing public health crises effectively. Vietnam learned lessons from SARS & avian influenza, and other countries can learn those same lessons from COVID-19.Early action, ranging from border closures và masks to testing và lockdowns, can curb community spread before it gets out of control.Thorough liên hệ tracing can help facilitate a targeted containment strategy.Quarantines based on possible exposure, rather than symptoms only, can reduce asymptomatic & presymptomatic transmission. Specifically, the mandatory testing và quarantining of international travelers appears to be an effective policy.Clear communication is crucial. A clear, consistent, and serious narrative is important throughout the crisis.A strong whole-of-society approach engages multisectoral stakeholders in decision-making processes and encourages cohesive participation in appropriate measures.
With the exception of the da Nang outbreak in August, Vietnam has managed, more or less, lớn prevent community transmission for a full year while keeping the economy mở cửa enough lớn facilitate GDP growth. Even the domain authority Nang outbreak was contained quickly, using a combination of many of the best practices the country had developed over time. No other country of Vietnam’s size has experienced this cấp độ of success.
This framework identified three countries which provide key success stories in addressing the pandemic: South Korea, Vietnam and Germany. In these related articles, in-country experts provide key insights into how these countries achieved this.