Friday - July 31, 2020

COVID Shocker

The United States is about 29 times larger than Vietnam. At 331,210 sq km, Vietnam is a little bigger than New Mexico. Yet the population of the USA is only 3 1/2 times greater; Vietnam has 97 million citizens, compared to around 330 million here.

But Vietnam, which shares a long border with China, has had only 536 cases of the ‘rona since January, and until yesterday, had only had 1 COVID related death. ONE. Now, sadly, today they have 2.

2 deaths, 536 total cases, 8 months, 97 million people. How is this possible?

Vietnam has a much younger population (median age 30.5 vs 38.4). There is almost no obesity; lowest in the world. They are nearly genetically monolithic; everyone is Vietnamese (although they recognize 54 types).  Very very few Poles, Danes, Venezuelans, Nigerians, or even Polynesians live there. Life expectancy 6 years less than ours.  Absolute one party communist rule, but I don’t know how gentle or tyrannical that leadership is.

But when COVID was just beginning, they shut the country down completely. Closed the borders, shut the airports, locked down all the towns and cities. Anyone who seemed to be sick with the virus and anyone they’d been in contact with was taken somewhere and isolated. Full quarantine. Anyone coming home to Vietnam was also quarantined for at least 2 weeks.

And it worked. Until a couple days ago, not one reported fatality. And now that number is up to two. They hadn’t had any new cases in 99 days.

Vietnam’s Health Ministry reported the country’s second Covid-19 death late on Friday.

The 61-year-old man died on Friday afternoon at a hospital in Da Nang city, where Vietnam last week detected its first domestically transmitted coronavirus infections in more than three months, the ministry said in a statement.

The country, which has recorded 546 coronavirus infections since its first cases were detected in January, reported its first coronavirus death earlier on Friday. The 70-year-old man who died had underlying health conditions, state media reported.

More than 53,000 people have been put in quarantine and although data from the country’s mass testing programme has yet not been released, the health ministry said.

[ May 15, 2020 ] Despite a long border with China and a population of 97 million people, Vietnam has recorded only just over 300 cases of Covid-19 on its soil and not a single death.

Nearly a month has passed since its last community transmission and the country is already starting to open up.

Experts say that unlike other countries now seeing infections and deaths on a huge scale, Vietnam saw a small window to act early on and used it fully.

But though cost-effective, its intrusive and labour intensive approach has its drawbacks and experts say it may be too late for most other countries to learn from its success.
‘Extreme but sensible’ measures

“When you’re dealing with these kinds of unknown novel potentially dangerous pathogens, it’s better to overreact,” says Dr Todd Pollack of Harvard’s Partnership for Health Advancement in Vietnam in Hanoi.

Recognising that its medical system would soon become overwhelmed by even mild spread of the virus, Vietnam instead chose prevention early, and on a massive scale.

By early January, before it had any confirmed cases, Vietnam’s government was initiating “drastic action” to prepare for this mysterious new pneumonia which had at that point killed two people in Wuhan.
Image copyright Getty Images

When the first virus case was confirmed on 23 January - a man who had travelled from Wuhan to visit his son in Ho Chi Minh City - Vietnam’s emergency plan was in action.

“It very, very quickly acted in ways which seemed to be quite extreme at the time but were subsequently shown to be rather sensible,” says Prof Guy Thwaites, director of Oxford University Clinical Research Unit (OUCRU) in Ho Chi Minh City, which works with the government on its infectious disease programmes.

Vietnam enacted measures other countries would take months to move on, bringing in travel restrictions, closely monitoring and eventually closing the border with China and increasing health checks at borders and other vulnerable places.

Schools were closed for the Lunar New Year holiday at the end of January and remained closed until mid-May. A vast and labour intensive contact tracing operation got under way.

“This is a country that has dealt with a lot of outbreaks in the past,” says Prof Thwaites, from Sars in 2003 to avian influenza in 2010 and large outbreaks of measles and dengue.

So the people are used to deadly epidemics, and maybe there’s some level of viral immunity? How bad were they hit with the similar SARS in 2003?

TAIPEI, TAIWAN - Vietnamese officials are rushing to control a sudden new outbreak of COVID-19 after reporting one of the world’s most successful control efforts earlier in the year.

Authorities in the Southeast Asian country sealed off the central coast tourist city Danang Sunday after two people tested positive for the deadly atypical pneumonia, domestic media reports say. The new spike in and near Danang had grown to 30 cases as of early Wednesday, mostly traced to a local hospital. 

People elsewhere in the economically booming country of 97 million worry that the Danang infections will spread outward and spark another nationwide shutdown like the one ordered for about a month through late April.

“It could be another outbreak, and it’s really sort of scared the Vietnamese, because they thought they’d gotten through it all, but as the rest of the world discovered, this thing spreads much quicker than you think,” said Adam McCarty, chief economist with Mekong Economics in Hanoi. 

While Vietnam’s latest figures still hardly match the hundreds of daily cases still being reported in much of the world, the country prides itself on throttling the disease earlier in the year with no deaths to date. Vietnam had gone without transmission for 99 days through Saturday and its domestic economy roared back to life by May.

Halts to flights and strict quarantine rules have kept the overall caseload to 446 including the latest outbreak. As of Tuesday, 369 people had recovered.

The 1.1 million-population city of Danang quit taking domestic tourists for 14 days, halted many gatherings and shuttered non-essential services such as bars and amusement parks, domestic news website VnExpress International reported.

Flights, buses, taxis, and trains to and from Da Nang are suspended too, business consultancy Dezan Shira & Associates says on its website. Thousands of tourists there now must remain. 

“We’re hoping it doesn’t spread out, because if it does, they’ll do another lockdown, and it’s going to impact business hard,” said Jack Nguyen, partner in the business advisory firm Mazars in Ho Chi Minh City. “I don’t think the country can sustain another lockdown.”

Quang Nam, a province bordering Danang, planned starting Wednesday to close bars, internet shops, cinemas and other spots to stop any disease spread there, the news website reported.

“Danang is done,” Nguyen said. “There are no tourists coming in or out.”

And now that city, if not others as well as needed, are once again on absolute lockdown. Roads closed, tourists stuck in place, fun canceled, nothing open but food and medical. Will it work again?

Interesting note: while they do report that they haven’t had a single new case in 99 days, and that this spike in Danang is 30 cases, the total number of 446 in this article with 369 recovered means 48 people (11%) are still sick with it after 100 days or more.

The other article says 546 cases, so I expect one of those numbers is a typo. 4 and 5 are neighbors on the keyboard.

And for the 99 days without transmission before last week claim to make sense, but 300 cases in mid-May, the assumption is that the case rate was flatlined by the 3rd week in April.

***
While Vietnam has some of the worst malaria on the planet, what they have at this point is largely multi-drug resistant malaria. This means the chloroquine drugs aren’t used so much. Instead they take Malarone, a two drug combo pill made from the potent anti-malarials Atovaquone and Proguanil. Proguanil can be used with chloroquine if the malaria strain isn’t strongly multi-drug resistant. But how to tell? Atovaquone may be effective against SARS COV-2; it seems to work in vitro, so further testing is warranted. Wait and see. But once again, Vietnam is one place where malaria is, and where malaria is, COVID-19 isn’t. 2 deaths and under 600 cases from 97 million people defines “isn’t” to my satisfaction.

Posted by Drew458     on 07/31/2020 at 01:55 PM   
Filed Under: • pandemic and epidemic diseases •  
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