The First Wave of the COVID-19 Outbreak in Vietnam

The first coronavirus infection case in Vietnam was a male traveler from Wuhan arriving in Ha Noi and then visiting Nha Trang. ^{Reference Phan, Nguyen and Luong2} This patient reportedly passed the coronavirus onto his son, who was touring Nha Trang with him. From January 23 to February 13, 14 more cases were recorded: 6 Vietnamese citizens returning from Wuhan, 6 persons having close contact with the 6 returnees, 1 transiting through Wuhan, and 1 having close contact with the first case. Until March 5, no new infections were documented in the country. Since a returnee from Europe who was identified as the 17th COVID-19 patient in Vietnam on March 6, the daily new cases have emerged, with the highest number hitting 20 on March 29. Notably, 2 coronavirus hotspots (a public hospital in Hanoi and a nightclub in Ho Chi Minh city) have been identified, accounting for 25% of the confirmed cases reported in this period. ^{Reference Nguyen and Vu3,Reference Chau, Hong and Ngoc4} The number of confirmed cases linked to these hotspots totaled 63, with 44 identified in the hospital. Among the hospital-acquired infections, 27 are nonclinical hospital staff working at the cafeteria in the hospital. One of the major factors contributing to the widespread of COVID-19 has recently been identified is the nonclinical hospital staff’s meal preparation and hot water and food delivery to units of the hospital. Multiple efforts to stop the spread of hospital-associated infections, including lockdown and disinfection of the hospital, quick COVID-19 testing of those closely contacting the patients, as well as suspension of new patient admission, have been taken. In regard to the bar infection cluster, the immediate response was to order closures of bars, restaurants, gyms, hair and nail salons as of March 24. In addition, public gatherings of over 10 people were banned.

The Second Wave of the COVID-19 Outbreak

While some SEA nations were struggling to contain the spread of SAR-CoV-2, Vietnam had seen no community transmission case since April 16. ^{Reference Nguyen5} After implementing 22 days of social distancing starting on April 1, the government of Vietnam lifted social distancing measures, allowing the country to resume its socio-economic activities. ^{Reference Nguyen5} For 99 days, Vietnam seemed to have won the battle against the COVID-19 as no new locally acquired cases were recorded. From July 24-27, 2020, an outbreak began in the coastal tourist city of Danang. As a precaution, the city authorities announced 15 d of social distancing starting on July 28, 2020. Furthermore, several streets in the city were placed under lockdown. As of September 12, 2020, the country confirmed 1063 positive cases of COVID-19 with 35 deaths. ^{Reference Nong, Le Thi Nguyen and Doan6}

Response to the Epidemic

On February 15, Vietnam with 16 active cases of COVID-19 was 1 of the 4 countries having the most coronavirus infections in the SEA region. In response to this unprecedented situation, the country swiftly took actions with a variety of precautionary preventive and control measures, including suspending school activities, tightening border controls, expanding entry restrictions, isolating infected and potentially infected people, and tracing and quarantining their close contacts to stem the disease spread. ^{Reference Trevisan, Le and Le7} The Vietnamese government’s written communications issued as Directive 15 and 16 control measures. Those directives were made publicly available through all multimedia platforms. In addition, face masks and frequent handwashing with soap have been strongly encouraged. The government held several public awareness campaigns about personal preventive measures, including mask policies and 5K message (5K means using face masks in public settings, keeping 6-feet distance, disinfecting regularly, no public gathering, and making health declarations). As an innovative approach, in late February 2020, the National Institute of Occupational Safety and Health released a song named “Ghen Co Vy” (translated as jealous coronavirus) that conveys a message of an appropriate handwashing against COVID-19. This song was later remixed and inspired a viral popular dance challenge on TikTok. ^{Reference Amul, Ang and Kraybill8}

Vietnam also imposed border restriction with China and ordered cancellation of all Wuhan-related tours and flights. During the period from February 15 to March 5, no daily new cases were recorded as a result of these implementations. As of March 23, it was shown that overseas-acquired infections accounted for 74% of the confirmed cases. ^{Reference Nguyen and Vu9} Thereby, the Vietnam government has learned that the coronavirus outbreak starting March 6 in the country is mainly ascribable to the COVID-19 infected repatriates and foreign visitors arriving in the country. While the number of total positive cases represents an overview of the COVID-19 situation in a nation, the daily new cases reflect how the nation has responded to challenges from the outbreak. To combat the accelerating outbreak, Vietnam has rapidly implemented mandatory wearing of face masks in public places, suspension of all religious gatherings, ban on public gatherings of over 2 people, closures of restaurants, bars, gyms, hair and nail salons, nationwide stay-at-home order and social distancing starting April 1, as well as suspended entry to all foreign nationals. ^{Reference Vo, Nguyen and Nguyen10}

Statistical Description

Age distribution of the COVID-19 cases is shown in Figure 1A. Among the positive cases reported as of January 11, 2021, the majority of patients (28%) fall in 21-30 age group years while children aged < 10 y only make up 3%. The rate of infection for the elderly (aged 61 and older) is 13% of the Vietnam’s cases. Figure 1B presents half of the infected patients are between the age of 21 and 40 y.

Figure 1.

(A) Percentage of COVID-19 cases by age groups in Vietnam (from January 23, 2020, to January 11, 2021) and (B) age distributions of infection cases and deaths.

In general, the average age is 38.7 y (median, 36 y; range, 0.3-100 y; interquartile range [IQR], 26-51 y). Among the COVID-19 deaths, the average age was 63.2 y (median, 65 y; range, 28-93 y; IQR, 55-71.5). The results indicate that the COVID-19 mortality rate was higher in the elderly in Vietnam.

Comparison With Other Countries in the Region

As seen in Figure 2, Indonesia and Malaysia are the hardest hit nations by the pandemic, with the increase in total number of infection cases showing no signs of stopping. Vietnam is the country with the number of daily new cases plummeting these days. While the SEA region’s highest number of deaths per 1 million population are reported by Indonesia (89) and the Philippines (85), the figure for Vietnam reaches 0.4. Moreover, while total cases per 1 million population for Singapore, Indonesia, Malaysia, and the Philippines range from 3,042 to 10,031, those for Thailand and Vietnam remain low, 151 and 15, respectively.

Figure 2.

The daily new cases of COVID-19 in the select SEA countries (from March 1, 2020, to January 11, 2021).