Data-driven decisions

Before the central city of Da Nang imposed a strict lockdown for a week, starting from August 16, the city's leaders made an important move to attract the trust and consensus of the people.

Director of the Department of Health Ngo Thi Kim Yen broadcast live from the meeting of the Da Nang People's Council and said that the city has about 2,500 beds for Covid-19 patients and 300 beds for resuscitation with ventilators and dialysis machines.

“However, these are the best and maximum efforts. If the city has more than 6,000 patients, with 5% as severe cases, we can only serve a maximum of 300 patients. If we have over 6,000 patients, the health system will be overwhelmed. Therefore, controlling the epidemic situation and reducing the number of infection cases requires drastic and strong action."

By 8 am on August 16, the streets of Da Nang were empty. Photo: Ho Giap

Da Nang experienced a second wave of the epidemic, leading to a city-wide blockade in August 2020. At that time, the city was criticized for imposing a drastic lockdown for a whole month, resulting in a growth rate of -9.1%.

But this time, when the Delta strain is very contagious with tragic consequences to human life, livelihood and economics, especially in southern provinces, there have been very few complaints on the media and social networks in Danang.

The publicity and transparency of the head of the local Department of Health about the weak state of the health system helped people understand, and they sympathized and shared with the local government.

Meanwhile, Hanoi leaders are also making great efforts to ensure accountability to the people.

For example, there was a difference between the recent data on new cases of Covid-19 infections of Hanoi and the Ministry of Health, which worried people.

At that time, Director of the Hanoi Department of Health Tran Thi Nhi Ha explained that the difference was due to the different updating times of the city and the Health Ministry, but the cumulative number of cases was the same. "The announcement of Hanoi's Covid-19 cases is accurate and done to make it transparent for the people," Ha pledged.

Secretary of the Hanoi Party Committee Dinh Tien Dung repeatedly explained to local people when the city implemented social distancing under Directive 16. The city is trying to increase testing capacity to 200,000 samples/day; quarantine capacity to 50,000 people; capacity of treatment beds to 40,000. It is establishing active resuscitation centers to receive and treat serious and critical patients.

However, these numbers are small compared to the city’s population of more than 8 million, and Hanoi lacks vaccines as the vaccine supply is prioritized for the southern provinces. Mr. Dung explained: “The fact shows that, without timely implementation of social distancing, Hanoi may not be able to maintain the current situation."

Statements in the direction of publicity, transparency and accountability about the treatment capacity of the health system and the risk of disease spread from the leaders of Hanoi, Da Nang and many provinces and cities are very important to gain the trust of the people.

However, these figures are still insufficient. At the national level, a lot of other data needs to be added in the health, economic and social fields.

It is necessary to fight the epidemic and impose social distancing based on data analysis and scientific evidence to make decisions. It is necessary to establish in advance special teams for important tasks such as buying ventilators and oxygen, or pre-design anti-epidemic procedures...

Scientific and humanistic approach needed

Doctors check machines before putting them into use at the No. 14 field hospital in Tan Phu district, Ho Chi Minh City. Photo: Thanh Tung

Recently, Director of the Medical Examination and Treatment Administration Luong Ngoc Khue said about the shift of Covid-19 treatment strategy: “Based on international experience and the clinical symptom model, the health sector will develop guidelines on treatment and management of infections at home. At that time, each family will become a 'home care' or a medical room."

He explained: “In addition to field hospitals specializing in treating Covid-19 patients, other hospitals have to split into two, performing dual tasks at the same time: treating ordinary patients and treating Covid-19 patients".

This strategy was confirmed by officials of the Ministry of Health a few times before, when Ho Chi Minh City proposed isolating Covid patients at home because the health system was overloaded and the doctors and nurses exhausted.

“Tracing, zoning, isolation”: Vietnam’s treatment policy is both good and bad. The good thing Ned's not to be repeated because everyone knows Vietnam’s anti-epidemic achievements, which were recognized by the world. But there are also bad ones.

Whenever an F0 case is detected, the factory, hospital, market, office... is locked down and all F1 cases are quarantined. This practice causes psychological fear, avoidance and risk of epidemic spread, while suffocating production and circulation of businesses and people's livelihoods.

We've focused too much on prevention, with effort and money poured into operating quarantine centers, where 80% people are asymptomatic or have mild symptoms. The treatment stage with ventilators, medicines, and hospital beds would have been upgraded if resources had been shared from the prevention stage.

In recent weeks, when HCM City was no longer able to give concentrated quarantine and treatment to F0 cases, new strategies were introduced, including the home quarantine policy.

Vietnam’s crude death rate is 0.63%, according to the General Statistics Office, which means that every year the country has about 620,000 deaths, or an average of 1,700 deaths every day. Many of those needed care, and of course, and many more patients beyond that need medical care, not only F0 and F1 cases.

A sociologist calculated that the overall crude death rate of Ho Chi Minh City was 4.7‰ in 2019, of which, according to the cause of fatality, deaths due to disease accounted for 95%. Assuming the numbers stay the same in 2021, with a population of about 9.42 million, the projected death toll from disease would be 42,060, or 115 people dying of diseases on average per day.

From that situation, it is clear that people with serious diseases such as cancer, stroke, and others face the risk of not receiving medical care. Moreover, people who have sudden and urgent illnesses such as appendicitis, accidents, injuries, and others can turn serious without urgent medical care.

These figures should be calculated in relation to the view of minimizing the number of F0 cases and deaths by serious locked down measures.

In the process of implementing the strictest anti-epidemic measures, two groups of essential activities must be ensured.

The first is public health care. Patients must receive medical treatment, telemedicine consultation and emergency care. The second is to maintain essential activities such as providing meals so that the ill and people in the blockade area. And that's not to mention the mental health factor.

If either of the two factors is not ensured due to efforts to reduce the number of F0 cases and deaths by strict blockades, it will lead to a sadder consequence: the number of deaths from other diseases will be greater than the number of deaths due to Covid-19.

Experience from the EU

This strategy has actually been implemented by European countries from the beginning of the epidemic. In the UK, in May 2020, two months after the outbreak of the epidemic, the British Prime Minister drafted a 130-page plan summarizing the government's assessment of the risk of the disease and the government's crisis response presented to Parliament, widely publicized to the people.

The presentation summarizes the main points of the assessment of the epidemic, its impact on society, including economic and social losses, health risks, travel restrictions, possible risks, and accompanying solutions, especially ensuring social welfare for the people.

The strategy has two parts. The first is the vaccine: The government funds, researches, orders, and tries its best to have vaccines as soon as possible. In parallel, it is to limit social communication to limit the risk of disease transmission, and also to fund the health system by urgently providing necessary medical equipment. For the British, the solutions are all based on science, technology and data.

Tu Giang

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