Alert for COVID-19 second wave: A lesson from Vietnam

www.jogh.org • doi: 10.7189/jogh.11.03012 1 2021 • Vol. 11 • 03012 The COVID-19 pandemic has posted an unprecedented new threat as many countries are seeing a resurgence of the disease after successfully controlling outbreaks early in the year. As China eases some stringent coronavirus-related restrictions after months with sporadic cases, its capital has raised the dangerous level as the total number of infections to 137 in one week in mid-June, the highest daily confirmed cases since March [1]. After the first COVID-19 curve flattening, Japan has entered the second wave with 12 629 people being treated in hospital as of 6 August, warning that an emergency may be declared for some cities since the nationwide month-long state of emergency ended in May [2]. Specifically, coronavirus has re-emerged in some Asia countries previously known as containment models such as Hong Kong, Australia, and so forth. In line with other countries, Vietnam is now also struggling with the second wave of the COVID-19 (Figure1).

T he COVID-19 pandemic has posted an unprecedented new threat as many countries are seeing a resurgence of the disease after successfully controlling outbreaks early in the year. As China eases some stringent coronavirus-related restrictions after months with sporadic cases, its capital has raised the dangerous level as the total number of infections to 137 in one week in mid-June, the highest daily confirmed cases since March [1]. After the first COVID-19 curve flattening, Japan has entered the second wave with 12 629 people being treated in hospital as of 6 August, warning that an emergency may be declared for some cities since the nationwide month-long state of emergency ended in May [2]. Specifically, coronavirus has re-emerged in some Asia countries previously known as containment models such as Hong Kong, Australia, and so forth. In line with other countries, Vietnam is now also struggling with the second wave of the COVID-19 (Figure1).
Vietnam's first case was reported on January 23, marking a fierce period against COVID-19 in Vietnam. A series of drastic and urgent measures, such as border closure, restrictions on domestic and international movements, school and workplace shutdown, cancellation of public events and gatherings, strict quarantine, social distancing, and effective communication strategies have been imposed to minimize the spread of virus in community and from other affected areas [3]. These decisive and rapid efforts kept the number of cases low at 268, allowing Vietnam to get into 99 consecutive days without community transmission since April 16 [4]. During the 99 days, life was gradually returning to a kind that has been missing for months. School reopened to welcome students after more than 3-absence-month since Vietnam Lunar New Year. All economic activities such as restaurants, shops, and public services were able to operate again. Notably, domestic travel activities are getting busy again in many coastal tourism localities thanks to promoted travel packages. From April 19 to May 18, 2020, the number of flights by local carriers was 8623, which increased 73.7% compared to previous month, especially in Da Nang, one of the best tourist destinations, to where 454 764 travellers visited in June [5]. All new confirmed cases in these 99 days were Vietnamese citizens who returned from abroad and quarantined upon arrival without any risk of community transmission, raising the total number of cases from 268 to 415 cases [4].
The country is bracing for the second wave of COVID-19 infection after recording a 57-year-old man with an unknown source of infection in Da Nang C hospital, ending its 99-day streak without community transmission. Vietnamese scientists have revealed that this type is the new, more contagious virus strain, which has been seen Vietnam has officially announced the second wave of COVID-19, ending its 99-day streak of zero community transmissions, although very strict measures were already in place.
in Bangladesh, Britain, and Ireland. This strongly suggests that the new case was introduced from outside Vietnam [6]. In the next few days, the clusters quickly emerged in three hospitals in Da Nang. All new COVID-19 cases related to Da Nang C hospital and they had contacts with suspected patients. Furthermore, Da Nang is a popular tourist hotspot, making thousands of travellers' possible sources of virus infection throughout the country. As predicted, during nearly one month, the total of confirmed cases doubled from 416 to 962 and widely spread to 15 cities/provinces from North to South as of August 16 [4]. Vietnam recorded its first-ever death on July 31, which rapidly increased to 21 deaths by August 15. The mortality increased steeply because almost all the deceased were inpatients with adverse underlying medical conditions who were being treated in hospitals in Da Nang. To respond to such emergencies, the government ordered Da Nang authorities to halt all charter flights to Da Nang international airport from the very first time after the case was recognized. In late July, Da Nang strictly placed seven districts in quarantine and rapidly imposed a lockdown in four hospitals including Da Nang C hospital, Da Nang Hospital, Da Nang Orthopedic and Rehabilitation Hospital, and Hoan My Hospital. Da Nang has started implementing social distancing, requesting people not go out unless for necessities such as buying food or drugs. In the capital Hanoi and other provinces, contact tracing and mass testing have been conducted extensively for people who recently returned from Da Nang to suppress the outbreak. On August 5th, one temporary field hospital has been built inside the largest sport center in Da Nang in anticipation of rising numbers of COVID-19 patients. Hundreds of doctors, nurses, and medical students have been mobilized to combat the COVID-19 in its epicenter -Da Nang.
The question raised here is where the outbreak originated while Vietnam strictly implemented border shutdown, suspended international flights, and all arrivals in mandatory 14-day quarantine facilities? The unidentified source of infection of the first case in Da Nang (in the second wave) could originate from the outside, as illegal foreigners may have entered Vietnam [2]. This was strongly confirmed when a Chinese who illegally entered Ho Chi Minh city tested positive for SARS-CoV-2 [7]. In fact, neighbouring countries of Vietnam including China, Cambodia and Laos have still tackled complicated developments of the pandemic. Mean- Illegal immigrants potentially create the loophole in controlling and preventing COVID-19 which might be a reminder for other countries.