Republic of Korea – World Bank Group Partnership on COVID-19 Prepare dness and Response Country Case Study: Vietnam by Assoc. Prof. Pham Quang Thai, MD, MPhil, PhD and Research assistant Ms. Tong Thi Thu Ha, MD National Institute of Hygiene and Epidemiology, Hanoi, Vietnam September 2023 On the cover: Fishermen working at sunrise on the beach in Binh Thuan, Vietnam. © 2023 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW Washington DC 20433 Telephone: 202-473-1000 Internet: www.worldbank.org This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy, completeness, or currency of the data included in this work and does not assume responsibility for any errors, omissions, or discrepancies in the information, or liability with respect to the use of or failure to use the information, methods, processes, or conclusions set forth. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Nothing herein shall constitute or be construed or considered to be a limitation upon or waiver of the privileges and immunities of The World Bank, all of which are specifically reserved. Rights and Permissions The material in this work is subject to copyright. Because the World Bank encourages dissemination of its knowledge, this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work is given. Any queries on rights and licenses, including subsidiary rights, should be addressed to World Bank Publications, The World Bank Group, 1818 H Street, NW, Washington, DC 20433, USA; fax: 202-522- 2625; e-mail: pubrights@worldbank.org. The case studies are products from the WBG-Korea Partnership on Pandemic Preparedness and Response (P175398). The views expressed here are those of the authors and do not necessarily reflect those of the World Bank. The case studies are available at: https://www.worldbank.org/en/ country/korea/brief/korea-wbg-partnership-on-pandemic-preparedness-and-response. Cover photo: © Jimmy Tran / Shutterstock. Further permission required for reuse. Cover design: Amy Chan Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response Country Case Study: Vietnam June 2023 Authors Assoc. Prof. Pham Quang Thai, MD, MPhil, PhD Research assistant Ms. Tong Thi Thu Ha, MD National Institute of Hygiene and Epidemiology, Hanoi, Vietnam Acknowledgements This case study was made possible by the support of Korea’s Ministry of Finance and Economy and the World Bank Group Korea office. This report was authored by a team from The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology (NIHE), including the lead author, Assoc. Prof. Pham Quang Thai and Dr. Tong Thi Thu Ha. The World Bank task team for this case study included team members from the World Bank’s Health, Nutrition and Population Global Practice, the World Bank Group Korea office, and the World Bank Group Vietnam office - Vikram Rajan, Kevin Yunil Kim, Preeti Kudesia, Katelyn Jison Yoo, Ahram Han, Akosua O. Dakwa, Christophe Lemiere, Sang Minh Le, and Nga Thi Anh Hoang. Amy Chan provided the overall design for this case study. The team is thankful for the valuable feedback received from the Vietnam National Steering Committee for COVID-19 Prevention and Control, the Ministry of Health, the Ministry of Science and Technology, and the National Institute of Hygiene and Epidemiology and Pasteur Institutes. The team also thank health care workers from Provincial Centers of Disease Control and COVID-19- assigned hospitals, as well as local authorities from provinces and cities in Vietnam, for their work in case finding, contact tracing, and disease control and prevention measures. The team is grateful for the overall guidance and support received from Jason Allford, Special Representative, World Bank Group Korea Office, and Aparnaa Somanathan, Practice Manager, World Bank Health, Nutrition and Population, East Asia and Pacific Region. TABLE OF CONTENTS Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 1.1. Epidemiology of COVID-19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 1.2 Overview of Vietnam’s Health Care System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 2. Methodology and Data Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 3. Preparedness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 3.1 Governance for disease surveillance and preparedness . . . . . . . . . . . . . . . . . 21 3.2 Health System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 3.3 Economic support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 4. Impact of COVID-19 pandemic on the national economY of Vietnam . . . . . . . . 29 4.1 Economic growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 4.2 Impact of COVID-19 on businesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 4.3 Exports, imports, and balance of trade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 4.4 Financial sector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 4.5 State budget . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 5. Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 5.1 Governmental response to contain COVID-19 . . . . . . . . . . . . . . . . . . . . . . . . . . 33 5.2 Contact Tracing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 5.3 Health system response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 5.4 Public’s response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 5.5 Vaccination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 5.6 Protecting vulnerable people . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 5.7 Innovation through leapfrogging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 5.8 Measures to contain COVID-19 with a human capital perspective . . . . . . . . 42 COVID-19 impact on the progress of Universal Health Coverage (UHC) 6.  and sustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 7. Lessons learned . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Annexes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 5 LIST OF FIGURES Figure 1: GDP growth in Vietnam from 1985 to 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Figure 2: New cases of COVID-19 per million population, in some Asian countries . . . . . . . . . . . . 14 The number of daily new confirmed cases, split by Figure 3:  community transmission (orange) and in quarantine (gray) . . . . . . . . . . . . . . . . . . . . . . . . . 15 Figure 4: (Waves 1 to 3) and Figure 4B. (Wave 4) in Vietnam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Flow of surveillance reporting for communicable diseases Based on Figure 5:  circular No 48 /2010/TT-BYT of Ministry of Health, dated December 31, 2010 . . . . . . . . 22 Four waves of COVID-19 pandemic in Vietnam and the Figure 6:  government’s intervention strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Figure 7: Organization chart of the Steering Committees against COVID-19 . . . . . . . . . . . . . . . . . . 25 Figure 8: Financial sources for infectious disease prevention and control in Vietnam . . . . . . . . . . 26 Figure 9: Contact Tracing in Vietnam (Chau et al. 2021) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 COVID-19 vaccine deployment in Vietnam (from March 7, 2021, to June 13, 2022) . . . 40 Figure 10:  Number of people unemployed and unemployment rate among Figure 11:  working-age population, by quarter, 2020–2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 6 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam LIST OF TABLES Table 1: Data sources and limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Table 2: The budget spent on pandemic prevention and control in 2020 and 2021 . . . . . . . . . . . 26 Table 3:  Impact of COVID-19 by sector (2020–2021) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Table 4: Distribution of COVID-19 vaccine in Vietnam by manufacturers (as of June 14, 2022) . . . 39 Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 7 LIST OF ACRONYMS LIST OF ACRONYMS ACRONYM EXPANDED FORM 5K message—facemask (Khẩu trang), disinfection (Khử khuẩn), 5K distance (Khoảng cách), no gathering (Không tụ tập), and health declaration (Khai báo y tế) ASEAN Association of Southeast Asian Nations CDC Center for Disease Control and Prevention (provincial level) COVID-19 Coronavirus disease 2019 DPT4 Diphtheria, whooping cough, tetanus DOH Department of Health (provincial level) EBS Event base surveillance EUA Emergency use authorization FETP Field Epidemiology Training Program Confirmed case; in contact tracing sometimes it indicates the first case of the F0 cluster, where other contacts of F0 are F1 F1 Contacts of F0 that have not turned out positive yet GDP Gross domestic product GSO General Statistics Office GDPM General Department of Preventive Medicine ICT Information and communication technology JE Japanese encephalitis MOET Ministry of Education and Training MOH Ministry of Health MR Measles-rubella NA National Assembly OOP Out-of-pocket PCR Polymerase chain reaction PPE Personal protective equipment PPP Public and private partnership QR Quick response RT-PCR Real-time polymerase chain reaction 8 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam LIST OF ACRONYMS ACRONYM EXPANDED FORM SARS Severe acute respiratory syndrome The new (secondary) coronavirus found as the cause of COVID-19, which is SARS-CoV-2 similar to SARS UHC Universal health coverage VNPT Water, sanitation, and hygiene WHO World Health Organization VN Vietnam VND Vietnamese dong (currency) Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 9 Immunization against COVID-19 at school for children in Ia Peng commune, Phu Thien, Gia Lai 2022 Executive Summary EXECUTIVE SUMMARY The COVID-19 pandemic has caused unprecedented damage to the economy and health of people worldwide. It has led to considerable losses in human life and the economy, exposing underlying health system challenges and inequities. In Vietnam, too, the pandemic posed significant disruption to the economy and the health care system. This country case study documents the epidemiology of COVID-19 from January 16, 2020 (before the first case was found in Vietnam on January 23), to June 30, 2022, in Vietnam, and covers its pandemic preparedness and control policies, governance, and health care system, as well as the impact on the economy and businesses. Lessons learned in the country and challenges for better preparation for the future are described. Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 11 Hoh Chi Minh City’s business central district view at night 1. Introduction INTRODUCTION A COVID-19 outbreak was first reported in Wuhan, contributed to limiting the effect of COVID-19 on the China, in December 2019 (WHO 2020). The World economy in 2020 (Ha et al. 2020, Lam and Thanh Health Organization (WHO) declared COVID-19 2020). Vietnam is one of the few countries that (caused by the SARS-CoV-2 virus) to be a pandemic witnessed an increase in the gross domestic product on March 11, 2020. As of June 30, 2022, it had (GDP) in 2020 according to a World Bank report, affected over 554 million people and caused nearly although this increase was much lower than that in 6.3 million deaths worldwide. Vietnam recorded 11 previous years. GDP in Vietnam averaged $US84.67 million cases and 43,000 deaths during the same billion from 1985 until 2020, reaching an all-time period (Worldometer 2020a). high of US$271.16 billion in 2020 and a record low of US$6.29 billion in 1989. In 2020, the Association Prompt and effective policy making has been a of Southeast Asian Nations (ASEAN) recorded an critical factor in controlling the pandemic. A study average decrease in GDP of -3.3 percent, while demonstrated that timely government policy and Figure 1: GDP growth in Vietnam from 1985-2021 Vietnam’s GDP increased, up to 2.9 percent. media responses, including effective measures to classify and quarantine people from pandemic zones, Figure 1:  GDP growth in Vietnam from 1985 to 2021 400 12% 350 10% 300 8% 250 200 6% 150 4% 100 2% 50 0 0 1985 1990 1995 2000 2005 2010 2015 2020 GDP (Billions of US $) Growth (%) Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 13 Introduction Vietnam has a history of successfully managing contain the spread of the virus, especially through disease outbreaks—it was the first country recognized the earlier waves.1 The number of cases reported in by the WHO as SARS-free in 2003. In addition, many Vietnam is low in comparison with that in other Asian policy reforms, measures, and interventions were countries and in many countries worldwide (Figure pioneered during and after SARS, which have helped 2) (COVID Live—Coronavirus Statistics—Worldometer respond to COVID-19. Similarly, the public’s prior 2020b). The first case of COVID-19 in Vietnam was experience with a respiratory infection outbreak declared on January 23, 2020. Until June 30, 2022, may have led to a greater willingness to comply with Vietnam reported a total of 10,746,470 cases with the government’s centrally directed public health 43,087 deaths, corresponding to a fatality rate of response (WHO 2003). about 0.4 percent (General Department of Preventive Medicine 2022). These relatively lower rates can be explained by some key factors, including a 1.1. Epidemiology of COVID-19 well-developed public health system, a strong central government, and a proactive containment Despite its proximity to China and the vulnerabilities strategy based on comprehensive testing, tracing, of its health care system, Vietnam had been able to and quarantining. Figure 2: New cases of COVIDi-19 per milion of some Asian countries Figure 2:  New cases of COVID-19 per million population, in some Asian countries 70000 60000 50000 40000 30000 20000 10000 0 Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20 Jul-20 Aug-20 Sep-20 Oct-20 Nov-20 Dec-20 Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21 Jul-21 Aug-21 Sep-21 Oct-21 Nov-21 Dec-21 Jan-22 Feb-22 Mar-22 Apr-22 May-22 Jun-22 Vietnam Thailand Malaysia India Japan 1 The definition of the waves of COVID-19 infection in Vietnam (described later in the case study) is different from that in several other countries. 14 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam Introduction For the first three waves from the onset of COVID-19 to April 2021, timely and appropriate responses have been vital in controlling the infection in Vietnam. For the first three waves from the onset of health declaration (Khai báo y tế) (Vietnamese COVID-19 to April 2021, timely and appropriate Government 2020a). However, the battle against responses have been vital in controlling the infection COVID-19 continues in Vietnam, as the country is in in Vietnam (Duc, Vui, and Ha 2020; Ha et al. 2020). its fourth wave. To understand the situation better, The Vietnam Ministry of Health (MOH) mandated this case study explored the data split between the actions based on the available scientific knowledge period of the first through third wave (January 2020 of the pandemic, such as the 5K message—facemask to April 2021) and the fourth wave (end-April 2021 to Khẩu trang), (Figure disinfection 3. The number (Khử of khuẩn), dailydistance June new confirmed 30, 2022) cases, (Figure split by 3, Figure 4A, and community 4B). transmission (Khoảng cách), no gathering (Không tụ tập), and (orange) and in quarantine (gray) (Type is recreated; graph is jpeg saved from Word doc) The number of daily new confirmed cases, split by community transmission (orange) Figure 3:   and in quarantine (gray) . Community cases Quarantine cases 600.000 400.000 200.000 0 /4 5 /5 /5 6 /6 /6 7 /7 /7 8 /8 /8 9 /9 /9 10 /10 /10 11 /11 /11 12 /12 /12 1 /1 /1 1/2 2 /2 3 /3 /3 4 /4 /4 5 /5 /5 1/6 6 /6 2/ 6/ 3/ 2/ 5/ 11/ 7/ 6/ 4/ 2/ 11/ 12 22 3/ 16 26 27 13 23 12 22 15 25 21 17 27 16 26 14 24 12 22 21 3/ 4/ 13 23 13 23 14 24 Source: https://covid19.ncsc.gov.vn/dulieu/graph [online source] Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 15 Figure 4A (waves 1-3) Introduction (Type is recreated; graph is jpeg saved from Word doc). Figure 4:  (Waves 1 to 3) and Figure 4B. (Wave 4) in Vietnam 3,500 100 90 3,000 80 Cumulative confirmed cases 2,500 Daily confirmed cases 70 60 2,000 50 1,500 40 1,000 30 20 500 10 0 0 23/01 23/02 23/03 23/04 23/05 23/06 23/07 23/08 23/09 23/10 23/11 23/12 23/01 23/02 23/03 23/04 2020 2020 2020 2020 2020 2020 2020 2020 2020 2020 2020 2020 2021 2021 2021 2021 Cumulative confirmed cases W1 W2 W3 12 500,000 450,000 10 400,000 Cumulative confirmed cases (in millions) 350,000 8 Daily confirmed cases 300,000 6 250,000 200,000 4 150,000 100,000 2 50,000 0 0 27/04 27/05 27/06 27/07 27/08 27/09 27/10 27/11 27/12 27/01 27/02 27/03 27/04 27/05 27/06 2021 2021 2021 2021 2021 2021 2021 2021 2021 2022 2022 2022 2022 2022 2022 Cumulative confirmed cases W4 The first wave commenced on January 22, 2020 (Vinh Phuc). Fourteen confirmed cases from this Figure 4B. Wave 4 in Vietnam (Figure 4A). The original case had a travel history from province were isolated in a designated hospital. In (Type is recreated; graph is jpeg saved Wuhan, China, to Vietnam, where he visited his son,from Word doc).the province activated community-wide addition, who also tested positive for COVID-19 later (MOH screening for COVID-19 (Thanh et al. 2020). 2020b). The next three patients were Vietnamese The second wave was triggered on March 6, 2020, citizens who had traveled on the same flight from when a 26-year-old person who had traveled to Wuhan on business (Van Cuong et al. 2020). These infected areas in Europe arrived in Vietnam and three cases led to a 14-day lockdown of a whole tested positive. Soon after the confirmation, the MOH village (Son Loi) in the country’s northern province successfully tracked and isolated about 200 people 16 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam Introduction who had close contact, lived on the same street, or 1.2 Overview of Vietnam’s Health were on the same flight to Vietnam (Định et al. 2020). Care System From the date of entry into Vietnam to before the date of detection in the community in Da Nang City, Vietnam invested heavily in its health care system, there were 399 cases; 301 of these were imported with an 80 percent increase in public health and 98 were due to community transmission. This expenditure per capita between 1995 and 2012 was followed by 99 days with no cases detected in (Hoang et al. 2015). These investments have paid the community (MOH 2020b), (Tran et al. 2020). off, with improving indicators. Between 1990 and 2020, life expectancy increased from 66 years in The third wave was identified with the COVID-19 males and 75 years in females to 71 and 80 years, outbreak in Da Nang city from July 23, 2020, to respectively. The under-five mortality rate fell from October 2020. A total of 388 cases and 35 deaths 52 to 21 deaths per 1000 live births, and the mortality were reported. This was followed by a wider outbreak rate (2017) from 139 to 43 deaths per 100,000 live from January 25, 2021, to March 26, 2021, with 901 births (World Bank 2022). The country has many cases reported in 13 provinces and cities (National policies to improve the quantity and quality of human Steering Committee for COVID-19 Prevention and resources in the health sector: diversified forms of Control 2021b). human resource training, preferential vocational The fourth wave started in late April 2021 and is policies, special allowances, and staff rotation policy continuing. This has been the most severe, with over (Quy 2019). The prime minister approved the “Project 10 million infected with a case fatality of more than to reduce hospital overload in the period 2013–2020” 40,000 until the end of June 2022. This time, many according to Decision No. 92/QD-TTg, dated January policies changed in response to the availability of 9, 2013. The positive impact of these policies has vaccines and antiviral drugs. resulted in the increase in the number of medical staff and the number of hospital beds, together with the The number of COVID-19 infections in the south improved quality of care. Between 2015 and 2021, the of Vietnam from June to September 2021 increased number of doctors per 10,000 inhabitants increased very rapidly due to the Delta variant, leading to an from 8.0 to 11.1; the number of patient-beds per 10,000 increase in severe cases and deaths. Most of the inhabitants increased from 26.5 to 31.2 (General deaths were among the elderly and people with Statistics Office of Vietnam 2021b). underlying diseases. In Ho Chi Minh City, 85 percent of deaths were among the unvaccinated or those with The country has robust data systems to collect and only one dose of the vaccine (VnExpress Jan 2022). analyze data from public health entities. The database system shifted to a central, real-time Web-based system in 2009. Since 2016, hospitals have been required to report notifiable diseases (case-based) within 24 hours to a central database, enabling the MOH to track epidemiological developments across the country in real time (Balajee et al. 2017). In collaboration with the U.S. Centers for Disease Control and Prevention (US CDC), Vietnam piloted an “event-based” surveillance program in 2016 and scaled it up nationally in 2018. Event-based surveillance accurately identifies clusters of people with symptoms, which could prevent an outbreak from spreading (Clara et al. 2018). This system also allows key stakeholders, including teachers, pharmacists, religious leaders, community leaders, and traditional medicine healers, to report public health events. Data entry into the covid vaccination information system at the school in Ia Peng commune, Phu Thien, Gia Lai 2022 Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 17 Taking samples for COVID-19 testing at Hoa Phong commune, Krong Bong district, Dak Lak province 2020 2. Methodology and Data Sources METHODOLOGY AND DATA SOURCES The case study has synthesized and evaluated quantitative and qualitative methods. A total of 435 relevant policies classified by agencies, periods, documents from the government to MOH level were types of policy communication, and category of obtained during the analysis period (Table 1). policy responses. It is a combination of both Table 1:  Data sources and limitations •  Data on COVID cases, compiled from the https://covid19.gov.vn website of the MOH •  Nineteen policy documents from 33 agencies at the central (national) to provincial levels, sourced from two main channels: https://thuvienphapluat.vn/ (legal library) (Legal library 2021)—the official website on Vietnamese legal documents—and https://ncov.moh.gov.vn/web/guest/trang-chu (MOH Data sources 2021) •  Reports on COVID-19 prevention and policies from official press, articles, reports, briefs, and presentations from reliable data sources in Vietnam and globally •  Interview data from key persons in health sector and survey All information, including that from key interviews, is in Vietnamese, and accurate translation can Limitations sometimes be complex. Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 19 Vaccination against COVID-19 for frontline workers against epidemics in Gia Lai province in March 2021 3. Preparedness PREPAREDNESS 3.1 Governance for disease surveillance and preparedness Organizational structure Vietnam has a centralized governance system for infectious disease control. The General Department of Preventive Medicine (GDPM) at the MOH plays a key role in health planning and policy formulation and implementation at the national level. Under the GDPM, there are four regional institutions that oversee infectious disease management: Northern Region— National Institute of Hygiene and Epidemiology (directly managing 28 CDCs), Central Region—Pasteur Institute Nha Trang (directly managing 11 CDCs), Activities of the Rapid response information team to prevent Southern Region—Pasteur Institute in Ho Chi Minh and control the COVID-19 epidemic, established in 2020, City (directly managing 20 CDCs), and Highland headquartered in Hanoi Region—Tay Nguyen Institute of Hygiene and Epidemiology (directly managing 4 CDCs). In addition from all levels of administration, from the commune to the CDCs, the GDPM manages national hospitals, to the national level. The data is reported weekly including psychiatric and tuberculosis hospitals, and and monthly (reporting modes used are fax, landline/ implements various public health policies by collaborating mobile phone, and emails), even in the absence of with local governments. any case of communicable disease during that period. Data includes the number of new patients, deaths, and surveillance results and line-listing in case of an Surveillance system in Vietnam outbreak. In case of an incidence of a communicable The communicable disease surveillance system is disease in any hospital, data is sought from the managed and controlled nationally and is responsible related community to identify additional cases, if any. for collecting surveillance data and receiving reports Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 21 Preparedness Figure 5. Flow of surveillance reporting for communicable diseases Flow of surveillance reporting for communicable diseases Figure 5:   Based on circular No 48 /2010/TT-BYT of Ministry of Health, dated December 31, 2010 MINISTRY OF HEALTH GENERAL DEPARTMENT OF PREVENTIVE MEDICINE National institute of Institutes National malariology parasitology /Pasteur hospitals and entomology DOH Health Provincial centre Regional hospitals Provincial center quarantine for preventive Provincial hospitals for malaria centers medicine Private hospitals prevention Company District centre District Hospitals, health for preventive Private clinics station medicine Commune health centre Direct report Exchange information Local health Local clinics centre Despite the robust surveillance system, there could infectious disease control. The law also mandates be errors at times. Most communicable diseases vaccinating the population to control vaccine- are identified clinically, and not by laboratory testing. preventable diseases. In 2013, the MOH issued Case definitions and surveillance techniques are not Circular No. 13/2013/TT-BYT, “Guidelines for infectious standardized across the health system, and there disease surveillance,” dated April 17, 2013, requesting could be differences from province to province. all hospitals to join the reporting system. By 2016, Circular No. 54 mandated hospitals at all levels reported more than 40 communicable diseases Legal framework, government through the web-based system. During the pandemic, directives, and government-led this system recorded and reported COVID-19 COVID-19 response statistics from all levels. The “Law on prevention and control of infectious The pandemic prevention and control system was diseases” No. 03/2007/QH12, dated November a timely and effective response of the government 21, 2007, was established to enact legal actions for and health care workers, and it reflected the public’s 22 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam Preparedness and accountability. The actions were focused on implementation of strategies and measures to control the infection. Later, on July 2, 2021, at the government’s online conference with localities, the government focused on directing the implementation of “dual goals”—developing the economy and ensuring social security, while continuing with prevention and control. A Steering Committee for COVID-19 Prevention and Control was established at the national and regional levels to manage and control the pandemic. The following measures were implemented: (i) “compartment block—quick detection—social Training on EPI for district staff in Gia Lai province, 2022 distancing—quarantine—effective outbreak response and treatment”; (ii) the motto “4 on the spot,” which trust, solidarity, and support. As soon as the first case entailed leadership on-spot; human resources of COVID-19 was reported in Vietnam, following the on-spot; means on-spot; and logistics on-spot; direction of the Standing Politburo, the government (iii) Directives No. 15/CT-TTg, dated March 27, 2020; and the prime minister proposed a motto—”fighting No. 16/CT-TTg, dated March 31, 2020; and the pandemic is like fighting the enemy.” This step No. 19/CT–TTg, dated April 24, 2020, of the Prime mobilized strong participation within the political Minister‘s “5K principle.” system and the public and promoted discipline Four waves of COVID-19 pandemic in Vietnam and the government’s intervention strategies Figure 6:   3500 90 Total Cộng dồn W1 W2 W3 W4 80 3000 70 2500 60 Daily confirmed cases 2000 50 1500 40 30 1000 20 500 10 0 0 22/01/2020 22/02/2020 22/03/2020 22/04/2020 22/05/2020 22/06/2020 22/07/2020 22/08/2020 22/09/2020 22/10/2020 22/11/2020 22/12/2020 22/01/2021 22/02/2021 22/03/2021 22/04/2021 22/1 26 28 29 30 31 01 02 06 12 23/2 25 03/3 10 21 25 28 1/4 18/4 7/5 25/7 27/5 29/7 1/8 7/8 29/8 31/8 4/11 30/11 28/1 30/1 5/2 9/3 8/3 23/3 26/4 2/5 5/5 Activate Vietnam Public Health declaration at the Announcement of the Strengthen border control Strengthening epidemic Health Events Emergency border gate, Isolate people Covid-19 epidemic Da Nang focuses on handling new cases prevention at medical Blockade the entire city of Chi Linh. Response Center from epidemic areas Social isolation examination and treatment Hai Duong and Quang Ninh apply Promote epidemic prevention facilities measures to close and stop operating Changing guidelines for diagnosis Coordinating propaganda, Release of Bluezone Implement social distancing in the whole city of Da Nang establishments that do not ensure and treatment surveillance and with the spirit of fighting application investigation of the against the epidemic like Strengthening supervision and epidemic prevention. outbreak fighting the enemy - Inspect and supervise epidemic prevention and control in management of entry Focusing resources to support Hai Duong, Take preventive key provinces and cities Quang Ninh quickly put an end to the - Do not organize activities that Mobilizing the entire Using hotels for centralized measures in school - Focus on handling the outbreak in Quang Nam province epidemic gather unnecessarily large numbers political system to isolation of people - Speed up tracing the source of infection. Reviewing and participate in epidemic - Stop the services of bars, karaoke, isolating cases who have been to Da Nang prevention discos, games Establish quick response teams - Mobilize central hospitals to support Da Nang Social distancing in high-risk areas - Changing guidelines for diagnosis and treatment of Covid- - Promote communication to Monitor people returning Urgently tracing and zoning out the 19 implement the 5K . message from epidemic areas and Limit gatherings of more than 50 people. Closed entertainment epidemic - Reviewing all available vaccines, close contact services. Pause entry 21-day concentrated isolation speeding up the injection schedule Make a request of 5K Activate the field hospital system Establishment of a National Changing guidelines for diagnosis and treatment Perform sample pooling Steering Committee Take measures to limit mass gatherings. Medical isolation at Bach Establishing a community Covid team Changes to specimen pooling guidelines - Correct the handover and Mai hospital Accelerating the implementation of Covid-19 testing reception of people who have Develop a response plan for completed isolation to their each level of disease Develop a plan to receive, store, distribute places of residence Establishing an anti-epidemic team in Vinh Applying epidemic prevention measures in the "new normal" Phuc. Strictly manage entry and exit in border areas and use vaccines - Medical isolation at Kim Chung Announcement of an acute respiratory infection caused by a new strain of Corona Accelerating vaccine research Hospital for Tropical Diseases, virus Administering the Covid-19 vaccine epidemiological investigation and tracing of related cases School closure Guidelines for diagnosis and treatment Medical guidance for foreigners on short-term entry Speeding up the implementation of vaccination Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 23 Preparedness Control mechanism Period of the fourth wave (from April 27, 2021, to June 30, 2022): Period of the first three waves (from January 23, 2020, to April 26, 2021): In 2021, the Government Working Group on vaccine diplomacy was set up to administer vaccines Vietnam applied the five strategic principles to equitably and efficiently across the country. When control the outbreak: “prevention, detection, isolating, vaccines became available in the country, initially they zoning, and effective treatment.” The government were not enough to cover all provinces. Full access to implemented these measures prior to the WHO COVID-19 vaccines began in the third quarter of 2021. recommendation by issuing directives2 by the By October 2021, the country achieved a 70 percent prime minister that provide guidance to localities rate of vaccination with at least one dose, and the in responding to the outbreak. The MOH actively country returned to “safely adapting, and flexibly and developed and proposed implementation plans and effectively controlling the pandemic.” scenarios for COVID-19 prevention and control soon after the disease was recorded in Wuhan (China). This With lessons learned through the first three plan has been continuously updated according to waves of COVID-19, the government quickly actual developments and levels of infection. adapted resolutions, policies, and measures, and mobilized, reallocated, and redefined human and Vietnam focused on implementing adequate and financial resources. For instance, on July 28, 2021, timely measures to not only minimize the incidence the National Assembly (NA) issued Resolutions and case fatality rate, but also to promote economic No. 30/2021/QH15, No. 268/NQ-UBTVQH15, and development through its dual goal strategy. Vietnam No. 30/2021/NQ-QH15, allowing the government is the first country to apply the mandatory measure to promptly implement appropriate regulations, of medical declaration for people on entry, and at mechanisms, policies, and measures to respond to the same time it continues to organize concentrated the urgent need for pandemic prevention and control. isolation for all citizens entering the country. The On September 30, 2021, the NA issued Resolution government also provided substantial financial No. 393/NQ-UBTVQH15, which reallocated resources support to workers who lost their jobs and/or from the central budget for COVID-19 expenditures. experienced a significant impact on their businesses Resolution No. 296/NQ-UBTVQH15, dated September through a support package worth 62,000 billion 7, 2021, supported financial relief for the public on Vietnamese dong (VND) approved on April 9, 2020. supplementing funds to buy back the exported The government also reallocated and mobilized national reserve rice for aid, relief, and support to security and armed forces personnel for tasks such as the people. Resolution No. 03/2021/UBTVQH15, isolation, control of entry on border lines, restriction dated September 24, 2021, supported employees and temporary suspension of entry visa issuance, and and employers affected by the COVID-19 pandemic extension or validation of an exemption certificate. through the Unemployment Insurance Fund. The National Assembly and the government were responsible for providing direction for infectious disease preparedness and response tasks, while the Steering Committees quickly consolidated the organization, assigned tasks to members, issued working regulations, and implemented assigned activities. Ministries, departments, branches, central agencies, and localities established command centers for pandemic prevention and control at all levels. Local government actively directed and organized the implementation of COVID-19 response in their localities. The prime minister established a special working group of the government in Ho Chi Minh City to handle the prevention and control in the provinces and cities in the southern region. The Ministry of Health supervises the implementation of vaccination against COVID-19 in Trung Liet Ward, Dong Da district, Hanoi, 2021 2 Nos. 15/CT-TTg, 16/CT-TTg, and 19/CT-TTg 24 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam Figure 7 Organization chart of the Steering Committees against COVID-19 Preparedness Figure 7:  Organization chart of the Steering Committees against COVID-19 Party Central Committee, Politburo, Secretariat, National Assembly and Government Commodity Production and Health Subcommittee Circulation Subcommittee Subcommittee on Security Subcommittee on Advocacy and Social Order National Steering and Social Mobilization Committee for COVID-19 Social Security Prevention and Control Subcommittee on Subcommittee Civil A airs Finance and Logistics Communication Subcommittee Subcommittee Steering Committee for COVID-19 Prevention and Control at Province level Head of Steering Committee: Chairman of the People’s Committee at the same level Steering Committee for Members: representatives of COVID-19 Prevention and agencies of health, finance, Control at District level information - communication, diplomacy, defense, and police at the same level Steering Committee for COVID-19 Prevention and Control at Commune level In late 2021, the government and the National During the fourth wave, the MOH developed, Steering Committee changed their stance and adjusted, and updated plans to ensure adequate direction in combating COVID-19, in consultation response depending on the incidence and mortality with scientists and experts. These changes included rates. Faced with the risk of penetration and spread (i) switching from defense to attack, implementing of the Omicron variant, the government, the prime the three pillars of isolation, testing, and treatment; minister, and the head of the National Steering (ii) identifying communes, wards, and towns as Committee for COVID-19 Prevention and Control “fortresses” and the people as “soldiers,” with the focused on directing the implementation of drastic people as the center and the subject of pandemic measures, tasks, and solutions for early detection, prevention and control, thus bringing health care and timely and effective response, which included and social security services close to them; and strengthening supervision and management of cases (iii) focusing on mobilizing support resources and of entry, especially of cases coming from countries providing timely aid to localities with outbreaks or and regions that have recorded the new variations. high risk of outbreaks. Several resolutions were passed to enable appropriate response and action.3 3 Resolution No. 86/NQ-CP, dated August 6, 2021, on urgent solutions to prevent and control the COVID-19 pandemic to implement Resolution No. 30/2021/QH15, dated July 28, 2021, of the XV National Assembly; Resolution No. 58/NQ-CP, dated June 8, 2021, on the Regular Government Meeting in May 2021; and Resolution 128/NQ-CP, dated October 11, 2021, which provided for “Safe adaptation, flexibility, effective control of the COVID-19 pandemic.” Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 25 Preparedness 3.2 Health System Health financing There are a number of sources, from both the central and local budgets, for the resource envelope for infectious disease prevention and control. These include the health insurance fund; aid from countries, international organizations, and other lawful funding sources; and donations and financial and in-kind support from businesses and domestic and foreign organizations/individuals through the COVID-19 Vaccine Fund, the Fatherland Front at all levels, and COVID-19 epidemic control activities of customs authorities in Mong Cai City, Quang Ninh Province, 2020 Figure direct 8 Financial support sourcesand to the authorities for medical infectious disease prevention and control in Vietnam facilities. Figure 8:  Financial sources for infectious disease prevention and control in Vietnam Donation, financial and in-kind support from domestic businesses, organizations and individuals State budget (both central and local) The COVID-19 Vaccine fund The health insurance fund The Fatherland Front at all levels Financial sources for epidemic prevention Directly support and control the authorities Aid sources from countries, international Medical facilities organizations Other lawful funding sources Donation, financial and in-kind support from foreign businesses, organizations and individuals Table 2:  The budget spent on pandemic prevention and control in 2020 and 2021 Year Central budget Local budget The total state budget 2020 VND 8,014.57 billion VND 11,628 billion VND 19,642.57 billion 2021 VND 26,300 billion VND 51,300 billion VND 77,600 billion 26 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam Preparedness In 2022, the resources allocated by the central Physical infrastructure and human budget totaled about VND 30,500 billion (unused resource capacity resources from 2021 have been transferred to 2022 to continue spending on public expenditures). In In Vietnam, most tertiary level hospitals have an addition to the domestic resources dedicated to infectious disease department, which oversees COVID-19, Vietnam received a myriad of financial and quarantine and treatment. For COVID-19, the MOH human resources support from other countries and deployed a “3-storey tower” treatment model to treat international organizations (estimated to be several different levels of infection severity. This enabled trillion VND) (Further details and the economic impact effective management and allocation of human of COVID-19 are described in the following Section). resources and finances. • Level 1: treatment of mild and asymptomatic cases at home, in the community, or by mobile Health service delivery clinics (where established). • Level 2: at the field hospital, for handling cases There are four tiers in the health service delivery with moderate symptoms, underlying diseases, system in Vietnam: central, provincial, district, and and high-risk factors. commune levels (Figure 5). The more than 12,000 commune health centers deliver primary health • Level 3: for the treatment of severe and critical care. District health centers and district hospitals, cases. This model was piloted in Bac Giang as the next level of health facilities, are available during the early stage of the fourth wave and in all 760 districts. Each of the 63 provinces has at deployed effectively in Ho Chi Minh City and least one general hospital, with some additional Binh Duong, among others. specialized hospitals. Private hospitals also joined the government health service delivery, including for COVID-19 treatment and vaccination. Since 2020, 3.3 Economic support telemedicine was introduced for both COVID-19 and Prompt and adequate economic policies, packages, non-COVID patients due to restricted mobility in the and relief measures were implemented in response country. The Hanoi Medical University Hospital took to the adverse socioeconomic impacts on businesses the lead, starting in April 2020. COVID-19 patients and individuals (Tran et al. 2020). The prime minister benefited through digital consultations, which issued Directive No. 11/CP to assist businesses ensured access to information, treatment support, impacted by COVID-19 and provided a credit package and timely referral, thereby contributing to lowering of VND 250 billion for social welfare on March the severity of cases and deaths. 4, 2020 (Prime Minister of Vietnam 2020, March 4). In April, the government provided an economic stimulus package valued at VND 60.9 trillion (Prime Minister of Vietnam 2020, April 9). For Vietnamese citizens in isolation in health care centers and quarantine facilities, about VND 80,000 in allowance per person per day (US$3.40) was provided, with all direct medical costs covered. In addition, taxes were exempted or deferred, and electricity tariffs were reduced for three months for individuals and enterprises affected by the pandemic (Ministry of Industry and Trade 2020). Deploying expanded vaccination in the situation of COVID-19 epidemic in Dak Dro commune, Krong No district, Dak Nong province – Waiting area before vaccination Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 27 Ho Chi Minh City skyline and the Saigon River at sunset. 4. Impact of COVID-19 pandemic on the national economY of Vietnam IMPACT OF COVID-19 PANDEMIC ON THE NATIONAL ECONOMY OF VIETNAM 4.1 Economic growth Table 3:  Impact of COVID-19 by sector (2020–2021) The COVID-19 pandemic had an adverse impact on 2020 2021 Vietnam’s economic growth prospects in both the short and medium terms. However, the country’s Accommodation and food -17% 20.21% growth rate is still significantly higher than the Mining -5.4% regional and global average. According to the General Statistics Office of Vietnam (GSO), Vietnam’s Transportation and storage -4% -3.11% GDP increased by 2.87 percent in 2020 and by 2.56 percent in 2021. This however, is the lowest increase Other services -4% in recent years (GSO 2021a). The pandemic affected Health sector 9.6% 41.01% industries differently during 2020 and 2021 (Table 3). During the first nine months of 2020, almost all Information and 7.4% 5.08% manufacturing sectors experienced a sharp decrease communication in growth compared to the previous year. However, Finance/banking/insurance 6.7% 9.5% some sectors, such as the health and information sectors, saw an increase in growth during the same Wholesale and retail 0.5% period. In 2021, many sectors recovered, and the Source: General Statistics Office of Vietnam (2020b, 2021a). health sector recorded the highest growth rate, more than 41 percent. Heavy dependence on imported and capital goods from China and South Korea increases the vulnerability of Vietnam’s entire production chain. There was production stagnation in both China and South Korea, along with restriction of trade between Vietnam and these two countries during the pandemic. The value of raw materials imported by Vietnam from China accounts for 30 percent of the total export of machinery and electronic equipment from China. Vietnam also imports computers and electrical components from South Korea, accounting for the highest market share of nearly 35 percent. Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 29 Impact of COVID-19 pandemic on the national economY of Vietnam 4.2 Impact of COVID-19 on businesses 4.3 Exports, imports, and balance Due to the impact of COVID-19, many businesses of trade temporarily suspended operations. Almost one-third Whereas the export and import market declined (29.87 percent) of enterprises reduced production sharply in the second quarter of 2020, a recovery and scale of their businesses, 3.07 percent was recorded in the third quarter. Trade balance suspended production and business activities, 0.27 in goods in 2020 experienced a trade surplus percent were waiting for dissolution/bankruptcy, and of US$20.1 billion compared to the previous year 0.27 percent stopped operating (NEU and JICA 2020). (US$10.8 billion). However, this was mainly due to Many businesses had to cut labor, with the greatest the fact that imports fell faster than exports. This was reductions seen in tourism, accommodation, and a concern because many domestic manufacturing catering. In 2021, the fourth COVID-19 wave, leading industries are highly dependent on imported raw to strict blockades and social distancing (especially materials. Vietnam’s services had a trade deficit of in the third quarter), had a negative impact on US$8.16 billion, equaling 149.2 percent of service businesses. The total number of enterprises entering export turnover (GSO 2020b). and re-entering the market in 2021 decreased by 10.7 percent (160,000 enterprises) compared to 2020. The timely promulgation and implementation of Resolution 4.4 Financial sector No. 128/NQ-CP, dated October 11, 2021, made an important contribution to restoring production and The average consumer price index increased by 3.51 promoting the market, gradually creating confidence percent, and the average inflation rate increased for manufacturers. The results of a survey on by 2.43 percent in 2020, when compared to the business trends of enterprises in the processing and previous year. Food prices increased significantly, manufacturing industry showed that enterprises were although gasoline prices decreased due to reduced optimistic about the business situation in the first transportation, entertainment, and tourism quarter of 2022, with 81.7 percent of them assessing it (GSO 2020a). as stable (GSO 2021a). Activities of garment production facilities in Dau Lieu Ward, Hong Linh Town, Ha Tinh Province during the COVID-19 epidemic period in 2021 30 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam Impact of COVID-19 pandemic on the national economY of Vietnam Along with direct expenditure from the state budget, support for businesses and people was also provided through insurance funds (social insurance, insurance for occupational accidents and diseases, unemployment insurance), totaling about VND 43.37 trillion. 4.5 State budget Resolution No. 42/NQ-CP and Decision No. 15/2020/ QD–TTg of the Prime Minister. About 16.2 thousand State budget and expenditure tons of rice for national reserve were issued to The country’s revenue in 2020 was VND 1,512.3 the people. trillion. For the first nine months of 2020, the total By the end of 2021, the state budget spent VND state budget revenue reached VND 975.3 trillion, 77.6 trillion on epidemic prevention and control (of equaling 64.5 percent of the financial plan of the which the central budget was VND 26.3 trillion and country. For 2020, the state budget balance was VND the local budget was VND 51.3 trillion). In addition, the 1,323.1 trillion, down by VND 189.2 trillion compared COVID-19 Vaccine Fund mobilized VND 8,803 trillion to the estimate. In this, the central budget revenue until the end of December 2021. The prime minister decreased by VND 126.5 trillion, and the local budget decided to spend VND 7.95 trillion from the COVID-19 revenue was about VND 62.7 trillion lower compared Vaccine Fund to buy about 75 million doses of to the estimate (Ministry of Finance of Vietnam 2020). the vaccine. In 2021 the country’s revenue was VND 1,568.4 Along with direct expenditure from the state trillion, with the estimated expenditure reaching VND budget, support for businesses and people was also 1,854.9 trillion (Ministry of Finance of Vietnam 2021). provided through insurance funds (social insurance, In the first six months of 2022, state budget revenue insurance for occupational accidents and diseases, reached VND 941.3 trillion, equaling 66.7 percent of unemployment insurance), totaling about VND 43.37 the estimate, up 19.9 percent over the same period in trillion (Ministry of Finance of Vietnam 2021). In 2021, 2021, with the state budget expenditure estimated at the state budget deficit was about VND 286.5 trillion, VND 713 trillion (40 percent of the estimate) (Ministry down by VND 57.2 trillion compared to the estimate, of Finance of Vietnam 2022). equal to 3.41 percent of realized GDP (Ministry of As of September 23, 2020, the state budget spent Finance of Vietnam 2021). about VND 17.49 trillion on pandemic prevention and control. In addition, VND 12.57 trillion has been spent to support 12.65 million people affected by the COVID-19 pandemic, according to the Government’s Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 31 Vaccination against COVID-19 for frontline workers against epidemics in Gia Lai province in March 2021 5. Response RESPONSE 5.1 Governmental response to contain airports that were still used for domestic travel. On COVID-19 March 22, 2020, The Government Office temporarily suspended entry for all foreigners coming to Vietnam Lockdown, travel restriction, (Prime Minister of Vietnam 2020, March 21), and quarantine this was implemented until the end of 2021. Mass quarantines were implemented at suspected hotspots Travel and mobility restrictions in the country, based on evolving epidemiological Even before the first case in Vietnam was confirmed, evidence over time (Annex 1). On April 1, 2020, a the country had taken measures to control COVID-19, national lockdown was announced, first for 15 days, such as limiting mobility for citizens and international but later extended to 21 days in most parts of the travelers at the borders. Due to its proximity to China, country (MOH 2020a). During the second and the country suspended visa issuance to Chinese third waves of COVID-19, instead of country-wide tourists as a temporary measure, and the Civil lockdowns, certain hospitals in Da Nang that had Aviation Authority of Vietnam suspended all flights outbreaks within them underwent a ‘blockade.” Social to and from China on February 1 (when the number distancing was implemented in the provinces of Da of cases was in the single digits) (Prime Minister of Nang and Hai Duong. During the first few days of the Vietnam 2020). Flights from the Schengen countries fourth outbreak, close contacts of confirmed cases and the United Kingdom (UK) were suspended on needed to self-monitor and isolate at home for 5 to 7 March 15, after the second wave of cases, which were days. Later this guidance was changed to only close traced to people who had traveled in Europe, and all contacts, needing to ensure infection prevention visa issuance was discontinued on March 18. Vietnam measures and to limit going to crowded places. On closed its borders and suspended all international March 15, 2022, the MOH issued Official Letter No. flights for a two-day period between March 20 and 1265/BYT-DP providing guidance for international March 22. travelers to the country: requirement of a negative result for SARS-CoV-2 before departure—within 72 Vietnam also implemented quarantine and isolation hours if the polymerase chain reaction (PCR) test is to control COVID-19 early on. In early February 2020, done, or within 24 hours if the rapid antigen test is the country initiated a 14-day quarantine, in large done—and self-monitoring without isolation for 10 government-run centers, for travelers from reported days after entry. hotspots. International flights were diverted from Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 33 Response During the first wave, testing focused on high-risk areas, detecting infection, and serving as a basis for guidance on the social distance norms. Testing, contact tracing, and isolation method in Da Nang helped to speed up testing and tracing. In the third wave, the Alpha variant appeared, In late January 2020, the Ministry of Science and increasing the rate of secondary infection, risk of Technology hosted a meeting with virologists to hospitalization, and fatality. Large-scale testing carried encourage the development of diagnostic tests. By out in the outbreak areas, along with rapid antigen early March 2020 the country developed four locally testing for screening in Bac Giang, Bac Ninh, and Ho made COVID-19 tests that were validated by the Chi Minh City, helped early detection, isolation, and Ministry of Defense and National Institute of Hygiene control. During the fourth wave, in which the Delta and Epidemiology, although their efficacy had not variant spread with a higher infection rate than Alpha, been verified by the WHO (Klingler-Vidra et al. 2020). testing remained key and was carried out quickly to Testing capacity ramped up quickly with the locally detect and prevent infection. For each mass testing manufactured tests, from just two testing sites in late campaign, the tests were carried out in two to three January to 63 sites across the country by May 1, 2020 batches, each batch lasting three to four days. In (Thai et al. 2021). high-risk areas, such as medical facilities, industrial The government commenced testing nationally parks, and production and business establishments, to identify clusters and prevent wider transmission. proactive screening and sample testing, together with When community transmission was detected, the organizing the entry and exit of personnel, working government reacted quickly with contact tracing, shifts, meals, and other activities, helped control commune-level lockdowns, and widespread testing infection. The principle of rapid testing to detect the in the community to ensure no cases were missed index case (F0 refers to any confirmed cases, but (Markovitz 2020). From 2020 until the middle of 2021, for contact tracing, F0 can mean the index case the testing rate was about 1000 tests per one positive detected) helped to identify the source of infection, case found. This rate was much higher than that for isolate, and provide timely care, thereby reducing any other country at that time (for example, Taiwan, the severity of illness, spread of infection, and deaths. China, and Korea, respectively, reported 200 and 170 Ho Chi Minh City alone, in the seventh phase of tests per one positive case). the testing campaign, completed three rounds of testing in seven days, isolated 35,000 positive cases Almost all provinces gradually increased their detected in the community, and provided them with testing capacity. Coordination of testing and treatment either in designated centers or at their sampling improved through each wave, with both respective homes. This reduced community positivity top-down and bottom-up participation (military, police, from 3.6 percent in the early rounds to 0.1 percent in volunteers, and neighboring localities); organized the final rounds of the campaign. This strategy was mobile testing; and effective combination of rapid implemented in localities such as Bac Giang, Bac antigen testing, real-time PCR (RT-PCR) testing, and Ninh, Hanoi, Nam Dinh, Khanh Hoa, Dong Thap, and pooled sample testing. This enabled increased Ho Chi Minh City (District 7, Cu Chi, Can Gio). testing speed and reduced costs, and the application of information technology (using QR codes) shortened Testing capacity has been markedly improved in the time of return test results. Vietnam over the course of the pandemic. To meet the increased testing demand, the MOH expanded During the first wave, testing focused on high-risk the capacity significantly. Initially, it was mainly carried areas, detecting infection, and serving as a basis out in the laboratories of the Institutes of Hygiene for guidance on the social distance norms. By July and Epidemiology, the Pasteur Institute, and a number 2020, Vietnam was faced with increasing incidence. of CDCs and last-line hospitals. By the beginning Employing large-scale testing with the pooled PCR of the second wave, 67 units had been approved 34 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam Response by the ministry to carry out COVID-19 testing. At the therefore potentially infected, in the past 14 days. All beginning of the third wave, 96 units were licensed close contacts—defined as people who have been for confirmatory testing. Currently, provinces, cities, within two meters of, or have had a face-to-face and many units of the MOH and branches can contact with, a confirmed COVID case—are identified perform confirmatory tests for SARS-CoV-2, including and tested for the virus. If a close contact tests rapid antigen tests and antibody tests. There are positive for the virus, that person is placed in isolation currently 357 laboratories in the country capable of at a hospital, at no cost, regardless of symptoms. If testing for SARS-CoV-2 through real-time reverse the close contact does not test positive, that person transcription polymerase chain reaction (real-time is quarantined at a government-run quarantine center RT-PCR), with a maximum testing capacity of about for 14 days. Subsequently, the secondary close 350,000 samples per day (public sector: 331 labs; contacts (F2) of the primary close contacts (F1) of the private sector: 26 labs). index case (F0) are required to self-isolate at home until the testing results from F1 are returned. If the F1 tests are negative, then their close contacts (F2) 5.2 Contact Tracing can end the home self-isolation; however, if F1 tests are positive, then the F2 contacts need to isolate Testing is used for detecting an infection, whereas at a government-run quarantine center for 14 days contact tracing and quarantine are the key parts of (MOH 2020a). One noteworthy aspect of Vietnam’s containment. Vietnam’s contact tracing strategy is approach is that it identified and quarantined based on the following process: once a patient with suspected cases based on their epidemiological COVID-19 is identified, the MOH, with support from risk of infection (if they had contact with a confirmed health professionals, security officers, the military, and case or traveled to a COVID-affected country), not on other civil servants, works with the patient to identify whether they exhibited symptoms, and this may have whom they might have been in contact with and Figure 9. Contact Tracing in Vietnam helped curb the speed of virus transmission. Figure 9:  Contact Tracing in Vietnam (Chau et al. 2021) Isolation and treatment of infected F0 patients in health facilities. F1 Institutionalized isolation of people having close contact with infected patients. F1 Home based isolation of people having close contact with those who are isolated in F1 IN D E X (F 0) FIR ) ST D (F1 EGREE SEC ) O N D D E G R E E (F2 T HIR D D E G R E E ( F 3) Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 35 Response Risk communication and information disclosure The Vietnamese government communicated clearly and transparently about the risk of infection even before the first case was reported in the country. On January 9, 2020, the MOH first warned citizens of the threat. Since then, the government has communicated frequently with the public, taking advantage of Vietnam’s high use of social media. By 2020, 75 percent of all internet users between 16 and 64 years old in Vietnam were using Facebook Messenger and 76.5 percent were using Zalo (Thanh Nien Magazine 2021). The country also used several creative measures to reduce the risk of infection. In late February 2020, the Vaccination against COVID-19 at Phong Tho District General National Institute of Occupational and Environmental Hospital, Lai Chau province, 2021 Health released “Ghen Co Vy,” a pop song turned into a hand-washing public service announcement 5.3 Health system response (PSA) that went viral on TikTok and other social media. In addition, the MOH sent SMS messages to all Hospital response and linkages to mobile phone users in the country to encourage and primary care motivate the country to fight the pandemic: “Fighting Treatment and care management were organized with the pandemic is like fighting against the enemy.” In the motto “four on the spot,” proactively supported early March 2020, the ministry also worked with by experts from central hospitals. The government telecom companies to launch the NCOVI application, quickly established 51 national mobile teams4 which provides citizens with real-time information on to strengthen support for localities in COVID-19 COVID-19, including a map of location of detected management, care, and treatment, especially for cases and clusters of infections. People used the app severe/critical cases. Local hospitals established to declare their own health status, report suspected treatment units at all levels (district, provincial, central). cases, and watch real-time movement of people The MOH established the Center for Management placed under quarantine. In mid-April, the Vietnamese and Operation to support testing, isolation, diagnosis, cybersecurity firm BKAV launched Bluezone, a and treatment of COVID-19 patients online through Bluetooth-enabled mobile app that notifies users if information technology and telecommunications. It they have been within two meters of a confirmed also established special working groups in Vinh Phuc, case within the previous 14 days. When users are Da Nang, Hai Duong, Bac Ninh, and Bac Giang, to notified of exposure, they were encouraged to provide support. contact public health officials immediately. Although the apps have fostered a “neighborhood watch During the fourth wave, the central and local health system” that may have helped to slow transmission of forces focused their effort on treatment to reduce the virus, they have also drawn criticism from privacy mortality by setting up rehabilitation centers. The advocates. MOH set up 11 intensive care centers, including five centers with 4,600 intensive care beds in Ho Chi On April 14, 2020, Vietnam passed a decree Minh City. Ho Chi Minh City and southern provinces allowing authorities to fine people who use social mobilized 184 COVID-19 treatment hospitals with media to “share false, untruthful, distorted, or a scale of 132,000 beds. The ministry set up a slanderous information.” This ordinance, too, field warehouse in Ho Chi Minh City for medicines, generated opposition from Amnesty International and equipment, and medical supplies to provide timely others. However, according to data from You Gov, as support to localities in the area. The Ministry of Public of April 2020, 93 percent of the Vietnamese people Security also coordinated with the central hospitals believed the government was responding “very” or to deploy a field hospital in Ho Chi Minh City with “somewhat” well. a capacity of 300 beds. Military medical forces participated in taking samples, testing, and taking 4 Local mobile teams, in contrast, are responsible for the field work and could manage mild cases. 36 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam RESPONSE care of COVID-19 patients at home and in support The government created favorable conditions to hospitals, isolation centers, and treatment. import, license, research, and produce drugs in the country. The National Assembly Standing Committee The government also focused on strengthening the issued Resolution No. 12/2021/UBTVQH15, dated delivery of COVID-19-related services through the December 30, 2021, and the government issued reallocation of resources to primary health care levels. Resolution No. 168/NQ-CP, dated December 30, Ho Chi Minh City alone established 536 mobile 2021, allowing the implementation of a number of medical stations within one week, and these have mechanisms and policies in the health sector to serve assisted in the management and treatment of over pandemic prevention and control. 152,000 cases. Mobile medical stations performed preliminary first aid, rapid testing, vaccination, support for referrals, and supply of home treatment/remedies. This resource reallocation has been highly effective, Human resources for health providing early and easier access to health services, During the COVID-19 pandemic, human resources especially for the vulnerable. for health have been challenged, and thus resources from ministries, hospitals, provinces, and cities were mobilized to meet the demand. Medical human Medications to support treatment for resources were deployed to provide support to areas COVID-19 affected, at different points in time. During the first wave, a mobile team was dispatched from Bach Mai In July 2021, the government issued a resolution to Hospital to support the Central Hospital for Tropical help local governments and health facilities procure Diseases. In the second wave of the outbreaks in Da equipment and consumables. The MOH ensured Nang, Quang Nam, teams from Bach Mai Hospital and timely delivery and access of drugs and mobilized Cho Ray Hospital were mobilized to strengthen the resources to supply drugs such as antiviral medicines hospitals of Da Nang City. Teams from Ho Chi Minh like Remdesivir, Favipiravir, and Molnupiravir, City University of Medicine and Pharmacy Hospital, according to treatment needs for COVID-19. For as well as the Hospital for Tropical Diseases, Ho Chi medical oxygen products, the government directed Minh City, strengthened Quang Nam Central General functional branches to change the purpose of using Hospital. The National Hospital for Tropical Diseases oxygen from industrial to medical use, thereby in Hanoi, and Hanoi Medical University Hospital ensuring availability of oxygen for treatment across strengthened human resources for Hue Central the country. Hospital, in addition to support from Hai Phong, Thua Thien, and Hue Departments of Health. care of COVID-19 patients at home and in support hospitals, isolation centers, and treatment. Supervising the prevention of COVID-19 epidemic in Quang Trung ward, Hai Duong City, Hai Duong province, 2021 Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 37 RESPONSE The government paid special attention to transparent and effective risk communication to the public with the motto “communication goes first.” In the fourth wave, the government mobilized a identifying outbreak zones and ensuring that strict large force of health workers, army, and police to social distancing was followed, all activities, including support Ho Chi Minh City, Hanoi, and other localities access to routine health care, remained unchanged experiencing outbreaks. Military medical forces in the “safe zones.” In the unsafe zones, however, supported and deployed 536 mobile medical stations there was a restriction—testing was mandatory for in Ho Chi Minh City. Support forces have closely going to a hospital. In outbreak areas, this restriction coordinated with local forces to synchronously also applied to any individual who came as a family implement measures to prevent and control the caregiver and wanted to stay in the hospital with the pandemic and support social security work. The patient. Telemedicine was also used to access these support and local forces worked tirelessly and health services. arduously, taking on risks and even making sacrifices while on duty. Thirty-four training institutions of the health sector 5.4 Public’s response mobilized their human resources to participate in Social distancing, personal hygiene, COVID-19 prevention, with 19,935 people supporting and social norms Ho Chi Minh City, Southeast Region. Up to now, 19,883 of them have completed their tasks and The 5K interventions, including social distancing, were returned to their respective work and study places. followed by the public according to the situation on the ground and location of the outbreak. Ensuring access to essential health services Trust in government and social institutions Access to essential health services for non-COVID-19 patients has also been a priority for Vietnam since the The government paid special attention to transparent start of the pandemic. Ever since the country began and effective risk communication to the public with the motto “communication goes first.” This explained the policies, created awareness among all citizens, created consensus on pandemic prevention and control solutions, and supported public supervision. In 2021, the Communications Subcommittee under the National Steering Committee for COVID-19 Prevention and Control brought about a reform in communication, ensuring uniform, timely, and accurate information and guiding viewpoints, and explaining effective control solutions given by the government, the prime minister, and the National Steering Committee. The MOH organized communication campaigns to mobilize people to support and actively participate in the fight against COVID-19 and to receive safe vaccination. For instance, the 5K Dance campaign of Routine immunization for children at out-of-station vaccination sites the ministry, in collaboration with Unilever Vietnam Foundation in July/August 2021, used vibrant tunes 38 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam RESPONSE to help the community remember and comply with 5.5 Vaccination the 5K measures. TikTok dances and songs and the campaign “Vaccination—Stay confident” incentivized Procurement, access, and deployment- people to socially distance while actively participating distribution in getting vaccinated. The government prioritized effective and safe Communication ensured that the principles of vaccination for the public. In the largest vaccination publicity; transparency; and timely, accurate, and campaign in the history of vaccination in Vietnam, the objective provision of information on the pandemic government managed the procurement, distribution, would serve as a basis for leadership, direction, and administration of vaccines at no cost in a timely administration, and implementation. With the help of manner for everyone residing and working in the effective communication, the public could understand country. In late May 2021, the government established and share the difficulties and allow volunteers to a COVID-19 vaccine fund and established a working participate in prevention and control activities. From group on vaccine diplomacy to promote aid for the start, information about the disease has been vaccines, therapeutic drugs, and medical products. reported by ministries, at the central and local Six vaccines have been approved and are in use levels, based on the MOH’s bulletins thrice daily. in Vietnam: AstraZeneca, Sinopharm (Verocell and Newsletters were provided on all communication Heyat), Pfizer (Cominarty), Moderna (Spike vac), platforms, including Facebook, Zalo, and Viber, to Sputnik V, and Apdala. As of June 2022, a total Party leaders, government, provinces, cities, and of 255,371,154 vaccine doses were available from press agencies. Media, grassroots organizations, and different sources (procurement from the state budget, telecommunications networks also spearheaded international aid, and domestic funding among the general secretary’s call on pandemic prevention others) and 228,825,994 doses of vaccines were and control to ensure the public’s trust, closely distributed nationwide (the number of vaccine doses follow the situation and developments, and handle administered is very close to the number distributed). misinformation. The MOH built an electronic database By December 2021, the first booster was given to with nearly 1,800 communications products related those 18 years of age and older, with administration of to COVID-19 prevention and control, including the second booster starting in May 2022. Vaccination infographics, videoclips, audio clips, music videos, began in November 2021 for 12-to-17-year-olds, who and posters. This helped quick distribution to all 63 were administered the first booster dose until June provinces, cities, units, and press agencies (Annex 2). 2022. In April 2022, vaccination was started for the 5-to-11-year-old group. Table 4:  Distribution of COVID-19 vaccine in Vietnam by manufacturers (as of June 14, 2022) Additional  1st booster 2nd booster Vaccines 1st doses 2nd doses 3rd doses5 dose dose dose AstraZeneca 29,131,079 24,878,351 236 3,928,552 14,101,362 29,898 Comirnaty 20,880,246 23,934,873 26 7,475,400 20,042,191 1,604,952 (Pfizer) Spikevax 8,571,947 3,990,712 8 1,715,347 7,922,549 106,494 (Moderna) Vero cell 23,940,098 22,637,988 0 1,822,437 768,537 1,534 Abdala 1,667,579 1,506,245 1,508,001 25,821 331,138 1,576 Sputnik 744,868 732,471 0 477 3,035 0 V+Light Total 84,935,817 77,680,640 1,508,271 14,968,034 43,168,812 1,744,454 5 The Abdala vaccine required 3 doses of primary immunization’ and later some other vaccines also required an additional dose in the primary series. Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 39 Figure 10. COVID-19 vaccine deployment in Vietnam (from Mar 7, 2021 to Jun 13, 2022 (Type is recreated; RESPONSE graph is jpeg saved from Word doc) COVID-19 vaccine deployment in Vietnam (from March 7, 2021, to June 13, 2022) Figure 10:   Average 7 days Fully vaccinated 2,000,000 1,500,000 1,000,000 500,000 0 7/3 /3 /3 4 /4 1/5 /5 /5 6 /6 /6 7 /7 /7 8 /8 /8 /9 /9 10 /10 /10 11 26 1 /11 2 28 2 /12 1 /1 /1 2 /2 3 /3 /3 7/4 /4 /4 /5 /5 1/6 /6 /1 9/ 6/ 9/ 5/ 8/ 3/ 7/1 /1 11/ 20 31 4/ 17 28 20 18 29 18 29 16 27 19 30 12 23 22 14 25 10 21 10 21 12 2/ 15 18 13 24 Financing (donation, government substantially. A record of about 2 million doses were budget) administered in one day in August 2021. Financing sources for vaccines include both public and private sources. A government budget report 5.6 Protecting vulnerable people had projected that vaccinating the eligible population in Vietnam would cost VND 25,000 billion, including 1. In Vietnam, unlike many developed countries, VND 8,000 billion from a donation campaign older people mostly live with their families, with spearheaded by the prime minister. This fund has often three to five generations living in the same not been used in full, as 60 percent of vaccines used household. Hence, managing nursing homes were donated as part of “vaccine diplomacy.” or long-term care facilities during the pandemic has not been an issue in the country. Due to the risk of infection in health facilities at the peak Coverage and equity of COVID-19 infections, the older population was advised to stay home. By late 2021, the Vaccination started in May 2021. Priority was given government had facilitated vaccinating this group, to front-line health care workers, volunteers dealing including at their homes. with managing the outbreaks, the elderly, and those with comorbidities. By June 14, 2022, 100 percent 2. Women and children: Vaccination was not of the population older than 18 years had as been recommended initially for pregnant women. vaccinated with the primary doses, and 64.2 percent However, when there were reports of some had received the first booster dose. In addition, more COVID-19-related deaths during pregnancy, than 97 percent of the 12-to-17-year-old group, and 44 the vaccination program was extended to this percent of the 5-to-11-year-old group, had received group. In Vietnam, there is no discrimination the primary dose of vaccine; and 55.6 percent of affecting women in terms of health service access the 12-to-17-year-old group had received the first or gender-based violence as a fallout of the booster dose (Technology Center National COVID-19 pandemic (Communist Party of Vietnam Online Prevention 2022). Newspaper 2021, October 11). 3. The poor and migrant workers: There has been no discrimination affecting the poor with respect Information, communication, and to COVID-19 testing, treatment, and vaccination compliance in Vietnam. The government provided financial support to those adversely affected by the Around March 2021, vaccine hesitancy was high lockdowns. However, due to the big outbreak among health care workers, and vaccination was in the south, many migrant workers in the area slow to start with. However, after the big outbreak in were substantially affected by COVID-19 and the south in late July 2021, people understood the were pushed into poverty (Vietnamplus 2022, need for vaccination, and vaccination rates increased GSO 2022a). 40 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam RESPONSE 5.7 Innovation through leapfrogging Telemedicine and social networks also played a significant role in Vietnam COVID-19 control. As the Information and communication number of infections in the community increased, technologies (ICTs) many localities deployed the F0 Home Care Call Center (F0 here refers to a COVID-19 confirmed The application of information technology helped the patient). The “virtual assistants” made and received country to effectively manage pandemic prevention thousands of calls every day to support F0 health and control. When new cases appeared, the contact care at home. In addition, the “virtual assistants” tracing platform was used to identify the source, actively called the F0 cases who were being treated localize the patients, and prevent the infection from at home to support their health care and record their spreading to the community. Technology-based health information. contact tracing also helped localities to identify issues and solutions that they could promptly propose to the government, such as the management of infected people while implementing Directive 16-CT/TTg. The Collaboration with other countries and government followed up, mobilizing many businesses public and private partnerships (PPP) and experts to build solutions and software to support Vietnam was one of the first four countries in the efforts during the pandemic. COVID-19 has provided world to isolate the virus. Four vaccines have been an opportunity to accelerate the digital transformation clinically tested in the country—three with technology of health care in the country. transfer from Russia, Japan, and the USA; and two Many initiatives were supported, such as vaccines with technology cooperation from China establishing a technology group for COVID-19 and Cuba. To date, the Nanocovax vaccine has prevention and control in the area of ICT. Technology completed phase 3 clinical trials; the COVIVAC applications were created, such as BLUEZONE vaccine is completing its midterm report phase 2; and (now PC-COVID), which allows contact tracing and the ARCT-154 vaccine has entered a phase 3c clinical provides vaccine certificates, travel permits, and trial, among others. Research and technology transfer health declarations in one app. When the PC-COVID is also ongoing with Japan and France for drugs to application was deployed, localities made efforts treat COVID-19. to coordinate with many related units to promptly Vietnam’s health sector faced many challenges update vaccination information and test results, and due to COVID-19, such as shortage of hospital beds, help people participate in activities. As of February supplies, and equipment; severe cases, especially 21, 2022, according to statistics from the Ministry among old people and migrant workers; and poor of Information and Communications, more than quality of medical services in some regions and 71,680,100 PC-COVID-19 applications have been health care facilities. For the health system to be installed in the country. resilient and respond to such a crisis, the role of the Data entry into the COVID vaccination information system in Phu Dong ward, Pleiku city, Gia Lai in 2021 Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 41 RESPONSE private sector during COVID-19 has been critical. the government closed the schools in all affected Governmental agencies and private companies areas for three months starting August 5, 2021. worked closely to cope with the pandemic, The telecommunications businesses provided a particularly with contact tracing (Viettel Corp and preferential package to support telecommunications VNPT). Several local manufacturers helped to services for that period, with a total value of nearly develop test kits. In addition, the government and VND 10,000 billion. Remote education was carried out private media joined to effectively communicate with with this preferential package. the public. The private sector created infographics, which helped disseminate COVID-19 information to the public. Social protection and jobs People were severely affected by the COVID-19 pandemic, both in terms of morbidity, in both 5.8 Measures to contain COVID-19 physical and mental health, and mortality. Income with a human capital perspective and employment were seriously affected, especially Education for workers in industrial zones and those working in the service industry. The unemployment rate of Educational services were provided normally during working age groups from the first quarter of 2020 the first three phases of the pandemic (from January to the second quarter of 2022 ranged from 2.32 22, 2020, to April 26, 2021). Virtual classes were percent (1.07 million people) to 3.98 percent (1.71 held only for the high-risk areas—defined as “red million people) (GSO 2022b). High unemployment zones”6—while the other zones (defined as medium particularly affected the south of Vietnam during the risk or “yellow” and with no cases or “green”) were lockdown. The government helped those affected not affected. Many organizations sponsored more by providing relief funds to either all or targeted than one million computers under the “wifi/4G households, employment retention subsidies to and computer for children” scheme, including the support small business owners, and employment information Figure and communication 11. Number of people industry. During the and unemployment rate amongage in working insurance, otherby quarter, support. 2020-2022 fourth wave (from April 27, 2021, to June 30, 2022), Figure 11:  Number of people unemployed and unemployment rate among working-age population, by quarter, 2020–2022 2000 4.5 1800 1714.8 0 1601.7 1600 3.98 3.56 3.5 1400 1264.7 1265.2 1232.5 3 2.85 2.73 1182.6 1200 2.63 1095.4 1112.2 1083.4 2.62 1070.6 2.46 2.5 2.34 2.42 2.32 1000 2 800 1.5 600 1 400 200 0.5 0 0 Q1/2020 Q2/2020 Q3/2020 Q4/2020 Q1/2021 Q2/2021 Q3/2021 Q4/2021 Q1/2022 Q2/2022 Number of people (thousand people) Ratio (%) 6 Red zones are very high-risk areas with clusters of infected cases whose source of infection is unknown or where the identified sources of infection are industrial parks, schools, large supermarkets, and areas where the source is difficult to control or hard to trace (National Steering Committee for COVID-19 Prevention and Control 2021). 42 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam RESPONSE Reduced income without a strong and accessible social protection system pushed many households to below poverty levels (World Bank Group 2021). As regular services were disrupted, families had to spend more to cover extra costs for essential pandemic prevention materials, pay higher transportation costs when bringing children for health checks or treatment, and provide nutritious meals for children. Poorer families with children had to seek exemptions or reductions for tuition fees as well as support for books and school supplies. They have coped by cutting spending on food and borrowing money (International Labor Organization 2020). Vaccination at school Different groups of workers experienced differing Production and Business,” carried out comprehensive impacts due to COVID-19. Those employed in the assessments of the impact of the pandemic on local formal sector, in general, coped better due to their socio-economic development, and proposed relevant stable sources of income and social protection measures for economic recovery and social security. support. In contrast, those in the informal sector The government promoted ICT solutions that helped struggled substantially. Heads of households and/or enterprises and citizens avoid having to go to public caregivers who lost jobs or income were unable to administration offices. Online shopping and banking finance the additional cost for their families or children systems were also promoted. The development to access essential services and meet their basic of private sector mobile distribution networks has needs. The impact, confirmed by studies, on women- accelerated in the cities. headed households is particularly stark. Families had no choice but to slash household expenditure. Poorer, During the third and fourth waves, the government wage-dependent families with no savings reported issued Resolution 68/NQ-CP, dated July 1, 2021, falling into debt, having to sell assets and lower their implementing some policies to support employees quality of meals. Employment opportunities and and employers in difficulty because of the livelihood security were clearly identified as long- pandemic. These included reduction of premiums for term needs of families with children. Many professed occupational accidents and diseases, loans to pay that the need for work would see them returning to wages and restore production, support for employees their previous employment if opportunities allowed, through training and job security, a provision to rather than to seek employment guaranteeing suspend/terminate labor contracts with one-time more secure and stable income (International Labor allowances of a specified amount, and unpaid leave Organization 2020). support for those who stop working with a one-time allowance of VND 1,000,000 per person. The In April 2020, the government issued a US$2.6 National Assembly Standing Committee promulgated billion social protection package for cash support Resolution No. 03/2021/UBTVQH15, dated September to the most vulnerable people and workers who 24, 2021, promoting a policy for affected employees had lost their jobs due to social distancing and and employers to obtain help from the unemployment lockdowns; it also provided affected enterprises with insurance fund. credit at zero or low interest rates to pay workers’ salaries. In addition, the government embarked on an When local transmission of the virus ceased in expansionary fiscal stance to strengthen its national April 2021, the government of Vietnam began to health systems, shore up the local economy, and ease physical distancing measures and focus on provide income assistance to the most vulnerable socio-economic recovery, in line with the orientation and impoverished. The government also issued a set out by Deputy Prime Minister Vu Duc Dam, the substantial financial package for restructuring loans chair of the National Steering Committee on COVID- and has approved a plan to delay collection of 19, for “safe co-existence with COVID-19” for both taxes and land rent to assist impacted enterprises people and enterprises. During the subsequent in selected sectors. All ministries, central agencies, wave, from July 25, 2021, onwards, the government and provincial/city authorities have implemented focused on establishing a balance between intensive national directives on “Measures to Ensure Citizens’ control measures in affected areas and maintaining Health, Social Security and Assist Enterprises in nationwide efforts for socio-economic recovery. Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 43 Implement vaccination against COVID-19 for medical staff in a field hospital treating patients with COVID-19 epidemic in Gia Lai province in March 2021 6. COVID-19 impact on the progress of Universal Health Coverage (UHC) and sustainability COVID-19 IMPACT ON THE PROGRESS OF UNIVERSAL HEALTH COVERAGE (UHC) AND SUSTAINABILITY Service coverage: When COVID-19 infections show that the rate of fully immunized infants in the appeared in the community, some people delayed first five months of 2020 was lower than in the same or even canceled going to medical facilities for period in 2019 (37.2 percent versus a projected 40 medical examination and treatment, which can percent, respectively). MR and DPT4 vaccination rates adversely affect disease status, health, and life (UN for 18-month-old children were 31.2 percent and 28.9 Women 2021). Some pregnant women canceled percent lower, respectively, in the first five months routine antenatal visits, which potentially could have of 2019. The 2021 outbreak also adversely affected increased the risk of obstetric complications and routine vaccination services. maternal mortality. The birth rate at health facilities COVID-19 caused service and supply chain in the provinces and cities in the first quarter of disruptions in the regions. There was a shortage 2020 decreased from 5 to 15 percent compared to of drugs, supplies, and local medical equipment the first quarter of 2019. The rate of use of modern at many medical facilities across the country. The contraceptives in the first quarter of 2020 also prolonged pandemic has also negatively impacted decreased by 5 to 10 percent compared to the first the medical staff due to increased work pressure and quarter of 2019 in some population groups (UNFPA occupational risk of infection (MOH 2022b). 2020). Many families have found it more challenging to access health care services for their children during social distancing. About 88 percent of commune health stations had to temporarily stop providing routine vaccination services due to social distancing. Similarly, the regular growth monitoring of “under-five” children was also affected. Administrative data from the Ministry of Health (2020) shows that, in most provinces and cities, in the first three months of 2020, there was a decrease in vaccination rates against measles-rubella (MR), diphtheria, whooping cough, tetanus (DPT4), and Japanese encephalitis (JE). In 13 provinces, the rate of MR vaccination decreased by 10 percent; and in seven provinces, the rate of DPT4 vaccination Diphtheria PCD checkpoint in Quang Hoa commune, Dak decreased by 10 percent. Statistics of the Central Glong district, Dak Nong province in 2020 – an example of Institute of Hygiene and Epidemiology, MOH, also quarantine area Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 45 Lights of Tran Quoc Pagoda reflected in lake by night, Hanoi 7. Lessons learned LESSONS LEARNED The COVID-19 pandemic has had a detrimental 2. Community COVID-19 group: The community impact on Vietnam’s economy and the health of COVID-19 group has been critical in influencing the people. The country experienced a relative people’s behaviors and social norms during the decrease in GDP growth rate, a decrease in imports pandemic. This community COVID group model and exports, an increase in debt, and a decrease in was first piloted during the Son Loi outbreak revenue with an increase in state budget expenditure. in Vinh Phuc (first wave), and then scaled up However, with flexible financial policies, Vietnam has to other affected areas such as Bac Ninh, Bac managed to control these effects, resulting in positive Giang, Ho Chi Minh City, and Binh Duong. The GDP growth projections, while ensuring social groups operate on a voluntary basis, led by civil security. A multisectoral committee for COVID-19 organizations in the community and volunteers, control and prevention under the leadership of the under the supervision of the government and prime minister spearheaded the pandemic response local police officers. Each group is in charge of and resilience actions. Several lessons have been 40 to 50 households. The groups mobilize and learned, including from challenges faced, and these promote behaviors to prevent and control the are described below. infection, guide people to self-monitor their health, and help families make medical decisions when a family member falls sick. The groups also support 1. Coordination and mobilization of all stakeholders. the monitoring, detection, and reporting to local The scale of the pandemic required all levels authorities and health care facilities when there is of support from not only the government (local a suspected case of COVID-19 in a household. and central), but also from the police, army, and 3. Model of mobile medical station: Mobile medical private sector enterprises to ensure security stations were set up to ensure access to medical and social order in the country. In addition, the services in a timely manner. This enabled early support from international organizations and diagnosis and timely referral to higher-level health other countries has been critical. Vietnam not facilities, thereby minimizing the risk of severe only received financial support and donations, cases and deaths. The stations made oxygen but also benefited from vaccine diplomacy, masks available when needed and were allowed knowledge exchanges, and sharing of lessons to conduct rapid testing and vaccination in their from other countries for the prevention and communities. These mobile medical stations also control of the crisis. Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 47 Lessons learned provided essential health services and medical four main activities: (i) taking samples for testing; examinations for other common diseases to (ii) providing necessary medicines (these were ensure that people in the outbreak areas had packaged as A, B, or C based on the medications access to timely healthcare. Mobile stations were required); (iii) supporting counseling for prevention established mainly in Ho Chi Minh City and Binh and control; and (iv) providing food packages Duong. Ho Chi Minh City established 536 mobile for the patient(s) and family members at home, medical stations to provide care and manage thereby contributing to reducing the risk of infected patients at home. Binh Duong province transmission. These measures contributed to was the first province to set up mobile medical the reduction in the case fatality rate in Ho Chi stations in industrial zones, with 43 mobile Minh City. medical stations established. 7. Teleconsultation support: The implementation 4. Rapid and targeted COVID-19 testing: Rapid of remote consultations helped those in need testing in high or very high-risk areas helped of support to access information on COVID-19, to detect and isolate cases, limiting the spread treatment, and referral, especially during the of the outbreak, and helped infected people period of strict social distancing. It also provided access health care facilities. Effective large-scale consultations for non-COVID-19 conditions. testing was possible due to the mobilization and 8. Transparent and clear communication to the coordination of key stakeholders, including local public. The role of the government was critical and central government, grassroots organizations, in communicating to the public on the pandemic and the public. and shaping the public’s behaviors and social 5. Treatment stratification: The “3-storeytower” norms. The role of the media was also important. treatment model was deployed due to the fact Using all forms of communication, such as social that treatment facilities could not accommodate media to reach the younger population, and treat all COVID-19 patients. Level 1 is the is recommended. treatment of mild and asymptomatic cases; level 2 9. Innovative communication strategies: Many is the field hospital, which specializes in handling creative communication programs (as described cases with moderate symptoms, underlying earlier also) with diverse content achieved diseases, and high-risk factors; and level 3 is improved communication and necessary behavior management of severe and critical cases. This change. For instance, the program “People ask— model was piloted in Bac Giang and deployed in The city answers” in Ho Chi Minh City created a Ho Chi Minh City and Binh Duong. strong connection between the people and the 6. Managing home treatment for infected people government. The Ministry of Culture, Sports and (F0): The Ministry of Health coordinated with Tourism directed the development and broadcast Ho Chi Minh City to implement a pilot program of 15 reportages and 150 video clips to guide the for controlled treatment of cases at their homes public in exercises at home, in isolation areas, and and in their communities. The pilot included at work, with the theme “The whole family practice Effective large-scale testing was possible due to the mobilization and coordination of key stakeholders, including local and central government, grassroots organizations, and the public. 48 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam Lessons learned Deploying vaccination against covid -19 for the whole population in Phu Dong ward, Pleiku city, Gia Lai in 2021 now, fight COVID-19.” The “Boundaries” (Ranh giới) 12. Need for cohesive leadership and coordination: by Vietnam Television highlighted the difficulties, Despite the strong leadership from the pain, and efforts of all forces involved in pandemic government, working with a diverse group of prevention and control, and the “Take off” stakeholders was at times difficult and complex. program created opportunities for many experts The coordination between the central and local to share experiences and lessons in pandemic government was challenging at times when roles prevention and control. and responsibilities were unclear. 10. Use of scientific evidence to inform decision- 13. Health care system: COVID-19 revealed existing making, while being flexible: It is critical to weaknesses in the health care system in Vietnam. accurately understand the situation with the best The level of spending on health per capita and available evidence at that time, make evidence- the number of physicians are still low in Vietnam, based projections, and thus inform policy makers which contributed to shortages during the peak so they can implement timely and effective of the outbreaks. In some provinces, maintaining measures. Policy, legal framework, and decision- the cold chain for the vaccines was challenging as making should be based on science and flexibility, the available equipment is old and could not meet responding to new and evolving evidence the requirements. while taking into account the country’s capacity 14. Dependency on importing drugs and medical and resources. equipment: Vietnam depends on importing 11. Legal framework: Although the government medicinal equipment, drugs, biological products, made substantial reforms to support COVID-19 and vaccines, which also contributed to the control, the legal provisions did not cover all economic burden on the country. areas in response to an outbreak of disease. 15. Lack of timely relief packages: The disbursement In addition, while these legal frameworks and of social security packages was at times slow, due policies have been established, operationalization to complicated administrative procedures. was sometimes more difficult. The translation of policy reforms into actions was weak at times— for instance, many localities did not implement the risk classification of people infected with SARS-CoV-2, leading to high-risk and very high- risk people being treated at home. Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 49 Annexes ANNEXES ANNEX 1. SELECTED LOCKDOWN PLACES IN VIETNAM FOR COVID-19 CONTROL AND PREVENTION Population Region Date Details affected Son Loi commune Feb. 13 to At the time, there were 16 cases of COVID-19 in the 10,000 people (Vinh Phuc province) March 4, 2020 country, with six in Son Loi (MOH 2020b). The area where patient no. 17 (the first confirmed case Truc Bach Street March 6 to of the second wave) lived was put under lockdown. 190 people (Hanoi) March 20, 2020 Sixty-six households were subjected to the lockdown (Vu and Tran 2020). Twenty-nine households on two streets, Hoang Van Thu Phan Thiet City, Mar 1 to 150 people and Ngo Sy Lien, where the house of patient no. 38 is Binh Thuan Province April 3, 2020 located, were locked down (Tien 2020). Van Lam: 3 villages Confirmation of the two COVID-19 cases, patients no. 61 (Phuoc Nam March 1 to and no. 67, led to total lockdown, including movement commune, Thuan 5,000 people April 14, 2020 restrictions for all residents, and all 16 entrances to the Nam district, village were barricaded (Cuong 2020). Ninh Thuan province) Isolation measures were imposed on 480 households Thua Loi village March 2 to 1,600 people after a resident, 17-year-old patient no. 123, was infected (Ben Tre province) April 20, 2020 with the virus. Ha Loi village Village was sealed off during lockdown, with the last April 6 to (Me Linh district, 10,000 people detected community cases (apart from the Ha Giang May 6, 2020 Hanoi province) patient no. 268). Lockdown was imposed before the suspected cases’ Dong Van district April 2 to test results came back. It was then lifted the next day, 7,600 people (Ha Giang province) April 23, 2020 after the test results came out negative, illustrating how quickly the authorities reacted. 50 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam Annexes ANNEX 2. DETAILS OF COMMUNICATION VIA SOCIAL MEDIA USED IN VIETNAM 1. Vietnam Health Page on Facebook: For the period from April 27 to November 9, 2021, there are 577 posts, including 86 videos. The total number of page followers is 163,777, an increase of 69,136 compared to the previous time. Facebook users accessed articles 518,351,115 times, and the articles on the page were displayed to users 627,751,043 times. The number of views of videos on the page is 38,590,501, and the number of Facebook users interacting with page posts is 12,126,985. 2. Communication on YouTube of the Ministry of Health: Total views for the period from April 27, 2021, to November 9, 2021, is 17,309,341 views. Total number of subscribers to the channel is 118,604. Total number of videos uploaded is 445 (up by 228 videos). The number of video impressions with users is 5,782,348,542, and the number of interactions (likes, comments, and Children in middle school get vaccinated against COVID-19 shares) is 116,125. at school, Phin Ngan commune, Bat Xat, Lao Cai, 2021 3. Communication on Zalo by the MOH: The number of people interested, or who follow 5. Communication on Lotus: The total number the channel, is 9,397,556 people. Zalo users of page likes is 12,958, and the total number read articles a total of 21,701,641 times. Average of tokens (views) is 13,149,412 tokens. User number of views, or the number of clicks on each reach through Lotus with articles via Noti news item/article for viewing, is 5 million clicks. announcements is 2,750,000 users. Active views The posts received a total number of 14,663 likes of videos on the page total 145,000. The number and shares. On average, five messages/posts are of Lotus users interacting with posts on the page sent to 60 million Zalo users each day. (including likes, comments, shares or clicks) is 1,358,000 tokens. 4. Media on TikTok: The total number of people who like the channel is 1,315,060 people, the total 6. Communication on telecommunications number of people interested in the channel is networks: For the period from April 27, 2021, 265,452, and the total number of videos posted to now, the MOH has proposed deploying 21 in the past week is 6 videos. The total number of texting sessions for mobile subscribers, with a video views is 3,775,186. total of more than 10 billion SMS messages to all electricity subscribers’ phones. Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 51 References REFERENCES Balajee, S. A., O. Pasi, A. G. Etoundi, P. Rzeszotarski, GSO (General Statistics Office of Vietnam). 2022a. T. Do, I. Hennessee, . . . A. Mounts. 2017. Report on the Impact of COVID-19 on Labor and “Sustainable Model for Public Health Emergency Employment Q1 2022 (webpage). Retrieved Operations Centers for Global Settings.” Emerging from https://www.gso.gov.vn/du-lieu-va-so-lieu- Infectious Disease Journal 23(13). doi:10.3201/ thong-ke/2022/04/bao-cao-tac-dong-cua-dich- eid2313.170435 covid-19-den-tinh-hinh-lao-dong-viec-lam-quy- i-nam-2022/ Clara, A., A. Dao, T. Do, T., P. Tran, Q. Tran, N. Ngu, . . . A. Mounts. 2018. “Factors Influencing GSO. 2022b. Press release labor employment Community Event-based Surveillance: Lessons situation of Q2 and first 6 months of 2022 Learned from Pilot Implementation in Vietnam.” (webpage). Retrieved from https://www.gso.gov.vn/ Health Security 16: S66–S75. doi:10.1089/ du-lieu-va-so-lieu-thong-ke/2022/07/thong-cao- hs.2018.0066 bao-chi-tinh-hinh-lao-dong-viec-lam-quy-ii-va-6- thang-dau-nam-2022/ Communist Party of Vietnam Online Newspaper. 2021, October 11. Retrieved from https:// GSO. 2021a. Socio-economic Situation in the Fourth dangcongsan.vn/phong-chong-dich-covid-19/ Quarter and the Whole Year 2021 (webpage). thu-hep-bat-binh-dang-gioi-trong-boi-canh-dai- Retrieved from https://www.gso.gov.vn/du-lieu-va- dich-593635.html so-lieu-thong-ke/2021/12/bao-cao-tinh-hinh-kinh-te- xa-hoi-quy-iv-va-nam-2021/ Cuong, Dinh. 2020. “COVID-19 Adds to Worry in Vietnam’s Drought-Struck Cham Village. Tuoi tre GSO. 2021b. Statistical Yearbook of Vietnam, 2021. online, March 23, 2020. Retrieved from https:// Hanoi: GSO. Retrieved from https://www.gso.gov. tuoitrenews.vn/news/features/20200323/covid19- vn/wp-content/uploads/2022/08/Sach-Nien- adds-to-worry-in-vietnams-droughtstruck-cham- giam-TK-2021-1.pdf village/53629.html GSO. 2020a. Inflation Is Well Controlled, Maintaining Định, Tất, Hoàng Táo, Viết Tuân, Võ Thạnh, and Đắc a Gradually Low Increase (webpage). Retrieved Thành. 2020. “Passengers on the Same Flight from https://www.gso.gov.vn/en/data-and- ‘Patient 17’ Spread to 10 Provinces and Cities.” statistics/2020/11/inflation-is-well-controlled- Vnexpress, March 8, 2020. Retrieved from https:// maintaining-a-gradually-low-increase/ vnexpress.net/khach-cung-chuyen-bay-benh-nhan- GSO. 2020b. Socio-economic Situation in the Fourth 17-toa-di-10-tinh-thanh-4065969.html Quarter and the Whole Year 2021 (webpage). Duc, D. M., L. T. Vui, and B. T. T. Ha. 2020. Retrieved from https://www.gso.gov.vn/du-lieu-va- “Controlling the COVID-19 Pandemic in Vietnam: so-lieu-thong-ke/2021/12/bao-cao-tinh-hinh-kinh-te- Lessons from a Limited Resource Country.” Asia xa-hoi-quy-iv-va-nam-2021/ Pac J Public Health 32(4): 161–62. https://pubmed. Ha, B. T. T., L. Ngoc Quang, T. Mirzoev, N. T. Tai, P. ncbi.nlm.nih.gov/32429676/ Q. Thai, and P. C. Dinh. 2020. “Combating the General Department of Preventive Medicine. 2022. COVID-19 Pandemic: Experiences from Vietnam.” COVID-19 Update Newsletter June 30, 2022. International Journal of Environmental Research Retrieved from: https://vncdc.gov.vn/ban-tin-cap- and Public Health 17(9): 3125. doi:10.3390/ nhat-covid-19-ngay-3062022-nd16977.html ijerph17093125 52 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam References Hoang, V. M., J. Oh, T. A. Tran, T. G. H. Tran, A. D. Ha, Markovitz, Gayle. 2020. To Test or Not to Test? N. H. Luu, and T. K. P. Nguyen. 2015. “Patterns of Two Experts Explain COVID-19 Testing. World Health Expenditures and Financial Protections in Economic Forum (website), April 1, 2020. Retrieved Vietnam 1992–2012.” Journal of Korean Medical December 20, 2020, from https://www.weforum. Science 30(Suppl 2): S134–S138. doi:10.3346/ org/agenda/2020/04/to-test-or-not-to-test-2- jkms.2015.30.S2.S134 experts-explain-covid-19-testing/ International Labor Organization. 2020. Rapid Ministry of Finance of Vietnam. 2022. Assessment of the Impact of the COVID-19 https://www.sav.gov.vn/Pages/chi-tiet-tin. Pandemic on Businesses and Workers in Several aspx?ItemID=39274&l=TinTucSuKien Key Economic Sectors: Response, Adjustment, Ministry of Finance of Vietnam. 2021. Budgeting and Resilience. Hanoi: ILO. Retrieved from https:// and Finalization Report. Hanoi: Ministry of Finance. www.ilo.org/wcmsp5/groups/public/---asia/--- Retrieved from https://ckns.mof.gov.vn/Lists/News/ ro-bangkok/---ilo-hanoi/documents/publication/ DispForm.aspx?ID=30&InitialTabId=Ribbon.Read wcms_757928.pdf Ministry of Finance of Vietnam. 2020. Budgeting UN Women (United Nations Entity for Gender and Finalization Report. Hanoi: Ministry of Finance Equality and the Empowerment of Women) and (webpage). Retrieved from https://mof.gov.vn/ ILSSA (Institute of Labour Science and Social webcenter/portal/btcvn/pages_r/l/tin-bo-tai- Affairs). 2021. “The impact of the COVID-19 chinh?dDocName=MOFUCM198832 pandemic on ethnic minorities in Viet Nam, regarding their access social protection and direct Ministry of Industry and Trade. 2020. Official cash transfer policies, from a gender equality lens.” Dispatch No. 2698/BCT-DTDL, dated April 16, Hanoi: UN Women and ILSSA. Retrieved from 2020, on electricity price reduction and discounts https://vietnam.un.org/vi/157994-thao-luan-chinh- for customers affected by COVID-19. Ho Chi Minh sach-tac-dong-cua-den-cac-dan-toc-thieu-so-o- City: Ministry of Industry and Trade. Retrieved from viet-nam-tiep-can-cac-chinh https://thuvienphapluat.vn/cong-van/EN/Tai-chinh- nha-nuoc/Official-Dispatch-2698-BCT-DTDL-2020- Klingler-Vidra, Robyn, Ba Linh Tran, and Ida Electricity-price-discounts-for-customers-affected- Uusikyla. 2020. Testing Capacity: State by-Covid-19/440232/tieng-anh.aspx Capacity and COVID-19 Testing. Global Policy (website), April 9, 2020. Retrieved December 15, MOH (Ministry of Health of Vietnam). 2022a. “The 2020, at https://www.globalpolicyjournal.com/ Conference on Preliminary Review of Expanded blog/09/04/2020/testing-capacity-state-capacity- Immunization Work in 2021” (webpage), April 28, and-covid-19-testing 2022. Hanoi: MOH. Retrieved from https://vncdc. gov.vn/hoi-nghi-so-ket-cong-tac-tiem-chung-mo- Lâm, Lê Hoàng Việt, and Nguyễn Phước Thạnh. rong-nam-2021-nd16970.html 2020. “Government and Assertive Anti-Pandemic Policies COVID-19.” Press Release, March 6, MOH. 2022b. Focus on early handling of 2020. Retrieved from https://vietnamnet.vn/vn/ shortcomings and limitations of the health sector tuanvietnam/tieudiem/chinh-phu-va-nhung-chinh- (webpage). Retrieved from http://dongnaicdc.vn/ sach-quyet-doan-chong-dich-covid-19-630565. tap-trung-xu-ly-som-nhung-ton-tai-han-che-cua- html nganh-y-te Legal Library. 2021. Lawsoft/Legal Library (webpage). MOH. 2021. Website of COVID-19 pandemic in thuvienphapluat.vn. Retrieved from https:// Vietnam. Hanoi: MOH. https://ncov.moh.gov.vn/ thuvienphapluat.vn/en/index.aspx web/guest/trang-chu MOH. 2020a. 878/QĐ-BYT: Guidance on Medical Isolation in Concentrated Isolation Facilities against COVID-19. March 12, 2020. Hanoi: MOH. Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 53 References MOH. 2020b. COVID-19 information website of MOH. Prime Minister of Vietnam. 2020, March 4. Directive Hanoi: MOH. Retrieved from https://ncov.moh.gov. No. 11/CT-TTg: urgent objectives and solutions vn/ for assisting businesses facing difficulties and assurance of social welfare amid COVID-19 National Steering Committee for COVID-19 pandemic. Ho Chi Minh City: The Prime Minister. Prevention and Control. 2021a. Decision No. Retrieved from https://thuvienphapluat.vn/ 2686/QD-BCDQG, dated May 31, 2021, on issuing van-ban/EN/Thuong-mai/Directive-11-CT-TTg- “regulations on risk assessment and correct 2020-solutions-for-assisting-businesses-facing- administrative measures in prevention and control difficulties-amid-Covid-19-pandemic/438005/ against COVID-19.” Ho Chi Minh City: National tieng-anh.aspx Steering Committee for COVID-19 Prevention and Control. Retrieved from https://thuvienphapluat. Prime Minister of Vietnam. 2020, January 5. No. vn/van-ban/The-thao-Y-te/Quyet-dinh-2686-QD- 01/CT-TTg: Directive of the Prime Minister to BCDQG-2021-bien-phap-hanh-chinh-trong-phong- strengthen the prevention of COVID-19. Ho Chi chong-dich-dich-Covid-19-476067.aspx Minh City: The Prime Minister. Retrieved from https://m.thuvienphapluat.vn/van-ban/the-thao-y-te/ National Steering Committee for COVID-19 chi-thi-01-ct-ttg-2021-tang-cuong-phong-chong- Prevention and Control. 2021b. Summary of dich-benh-covid-19-461446.aspx Reports on COVID-19 Prevention and Control in Vietnam. Hanoi, Vietnam. Prime Minister of Vietnam. 2020. Directive No. 358/ CT-CHK: Prevention of acute respiratory infections NEU (National Economics University) and JICA caused by new strains of Coronavirus to aviation (Japan International Cooperation Agency). activities in Vietnam. Ho Chi Minh City: The Prime 2020. Assessment of the Policies to Respond Minister. to COVID-19 and Recommendations. Hanoi: NEU and Tokyo: JICA. Retrieved from https:// Prime Minister of Vietnam. 2013, January 9. Decision www.jica.go.jp/vietnam/vietnamese/office/topics/ No. 92/QD-TTg: Project to Reduce Hospital c8h0vm00009crmm6-att/210305_01_vn.pdf Overload in the Period 2013–2020. Ho Chi Minh City: The Prime Minister. Prime Minister of Vietnam. 2020, April 9. Resolution No. 42/NQ-CP: assistance for people affected by Quy, Thanh. 2019. “Human Resource Development COVID-19 pandemic. Ho Chi MInh City: The Prime in the Health Sector: Situation and Solutions.” Minister. Retrieved from https://thuvienphapluat.vn/ Communist Magazine, July 29, 2019. Retrieved van-ban/Lao-dong-Tien-luong/Resolution-42-NQ- from https://www.tapchicongsan.org.vn/web/guest/ CP-2020-assistance-for-people-affected-by-Covid- chuong-trinh-muc-tieu-y-te-dan-so/-/2018/515704/ 19-pandemic-439660.aspx phat-trien-nguon-nhan-luc-nganh-y-te--thuc-trang- va-giai-phap.aspx Prime Minister of Vietnam. 2020, March 21. 118/ TB-VPCP: Announcement: Conclusion of Prime Technology Center National COVID-19 Prevention Minister Nguyen Xuan Phuc, a government (website). 2022. https://covid19.ncsc.gov.vn/dulieu, standard meeting on the prevention and control accessed July 2, 2022. of COVID-19. Ho Chi Minh City: The Prime Minister. Thai, P. Q., M. A. Rabaa, D. H. Luong, D. Q. Tan, Retrieved from https://thuvienphapluat.vn/van-ban/ T. D. Quang, H. L. Quach, . . . M. Choisy. 2021. The-thao-Y-te/Thong-bao-118-TB-VPCP-2020-ket- “The First 100 Days of Severe Acute Respiratory luan-Thu-tuong-Chinh-phu-phong-chong-dich- Syndrome Coronavirus 2 (SARS-CoV-2) Control COVID-19-437870.aspx in Vietnam.” Clin Infect Dis 72(9): e334-e342. doi:10.1093/cid/ciaa1130 54 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam References Thanh, H. N., T. N. Van, H. N. T. Thu, B. N. Van, B. Vietnamplus. 2022. “More than 46.8% of Workers D. Thanh, H. P. T. Thu, . . . T. -A. Nguyen. 2020. in Ho Chi Minh City Are Affected by COVID- “Outbreak Investigation for COVID-19 in Northern 19,” January 4, 2022. Retrieved from https://www. Vietnam.” The Lancet Infectious Diseases 20(5): vietnamplus.vn/hon-468-lao-dong-o-thanh-pho-ho- 535–36. doi: 10.1016/S1473-3099(20)30159-6 chi-minh-bi-anh-huong-boi-covid19/766568.vnp Thanh Nien Magazine. 2021. “Zalo Becomes the VnExpress. Jan. 2022. 85 percent of Covid deaths Most Popular Messaging Application in Vietnam,” are unvaccinated: health ministry. January 21, June 4, 2021. Retrieved from https://thanhnien.vn/ 2022, Retrieved from https://e.vnexpress.net/ zalo-tro-thanh-ung-dung-nhan-tin-duoc-yeu-thich- news/news/85-percent-of-covid-deaths-are- nhat-viet-nam-post1074730.html unvaccinated-health-ministry-4419186.html Tien, Nguyen. 2020. “Binh Thuan Imposes Lockdown Vu, Minh, and Bich T. Tran. 2020. “The Secret on Two Streets to Tackle Coronavirus Outbreak.” to Vietnam’s COVID-19 Response Success: A Giai phong online, March 13, 2020. Retrieved review of Vietnam’s Response to COVID-19 and from https://sggpnews.org.vn/health/binh-thuan- Its Implications.” The Diplomat, April 18, 2020. imposes-lockdown-on-two-streets-to-tackle- Retrieved from https://thediplomat.com/2020/04/ coronavirus-outbreak-86025.html the-secret-to-vietnams-covid-19-response-success/ Tran, P. B., G. Hensing, T. Wingfield, S. Atkins, K. WHO (World Health Organization). 2020. Novel Sidney Annerstedt, J. Kazibwe, . . . K. Lönnroth. Coronavirus (2019-nCoV): Situation Report–1. 2020. “Income Security during Public Health Washington, DC: WHO. Retrieved from https:// Emergencies: The COVID-19 Poverty Trap in www.who.int/docs/default-source/coronaviruse/ Vietnam.” BMJ Glob Health 5(6). doi:10.1136/bmjgh- situation-reports/20200121-sitrep-1-2019-ncov. 2020-002504 pdf?sfvrsn=20a99c10_4 Tran, T. P. T., T. H. Le, T. N. P. Nguyen, and V. M. WHO. 2003. The World Health Report 2003— Hoang. 2020. “Rapid Response to the COVID-19 Shaping the Future. Washington, DC: WHO. Pandemic: Vietnam Government’s Experience Retrieved from https://www.who.int/news/item/28- and Preliminary Success.” Journal of Global 04-2003-viet-nam-sars-free Health 10(2): 020502–020502. doi:10.7189/ World Bank. 2022. World Development Indicators jogh.10.020502 (website). Washington, DC: World Bank. https:// UNFPA (United Nations Population Fund). 2020. datatopics.worldbank.org/world-development- The Impact of the COVID-19 Pandemic on Maternal indicators/themes/people.html Health and Family Planning in Vietnam. Technical World Bank Group. 2021. Economic Update Report Report. UNFPA. East Asia and Pacific—COVID-19 Persists. October. Van Cuong, L., H. T. N. Giang, L. K. Linh, J. Shah, Washington, DC: World Bank. Retrieved from L. Van Sy, T. H. Hung, . . . N. T. Huy. 2020. “The https://openknowledge.worldbank.org/bitstream/ First Vietnamese Case of COVID-19 Acquired handle/10986/36295/211799VT.pdf?sequence=18 from China.” The Lancet Infectious Diseases 20(4): Worldometer. 2020a. COVID-19 Coronavirus 408–09. doi:10.1016/S1473-3099(20)30111-0 Pandemic (website). Retrieved from https://www. Vietnamese Government. 2020a. “5K Message worldometers.info/coronavirus/ Launched in COVID-19 Pandemic Time,” Worldometer. 2020b. COVID-19 Coronavirus September 7, 2020. Retrieved from http://news. Pandemic (website): Reported Cases and Deaths chinhphu.vn/Home/5K-message-launched-in- by Country or Territory. Retrieved from https://www. COVID19-pandemic-time/20209/41455.vgp worldometers.info/coronavirus/#countries Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam | 55 PHOTO CREDITS Page 12: © People Image Studio / Shutterstock. Further permission required for reuse. © The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 17:  (NIHE) in Vietnam. Further permission required for reuse. © The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 18:  (NIHE) in Vietnam. Further permission required for reuse. © The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 20:  (NIHE) in Vietnam. Further permission required for reuse. © The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 21:  (NIHE) in Vietnam. Further permission required for reuse. © The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 23:  (NIHE) in Vietnam. Further permission required for reuse.  The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 24: © (NIHE) in Vietnam. Further permission required for reuse.  The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 26: © (NIHE) in Vietnam. Further permission required for reuse.  The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 27: © (NIHE) in Vietnam. Further permission required for reuse. Page 28: © CravenA / Shutterstock. Further permission required for reuse. © The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 30:  (NIHE) in Vietnam. Further permission required for reuse.  The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 32: © (NIHE) in Vietnam. Further permission required for reuse.  The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 36: © (NIHE) in Vietnam. Further permission required for reuse. © The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 37:  (NIHE) in Vietnam. Further permission required for reuse.  The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 38: © (NIHE) in Vietnam. Further permission required for reuse. © The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 41:  (NIHE) in Vietnam. Further permission required for reuse. © The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 43:  (NIHE) in Vietnam. Further permission required for reuse. © The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 44:  (NIHE) in Vietnam. Further permission required for reuse.  The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 45: © (NIHE) in Vietnam. Further permission required for reuse. Page 46: © amadeustx / Shutterstock. Further permission required for reuse.  The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 49: © (NIHE) in Vietnam. Further permission required for reuse. © The Communicable Disease Control and Prevention Department, National Institute of Hygiene and Epidemiology Page 51:  (NIHE) in Vietnam. Further permission required for reuse. 56 | Republic of Korea – World Bank Group Partnership on COVID-19 Preparedness and Response | Country Case Study: Vietnam