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Reviewing 4 waves of Covid-19 in Vietnam from February 2020 to June 2021

Since early 2020, Vietnam has experienced 4 waves of Covid-19 infection.

With a population of 97.6 million (2020), Vietnam is considered to have Covid-19 outbreak when it has at least 976 patients. In the first 3 waves, the number of patients under treatment was under 976. By April 30, 2021, Vietnam had Covid-19 infections, but there was no epidemic at the national level. Vietnam was among 20 countries that did the best in epidemic prevention in the world.

However, the fourth wave of infections has a qualitatively different nature:

- In the previous three waves of infection, it took about 22 days (March 8, 2020 - March 29, 2020; July 27, 2020 - August 17, 2020; January 1, 2021 - February 17, 2021) to reach the peak. For the fourth wave, 36 days have passed and it still has not reached the peak and it is difficult to predict when the current wave will reach its peak. Most likely, the fourth wave will not peak before June 30, 2021, which means the outbreak time is at least 56 days, 2.5 times more than that of the previous three waves.

- Although the peak has not been reached, the number of people being treated has surpassed 6,000, more than 8.4 times over the peak of the 3rd wave, while the peak of the 3rd wave is only 1.4 times higher than that of the 2nd wave. Most likely, when the 4th wave reaches the peak, the number of people under treatment will be over 7,500, more than 10 times higher than that of the 3rd wave.

- In the first three waves, the number of patients per 1 million people when the epidemic reaches its peak was still lower than the epidemic threshold of Vietnam - 976 people. That means Vietnam had Covid-19 infections but not on a national scale. But in the 4th wave of infection, the number of people under treatment was 1,098 on May 13, surpassing the epidemic threshold of 976 people. Vietnam has had a Covid-19 outbreak on a national scale.

- In the first wave of infection, during the time when the disease broke out strongly before reaching its peak, Vietnam had nearly six new patients each day. The numbers were 20 people in the second wave, nearly 29 people in the third wave, and up to 156 people in the 4th wave, from May 5 to June 10. That is, in the current 4th wave of infection, community infection is over five times higher than that of the 3rd wave, and over 25 times than in the first wave.

Without breakthrough solutions, after the fourth wave hits the peak (most likely on June 30), it will take about three more months (90 days) for the number of Covid-19 patients under treatment to decrease to the level before the 4th wave out began (May 5) - less than 500 people. Such a long time of nearly five months will cause great damage to people's lives and economic activities.

The current epidemic situation and preliminary forecasts require breakthrough solutions to stamp out the epidemic, in order to bring lives back to the new normal.

Breakthrough solutions needed in next 3 months

Since May 5, the rate of infection in the community has been almost unchanged. It took about seven days for the number of people under treatment to increase from 1,000 to 2,000, from 2,000 to 3,000 people within about six days, from 3,000 to 4,000 within about four days, from 4,000 to 5,000 within about six days, and from 5,000 to 6,000 within five days. On average, Vietnam has an additional 1,000 people that need to be treated every week.

To stamp out the epidemic, it is necessary to reduce the increase in the number of people being treated in hospitals every day, which is currently an average of 156 people each day, to 0 people/day, then decreasing until the total number of people being treated does not exceed 976.

At present, 46 out of 63 provinces and cities have Covid-19 patients, but the distribution is very uneven among them. Out of a total of 6,068 patients as of 7am, June 11:

- 17 provinces that account for 15.83% of the country's population (15.45 million people) had no patients.

- 25 provinces and cities that account for 40.38% of the country's population (39.41 million people), had only 106 infected people, or 2.69 patients/1 million people so they are considered to be experiencing an outbreak. 

- There are 21 provinces and cities, which account for 43.79% of the country's population (42,742 million people), with 5,962 patients, accounting for 98.3% of the total number of patients in the country. These provinces and cities are considered to have an outbreak. Among these, Bac Giang province had the highest number of patients, with up to 3,454 people; followed by Bac Ninh province with 963 patients; Ho Chi Minh City (613); and Hanoi (317).

The two provinces of Bac Giang (with a population of 1.841 million) and Bac Ninh (1.419 million) account for only 3.3% of the country's population, but they had up to 72.8% of the patients. If vaccination is given to 70% of the population of Bac Giang and Bac Ninh, priotizing workers, civil servants and public employees in the health, education, state management, police, military, and people with underlying diseases, we can eliminate 72.8% of the infection source of the whole country. The number of people who need vaccination is 2.28 million, only 2.33% of the national population.

There are more than 1 million people are members of the frontline force against Covid and those who face high risks of infection in the whole country. It is necessary to concentrate enough vaccines to vaccinate 2.28 million people in Bac Giang and Bac Ninh in June and July. This is the fastest way to stamp out the pandemic.

Ho Chi Minh City (with a population of 9.227 million) and Hanoi (8.28 million) account for 17.9% of the country's population and 15.3% of the total number of patients. They are the two localities with the highest population density in the country and high potential for infection. If vaccinating 70% of the population of Hanoi and Ho Chi Minh City, 15.3% of the country's infection source will be eliminated. The number of people who need to be vaccinated in these two cities is 12.25 million people, equal to 12.55% of the country's population.

It is necessary to mobilize enough vaccines to vaccinate 12.25 million people in Hanoi and Ho Chi Minh City in July and August.

If we do it that way, within three months (June to August), we only need to vaccinate 14.53 million people, equal to 14.9% of the population, to eliminate more than 88% of the source of infection, completely stamping out the epidemic in the whole country.

If we can buy more vaccines, the remaining 17 provinces and cities with Covid-19 patients, including Lang Son, Dien Bien, Vinh Phuc, Da Nang, Ha Nam, Kien Giang, Khanh Hoa, Ba Ria - Vung Tau, Ha Tinh, Tay Ninh, Hai Duong, Soc Trang, Hung Yen, Ben Tre, Long An, Thai Binh, Quang Nam, with a total population of 21.975 million, equal to 22.5% of the country's population and 10 .1% of the total number of Covid-19 patients in the country. The number of people who need vaccination is 15.38 million people.

If the vaccination in these provinces can be implemented in August and September, then we will have vaccinated 30.91 million people, equal to 31.7% of the population, and will eliminate 98. 3% of the country's current sources of infection.

After that, if Vietnam has more vaccines, the people in 25 provinces and cities that have a very small number of patients will be vaccinated. These provinces have a total population of 39.41 million so the number of people who need vaccination is 27.59 million.

By November, if we have more vaccines to vaccinate the people in the 17 provinces that are currently free of Covid-19, with a population of 15.45 million, we will complete the vaccination for 70% of the country's population. The number of people who need vaccination in these 17 provinces is 10.82 million.

The breakthrough solution proposed here to stamp out the current 4th wave is the optimal vaccination route: Vaccinations should be completed in each province and city in order of priority, based on the current situation of the pandemic.

Prof. Nguyen Thien Nhan

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