“I go to the ward every day, I know the case, I know there are no deaths,” said Thwaites, who also heads the Oxford University Clinical Research Unit in Ho Chi Minh City.

“If you have an unreported or uncontrolled community transmission, then we will see cases in our hospital, people who come with chest infections may not be diagnosed – it never happened,” he said.

So how does Vietnam seem to counter global trends and largely escape the specter of coronavirus? The answer, according to public health experts, lies in the combination of various factors, ranging from the government’s rapid initial response to preventing its spread, to strict contact tracing and quarantine and effective public communication.

Act early

Vietnam began preparing for a coronavirus outbreak weeks before the first case was detected.

At that time, Chinese authorities and the World Health Organization stated that there was no “clear evidence” for human-to-human transmission. But Vietnam doesn’t take risks.

“We are not just waiting for guidance from WHO. We are using data we have collected from outside and inside (the country to) decide to take action earlier,” said Pham Quang Thai, deputy head of the Department of Infection Control at the National Institute of Hygiene and Epidemiology in Hanoi .

Thwaites, an infectious disease expert in Ho Chi Minh City, said the speed of Vietnam’s response was the main reason behind its success.

“Their actions in late January and early February are far ahead of many other countries. And it is very helpful … for them to be able to maintain control,” he said.

Careful contact tracking

The initial decisive action effectively limited community transmission and kept only 16 confirmed cases in Vietnam on 13 February. For three weeks, there were no new infections – until the second wave struck in March, brought by Vietnamese returning from abroad.

Authorities closely track the confirmed coronavirus patient contacts and place them in mandatory two-week quarantine.

“We have a very strong system: 63 provincial CDCs (disease control centers), more than 700 district level CDCs, and more than 11,000 commune health centers. All of them connect contact tracing,” said Pham doctor with the National Institute of Hygiene and Epidemiology.

A confirmed coronavirus patient must provide a complete list of all the people he meets with health workers in the past 14 days. Announcements were placed in newspapers and broadcast on television to inform the public about where and when a corona virus patient called on people to go to the health authorities to test whether they were there at the same time, Pham said.

When Bach Mai hospital in Hanoi, one of the largest hospitals in Vietnam, became a coronavirus hotspot with dozens of cases in March, the authorities imposed a lock on the facility and tracked nearly 100,000 people associated with the hospital, including medical officers, patients, visitors and their close contacts, according to Pham.

“Using contact tracing, we found almost everyone, and asked them to stay at home and quarantine themselves, (and that) if they have symptoms, they can visit the health center for free testing,” he said.

The search for Vietnamese contacts was so thorough that it not only occurred after direct contact with an infected person, but also indirect contact. “That is one unique part of their response. I don’t think any country has carried out quarantine to that level,” Thwaites said.

As of May 1, around 70,000 people were quarantined at Vietnamese government facilities, while around 140,000 had been isolated at home or in hotels, the study said.

The study also found that of the first 270 Covid-19 patients in the country, 43 percent were asymptomatic cases – which he said highlighted the value of strict contact and quarantine tracking. If the authorities do not proactively look for people at risk of infection, the virus can spread silently in the community several days before being detected.

Public communication and propaganda

From the beginning, the Vietnamese government has been communicating clearly with the public about the outbreak.

Specialized websites, telephone hotlines and telephone applications were formed to update the public about the current situation of the plague and medical advice. The Ministry of Health also regularly sends reminders to residents via SMS messages.

Pham said on a busy day, the national hotline alone could receive 20,000 calls, not counting hundreds of provincial and district level hotlines.

Thwaites said that Vietnam’s rich experience in dealing with infectious diseases, such as the SARS epidemic from 2002 to 2003 and the subsequent bird flu, has helped the government and society better prepare for the Covid-19 pandemic.

“The population respects infectious diseases far more than many countries that might be more prosperous or countries that do not see many infectious diseases – Europe, Britain and the US for example,” he said.

“This country understands that these issues need to be taken seriously and in accordance with government guidelines on how to prevent the spread of infection.”