Lessons learned from Vietnam’s COVID-19 response: the role of adaptive behavior change and testing in epidemic control

Abstract

BackgroundVietnam has emerged as one of the world’s leading success stories in responding to COVID-19. After prolonged zero-low transmission, a summer outbreak of unknown source at Da Nang caused the country’s 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.ConclusionsVietnam’s 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.

Covasim: an agent-based model of COVID-19 dynamics and interventions

“…To date, Covasim has been used by researchers and public health officials in over a dozen countries. Covasim has been used to inform policy decisions in the United States (25,27), Vietnam (28), the United Kingdom (29), and Australia (30). It has also been used for research studies in these locations (31)(32)(33)(34), and well as other countries including India, Russia, Kenya, and South Africa.…”

Integrated health service delivery during COVID-19: a scoping review of published evidence from low-income and lower-middle-income countries

“… 54 In L-LMICs specifically, historically verticalised and disease-oriented approaches have created additional fragmentation, which may have posed further challenges for COVID-19 pandemic preparedness and response. 30 54 55 We have found evidence of a range of opportunities in the L-LMICs towards introducing IHSD innovations in response to the COVID-19 pandemic. The importance of existing primary healthcare and public health infrastructure was emphasised in several studies, 37 43 and existing networks/infrastructure was identified as an enabler to integration.…”

“…While we cannot directly compare the strategic response of these two countries against COVID-19, Vietnam’s experience with containment of the SARS epidemic may have provided them valuable lessons in pandemic response. 30 Following their experience in managing SARS, Vietnam designed to mobilise an integrated and comprehensive response with the community and preventive healthcare services, acting together as one united workforce.…”

Digital cities and the spread of COVID-19: Characterizing the impact of non-pharmaceutical interventions in five cities in Spain

“…Besides, all the teachers that work in the same center are also connected. We included in this layer the infant levels (0-3 and 3-6 years old), primary school (7)(8)(9)(10)(11)(12), secondary school (13-16), high school (17)(18), and job training (from 17). We inferred these connections using data on the number of students per level, the number of units per level, and the number of schools, taking into account the levels offered by each kind of school.…”

“…The probabilities of developing symptoms, severe symptoms, a critical case, and from it the death of the individual are specified by age groups, arranged in 10-year-long age cohorts. This software has been used for studying different scenarios, for example, assessing the test-trace-quarantine strategy (17) or quantifying the risk of outbreaks after international border opening (18). We modified COVASIM to include the specific details of our synthetic cities.…”