Professor Nhan has written an article giving his assessment on the third wave of coronavirus in Vietnam. Nhan Dan Online introduces the full-text of the article as follows.
On January 27, the third wave of COVID-19 infections in Vietnam began, when two cases of community infection were found in the two northern neighbouring provinces of Hai Duong and Quang Ninh. On January 28, there were 91 more cases of community infection, and a day later, 61 more were found. Subsequently, local infections spread to 11 other provinces and cities and on February 17, the total number of COVID-19 infections being treated in hospitals was 710. After February 17, the number of infected cases began to decrease gradually, although it saw some fluctuation. Because the level of infection in Vietnam is very low globally speaking and from its experience in responding to the second wave of infections in Vietnam (from July 27 to September 23, 2020), when the number of patients treated in hospitals reached its peak, the infection trend will gradually decrease and this wave of the coronavirus will end in about 60 days. However, in order to predict the development of the third infection wave in Vietnam, it is necessary to analyse the evolution of COVID-19 in the provinces and cities with the largest number of community infection in Hai Duong, Quang Ninh, Ho Chi Minh City and Hanoi.
1. COVID-19 evolution in Hai Duong
The development of the COVID-19 infections in Hai Duong, relative to the number of infected cases being treated in hospitals, reflects two trends. One is infection in the community. As infections increase, the number of patients going to hospitals will increase as well as the number of people being treated, and vice versa. Second is the effectiveness of the treatment of infected cases in hospitals. If the treatment is highly effective, the number of patients discharged will be high, thus reducing the number of remaining individuals undergoing treatment. The risk of infection to the community will decrease and vice versa.
With a population of 1.9 million, Hai Duong’s safety threshold is 19 COVID-19 patients being treated in hospitals (equivalent to 10 infected per 1 million people). On the first day of the new outbreak, only five in Hai Duong were being treated, but by the second day, 77 more were being treated in hospitals, 8.5 times higher than the epidemic safety threshold. That means the level of community infection in Hai Duong on January 28 was far too high.
By February 18, the total number of infected cases being treated was 497, equal to 26 times the safe level and meaning the epidemic had peaked. After that, the number of patients tended to decrease. In the coming days, there may be new cases of infections in the community in Hai Duong. However, if Hai Duong drastically implements measures that help decrease the number of patients on a downward trend as at its current level, combined with adjustments until the number of patients being treated are at a lower level than the safety threshold (19 patients), it can be predicted that the COVID-19 outbreak in Hai Duong will end at the end of March.
Within 23 days, from January 27 to February 18 (the epidemic peak), the average increase of patients treated was 21.4 a day. In Da Nang, the epicentre of Vietnam’s second wave of COVID-19 infection last year, the average rate of increase was 14.6 per day. However, from these two figures, it is nonsense to conclude that the outbreak in Hai Duong is spreading more rapidly, 1.5 times faster (21.4 compared to 14.6) than Da Nang. The population of Hai Duong and Da Nang are different, so it is impossible to compare the average rate of increase in the number of COVID-19 patients being treated in the two localities.
To compare the rate of COVID-19 infection in two countries or two localities, it is necessary to refer to the infection rate per 1 million people. If taking the number of infections being treated in the US with a population of 331 million on December 27, 2020 at 7.68 million, compared with the figure in Belgium with a population of 11.5 million at 575,408, it is incorrect to say that the US has a higher rate of COVID-19 infection than Belgium. Per 1 million people, the US has 23,208 COVID-19 patients currently being treated, and the figure for Belgium is 49,778. That is, the intensity of the epidemic in Belgium is twice as high as that of the US.
Hai Duong’s population is 1.9 million, and per 1 million people, the average increase in the number of COVID-19 patients receiving treatment, from the start of the third wave to the time the epidemic reached its peaks, was 11.26 per day per 1 million people (21.4 infections per day from a total of 1.9 million people), that is, out of 1 million people in Hai Duong, on average there was 11.26 additional infections each day. Da Nang’s population is 1.14 million, so the average increase in the of COVID-19 patients receiving treatment was 12.8/day/1 million people (14.6/day/1.14 million) during the second wave, higher than Hai Duong (11.26/day/1 million people) in this third wave. If one does not include the number of recovered cases during the outbreak, the average infection per 1 million people per day in Hai Duong was 13.4 new cases, while in Da Nang it was 14.8 new cases a day. That means the rate of epidemic spread in Da Nang was higher than in Hai Duong.
2. Evolution of COVID-19 in Quang Ninh
On January 27, Quang Ninh had only one new case of community infection, but a day later, 12 more were confirmed, higher than the safety threshold of 11. That is, after only two days since the new outbreak began in the community, Quang Ninh was already considered an epidemic hotspot. On February 11, the epidemic reached its peak with 59 infected people being treated, 5.17 times higher than the safety level (compared to Hai Duong, the epidemic prevalence rate was much lower, because the number of people being treated in Hai Duong at the time of the new pandemic wave’s peak was at 497 people, 26 times more than the safety threshold). After February 11, the number of patients being treated in Quang Ninh tended to decrease gradually. If Quang Ninh continues to maintain its prevention measures, with adjustments as needed, until the number of patients being treated is lower than the epidemic safety threshold (11 patients receiving treatment), the outbreak in Quang Ninh should end in early March.
3. Infection evolution in Ho Chi Minh City
With a population of more than 9 million, Ho Chi Minh City’s pandemic safety threshold is 90 COVID-19 patients being treated in hospitals. According to statistics, this number increased sharply after February 7, when infections were discovered among the cargo handling staff at Tan Son Nhat Airport. However, the number of patients being treated never exceeded 50 and the outbreak peaked on February 13 with 48 patients being treated. That means, Ho Chi Minh City had no serious outbreak announced. The rate of patients receiving treatment per 1 million people when the outbreak reached its peak was 5.33, equal to 2% of Hai Duong’s level at the peak (261 patients per 1 million people). 12 days have passed (since February 11) and Ho Chi Minh City has not recorded any new cases of community infection. It is forecast that in the last week of February there will be more recovered patients discharged and by the end of February, the number of patients being treated will be at the same level as prior to February 7 (no more than 15).
4. Evolution of COVID-19 infection in Hanoi
Because of its position near Hai Duong, two days after the first infections detected in Hai Duong (January 27), Hanoi also recorded its first community infections and new cases increased gradually, peaking on February 15 with 36 patients undergoing treatment. Hanoi’s epidemic safety threshold is 80 COVID-19 patients, so there was no widespread transmission in the capital city. The percentage of patients being treated per 1 million people in Hanoi at this time is 4.5, lower than in Ho Chi Minh City (5.33) and equal to 1.7% of Hai Duong when the outbreak reached its peak (261 per 1 million people). It is forecast that in early March, the number of infections being treated in Hanoi will decrease to the level prior to January 29 (no more than 10 patients).
5. General assessment
Firstly, the third wave of COVID-19 infections in Vietnam originated from two localities with community infections, Hai Duong and Quang Ninh, discovered on January 27, then spread to 11 other provinces and cities. As of February 23, 811 cases of infection had been detected, of which 627 were in Hai Duong (accounting for 77.3% of the total), 61 in Quang Ninh (7.5%), 36 in Ho Chi Minh City (4.4%), 35 in Hanoi (4.3%), 27 in Gia Lai (3.3%), six in Binh Duong, five cases in Bac Ninh, Hai Phong with four, Dien Bien three, Hoa Binh with two, Bac Giang with two, Hung Yen with two and Ha Giang two. The two localities with the highest rates of infection per 1 million people were Hai Duong with 330 infections per 1 million people and Quang Ninh with 53.5 per 1 million people. They are also considered the two localities with widespread COVID-19. The rest, though recording infections at different rates were practically not seeing widespread transmission, as infections were always below epidemic safety levels in each respective locality (10 patients treated per 1 million people).
Hai Duong and Quang Ninh accounted for 84.8% of the total number of community infections as of February 23. Eight provinces and cities with the number of people infected at six or below have a total of 25 cases, equalling 3.08% of the whole country’s total infections. The remaining 50 provinces and cities have had no community infection, accounting for 79% of the total number of provinces and cities nationwide. Vietnam is experiencing its third wave of COVID-19 infections, but there is no large-scale epidemic prevalence, only the two provinces of Hai Duong and Quang Ninh have seen widespread outbreaks.
Secondly, with the efforts and determination of 13 provinces and cities, the active support of the health sector across the country, the clear and concise direction of the Government, and collective experience against outbreaks in the previous two waves, the third wave is likely to be terminated by the end of March, that is, after about 60 days (January 27 – March 27), like the two waves before (first wave: 58 days, second wave: 59 days).
It is expected that in Ho Chi Minh City, by the end of February, the situation will return to normal, and in Hanoi and Quang Ninh in early March, while Hai Duong should do so by the end of March. Exports, business operations, transport and entertainment activities can resume in a new normal state in accordance with the above forecasted timelines.
Thirdly, the risk of a new wave of COVID-19 infections still exists, if Vietnam does not promptly and strictly control entry into the country, including both official and illegal cases, to eliminate and minimise the risk of entries bringing infections into the community.