Spread of COVID-19 and policy responses in Vietnam: An overview

Psychological impacts of COVID-19 on Vietnamese health workers over the prolonged restricted COVID-19 responses: a cross-sectional study

OBJECTIVE

We assessed the psychological impact posed by COVID-19 and its associated factors on the healthcare workforce nationwide during the peak of Vietnam's fourth outbreak.

DESIGN

A cross-sectional study.

SETTING

Our study was conducted in 61 provinces of Vietnam.

METHODS

A total of 2814 healthcare professionals in 61/63 provinces of Vietnam. An online questionnaire using Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale-4 (PSS-4) and Generalised Anxiety Disorder-7 (GAD-7) scales was distributed randomly to a subgroup of 503 respondents.

PRIMARY AND SECONDARY OUTCOME MEASURES

To determine the impact of COVID-19 on the psychological of health workers, we conducted analyses to test a primary hypothesis related to participants based on three main scales including PHQ-9, PSS-4 and GAD-7 scales.

RESULTS

Nearly half (49.7%) of healthcare workers experienced mild depression symptoms, 34.0% underwent moderate anxiety symptoms and 49.3% reported high-stress levels. Respondents who had a monthly income below 5 million VND (~US$212) and had more than 3 days of duty per week had a higher score on the anxiety scales. Compared with medical doctors, nurses/midwives had lower PHQ-9 (Coef=-2.53; 95% CI=-3.71 to -1.36) and GAD-7 scores (Coef=-2.36; 95% CI=-3.56 L to -1.16). Increased workload and work time was the harmful factor that increase the PHQ-9, GAD-7 or PSS-4 scores. More than half (53.9%) of respondents stated no demand for mental healthcare services.

CONCLUSIONS

Health workers who gained less financial rewards are reported to have higher levels of mental distress than others, implying the need for a raise in basic salary as well as compensation and encouragement schemes. To tackle hesitancy in seeking mental help, integrating online mental health therapy with e-health consultations via social media can be strategically implemented to augment service delivery, and simultaneously enhance the standard of mental health services.

Enhancing human resilience beyond COVID-19-related stress: public responses to multi-benefits of home gardening

The SARS-CoV-2 virus has caused a public health crisis globally. Against the backdrop of global resilience, studies have demonstrated the therapeutic value of home gardening as a measure to strengthen human health. However, there is a lack of comparative studies on its benefits across countries. Studies need to examine the role of home gardening in improving public health in various societies to understand and encourage this practice broadly and effectively. We chose Taiwan, Thailand, and Vietnam as case studies, which have suffered substantial pandemic impacts, with millions of infections and thousands of deaths. We explored and compared the perceptions of people on home gardening and its health benefits during the COVID-19 pandemic. We conducted online surveys in three countries between May 1 and September 30, 2022, with a total of 1172 participants. Data were collated on perceived pandemic stress, challenges and solutions in gardening, home gardening intentions, and mental and physical health benefits. In these countries, we found that perceived pandemic stress positively affects home gardening intentions, whereby the motivation of Vietnamese people is the highest. Challenges hinder gardening intentions, while the solutions only positively affect gardening intentions in Taiwan and Vietnam. Home gardening intentions positively affect mental and physical health, whereby there are higher mental health benefits in Taiwanese people than in Thai people. Our findings potentially support public health recovery and promote healthy lifestyles during the COVID-19 pandemic.

Design and generation of mRNAs encoding conserved regions of SARS-CoV-2 ORF1ab for T cell-mediated immune activation

Aim

To generate mRNAs encoding conserved regions within SARS-CoV-2 ORF1ab which can induce strong T-cell responses to overcome the immune invasion of newly emergent variants.

Methods

We selected two conserved regions with a high density of T-cell epitopes using immunoinformatics for mRNA synthesis. The ability of testing mRNAs to activate T cells for IFN-γ production was examined by an ELISpot assay and flow cytometry.

Results

Two synthesized mRNAs were successfully translated in MDA-MB-231 cells and had comparable potency to the spike mRNA to induce CD4+ and CD8+ T-cell responses in peripheral blood mononuclear cells in 29 out of 34 participants.

Conclusion

This study provides a proof-of-concept for the use of SARS-CoV-2 conserved regions to develop booster vaccines capable of eliciting T-cell-mediated immunity.

Education and training for infection prevention and control provided by long-term care homes to family caregivers: a scoping review protocol

OBJECTIVE

The objective of this review is to map the infection prevention and control education and training that long-term care homes use with families during a pandemic or infectious outbreak.

INTRODUCTION

During the COVID-19 pandemic, restrictions were imposed on visits to long-term care homes to decrease the risk of virus transmission. These restrictions had negative consequences for both residents and families. A scoping review of infection prevention and control education and training used with families will inform family visitation practices and policies during future infectious outbreaks.

INCLUSION CRITERIA

This review will examine literature describing infection prevention and control education and training provided to families in long-term care homes. Research and narrative papers, including experimental, quasi-experimental, descriptive observational quantitative and qualitative studies, reviews, text, policy, and opinion papers, will be considered for inclusion.

METHODS

A 3-step approach will be followed, in line with the JBI methodology for scoping reviews. Published literature will be searched for in databases including CINAHL, Embase, ERIC, MEDLINE, and AgeLine. Published and unpublished papers will be considered from 1990 to the present, in English or in French. The World Health Organization, Centers for Disease Control, and the Public Health Agency of Canada websites will be searched for unpublished and gray literature. Two authors will independently review and assess studies for inclusion and extract the data. The findings will be charted in a narrative summary and tables.

Health-Related Quality of Life Among Patients Recovered From COVID-19

The Coronavirus disease 2019 (COVID-19) has impacted the lives and well-being of individuals worldwide, affecting both short-term and long-term quality of life. This study aimed to assess health-related quality of life (HRQoL) and associated factors among patients who have recovered from COVID-19. A cross-sectional survey was conducted at 2 hospitals in Ho Chi Minh City, Vietnam between January and March 2022. Data were obtained from patients who recovered from COVID-19 using a structured questionnaire which included the EuroQoL-5 Dimension-5 Level (EQ-5D-5L) scale to quantify problems in 5 health dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) and the EuroQoL-Visual Analog Scale (EQ-VAS) to determine self-rated health status. Factors associated with HRQoL were determined using a generalized linear model (GLM). A total of 325 participants were included in the analysis. The overall mean score from the EQ-5D-5L and EQ-VAS was 0.86 (SD 0.21) and 78.6 (SD 19.9), respectively. Anxiety/Depression and Pain/Discomfort were the major problems experienced by the participants. Lower HRQoL scores were reported among those who were 60 years and older, female, had comorbidities, persistent symptoms, living alone and experiencing stress (all P < .05). This study showed that there was a significant reduction in HRQoL among individuals who recovered from COVID-19, compared with the general population. The findings suggest that more interventions need to be implemented to increase such individuals' quality of life, particularly for those who exhibit high-risk factors such as females, those with comorbidities, persistent symptoms, living alone and experiencing from stress.

Uneven stigma loads: Community interpretations of public health policies, 'evidence' and inequities in shaping Covid-19 stigma in Vietnam

The infectious spread of COVID-19 has been accompanied by stigma in both global and local contexts, sparking concern about its negative effect on individuals, communities, and public health responses. The changing epidemiological context of the COVID-19 epidemic and evolving public health responses during the first year of the pandemic (2020) in Vietnam serve as a case study to qualitatively explore the fluidity of stigma.

We conducted in-depth interviews with 38 individuals, (13 cases, 9 close contacts, and 16 community members) from areas affected by local outbreaks. Thematic analysis was conducted iteratively.

Our analysis indicates that the extent and impacts of COVID-19-related stigma were uneven. Adapting the clinical term 'viral load' as a metaphor, we describe this variation through the wide range of 'stigma load' noted in participants' experiences. Individuals encountering more acute stigma, i.e. the highest 'stigma load', were those associated with COVID-19 at the start of the local outbreaks. These intensively negative social responses were driven by a social meaning-making process that misappropriated an inaccurate understanding of epidemiological logic. Specifically, contact tracing was presumed within the public consciousness to indicate linear blame, with individuals falsely considered to have engaged in 'transgressive mobility', with onward transmission perceived as being intentional. In contrast, as case numbers grew within an outbreak the imagined linearity of the infection chain was disrupted and lower levels of stigma were experienced, with COVID-19 transmission and association reframed as reflecting an environmental rather than behavioural risk.

Our findings demonstrate the role of public health policies in unintentionally creating conditions for stigma to flourish. However, this is fluid. The social perceptions of infection risk shifted from being individualised to environmental, suggesting that stigma can be modified and mitigated through attending to the productive social lives of public health approaches and policies.

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Those associated with COVID-19 experienced variable degrees of stigma - 'stigma load'.

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Those linked to COVID-19 at the start of outbreaks experienced highest stigma load.

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Misinterpretation of public health strategies contributed to blaming discourses.

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Stigma receded when risk framed as environmental not behavioural.

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Fluidity of stigma suggests potential to allay stigmatising effect of interventions.

Close contact behavior-based COVID-19 transmission and interventions in a subway system

During COVID-19 pandemic, analysis on virus exposure and intervention efficiency in public transports based on real passenger's close contact behaviors is critical to curb infectious disease transmission. A monitoring device was developed to gather a total of 145,821 close contact data in subways based on semi-supervision learning. A virus transmission model considering both short- and long-range inhalation and deposition was established to calculate the virus exposure. During rush-hour, short-range inhalation exposure is 3.2 times higher than deposition exposure and 7.5 times higher than long-range inhalation exposure of all passengers in the subway. The close contact rate was 56.1 % and the average interpersonal distance was 0.8 m. Face-to-back was the main pattern during close contact. Comparing with random distribution, if all passengers stand facing in the same direction, personal virus exposure through inhalation (deposition) can be reduced by 74.1 % (98.5 %). If the talk rate was decreased from 20 % to 5 %, the inhalation (deposition) exposure can be reduced by 69.3 % (73.8 %). In addition, we found that virus exposure could be reduced by 82.0 % if all passengers wear surgical masks. This study provides scientific support for COVID-19 prevention and control in subways based on real human close contact behaviors.

Containment strategy during the COVID-19 pandemic among three Asian low and middle-income countries

Background

COVID-19 has not been effectively controlled, seriously threatening people’s health and socioeconomic development. This study aims to summarise the successful experiences and lessons in containment strategy learned from Asian Low- and Middle-Income Countries (LMICs) during the COVID-19 pandemic and analyse the effectiveness of their measures to provide lessons for LMICs in general.

Methods

This is a retrospective study on the effectiveness of China, India, and Vietnam’s containment strategies. The objective was to assess the effectiveness of measures taken for COVID-19 and provide lessons for wider LMICs in controlling and preventing the COVID-19 pandemic.

Results

As of June 16, 2021, the Indian epidemic was in the declining part of the rebound stage, with a total of 21 521.900 cases per million and 276.740 deaths per million – both the highest among the three countries. Entering the normalised prevention and control stage, China stably remained at a total of 63. 615 cases per million and 3.211 deaths per million. Vietnam's number of new cases per million was very low in the first stage and almost stagnant except for cluster epidemics. In May 2021, the number of new cases per million started to rapidly increase, but the total of deaths per million was at the low level of 0.627.

Conclusions

A high attention to epidemics at early stages, strict border control measures, and synchronization of government and population on COVID-19 prevention and control opinions and behaviours play important roles in designing containment strategies. In addition, rapid close contact tracing and large-scale nucleic testing are good options for response to cluster epidemics.

Surveillance and pandemic governance in least‐ideal contexts: The Philippine case

This paper inquires how surveillance manifests in least‐ideal contexts (LICs), that is, countries with resource constraints, poor governance and proclivity for populism during COVID‐19, and its implications for crisis governance. Using the Philippines as a case, we advance three arguments. First, LICs can become spaces where inappropriate surveillance is undertaken. Second, liminal surveillance practices can become permanent policy fixtures in LICs. Finally, when a prevailing crisis approach of a government is perceived to be inconsistent with the needs of the public, it can lead to a self‐help system among various societal groups and actors. This self‐help system may not necessarily be aligned with the general direction of the national government. As a result, it can perpetuate a disjointed and maladaptive crisis governance approach, where main actors like national governments, and complementary actors like private sector firms, local government units and citizen organizations pursue goals independent of one another.

Are Stringent Containment and Closure Policies Associated with a Lower COVID-19 Spread Rate? Global Evidence

Stringent government policies, in general, and strict containment and closure policies in particular including workplace closing, restrictions on gatherings, close of public transport, stay-at-home order, restrictions on internal movement, and international travel control are associated with a lower spread rate of COVID-19 cases. On the other hand, school closures and public event cancellations have not been found to be associated with lower COVID-19 spread. Restrictions on international travel and the closing of public transport are two policies that stand out and have a consistent and slowing effect on the spread of COVID-19. The slowing effect of the containment and closure policies on the spread of COVID-19 becomes stronger one week after the policies have been implemented, consistent with the SARS-CoV-2 transmission pattern and the incubation period evolution. Furthermore, the slowing effect becomes stronger for culturally tight countries and countries with a higher population density. Our findings have important policy implications, implying that governments need to carefully implement containment and closure policies in their own countries’ social and cultural contexts, with an emphasis on the ideas of the common interest, personal responsibility, and the sense of community.

Demand for Mobile Health in Developing Countries During COVID-19: Vietnamese's Perspectives from Different Age Groups and Health Conditions

BACKGROUND

Vietnam's economy and intellectual standards have witnessed significant development, improving conditions for residents to acquire novel mHealth applications. Additionally, the outbreak of the COVID-19 pandemic has influenced Vietnamese awareness of healthcare; however, previous studies have only been clinician-centered rather than customer-centered.

METHODS

This study addresses this literature gap by interviewing 50 Vietnamese participants grouped by age, namely Generation X, Generation Y, and Generation Z, and health conditions, namely whether participants or family members have chronic illness. The study utilized semi-structured and in-depth interviews to collect the data and used thematic analysis to analyze the data under the unified theory of acceptance and use of technology framework.

RESULTS

Most participants were willing to adopt this technology and demanded a convenient and user-friendly one-stop-shop solution, endorsements from credible and authoritative sources, and professional customer services. However, each group also had distinctive demands and behaviors.

CONCLUSION

This study contributes theoretically by providing context-rich demand for Vietnamese customers across three generations and healthcare conditions during the COVID-19 pandemic and comparing their behavior with pre-COVID literature. While this research provides helpful information for potential app developers, this study also suggests that mHealth developers and policymakers should pay more attention to the differences in the demand of age groups and health conditions.

A year of living distantly: global trends in the use of stay-at-home orders over the first 12 months of the COVID-19 pandemic

During the first year of the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) were the main pillar of defence to protect human society against the virus. While a variety of modelling studies try to quantify the effects of NPIs, this paper investigates when and how national and subnational governments have taken actions. We observe longitudinal changes in the global pattern of policymaking to combat the COVID-19 pandemic, with a particular focus on stay-at-home orders. Drawing on data from the Oxford COVID-19 Government Response Tracker, we show several important trends. First, while national governments exhibited a strong alignment in policy settings initially in March and April 2020, their cross-country policy heterogeneity has grown since May 2020, although countries within global regions continue to display similarities in their approaches. Second, most governments that have implemented multiple stay-at-home orders over the course of the pandemic have become less sensitive to case levels (insofar as they implement subsequent restrictions at progressively higher case levels), apart from a small number of contrast cases which have mostly eliminated domestic community transmission. Third, pandemic policies are increasingly specific to subnational levels, and there is often significant heterogeneity with regard to policy approaches even within the same country.

An analysis of the impact of policies and political affiliation on racial disparities in COVID-19 infections and deaths in the USA

This research aimed to quantify the racial disparities of COVID-19 for primarily positive tests and deaths across the US and territories individually and collectively. The first research hypothesis investigated whether positive cases and death rates were higher for people of color (POC) than the White ethnic group. The second hypothesis examined whether there is a significant difference in confirmed positive cases and death rates between ethnic groups across the US and territories. The third hypothesis investigated if political party control and governmental policies affected the number of cases and death proportion rates across ethnic groups. The research findings suggest that POC positive cases and death rates were higher in some states. Black ethnic groups were dying at a high rate in the southeastern states, the District of Columbia, and in Maryland. Specifically, in the District of Columbia, the death rate is five times higher than the White ethnic group. For Latinx ethnic groups, the high cases and death rates have mostly occurred in western states, including Texas. The Latinx ethnic group accounted for half the total deaths in Texas and California. The Latinx ethnic group death rate is higher than the White ethnic group in four states: Texas, California, New Mexico, and the District of Columbia. The research findings also show that the rate of deaths and cases per ethnic group for policies and political factors were significant except for the mask mandate policy. Based on the analyzed data, mask mandates were not a factor in the cases or death rates of any ethnic group. Each state's policies for bars, curfews, public schools, and travel-along with legislative party control-had the most influences across ethnic groups. The research results for the death rates and number of cases due to these implemented policies varied between ethnic groups.

The Contribution of Digital Health in the Response to Covid-19 in Vietnam

Emerging from early of 2020, the COVID-19 pandemic has become one of the most serious health crisis globally. In response to such threat, a wide range of digital health applications has been deployed in Vietnam to strengthen surveillance, risk communication, diagnosis, and treatment of COVID-19. Digital health has brought enormous benefits to the fight against COVID-19, however, numerous constrains in digital health application remain. Lack of strong governance of digital health development and deployment; insufficient infrastructure and staff capacity for digital health application are among the main drawbacks. Despite several outstanding problems, digital health is expected to contribute to reducing the spread, improving the effectiveness of pandemic control, and adding to the dramatic transformation of the health system the post-COVID era.

The Levels of COVID-19 Related Health Literacy among University Students in Vietnam

Background

Vietnam is among the few countries that were successful in the fight against the first wave of coronavirus disease 2019 (COVID-19). However, subsequent domestic outbreaks of COVID-19 continue to occur. To sharp the community education program to guarantee the final success in the fight against COVID-19 in Vietnam and comparable countries, we examined the levels of COVID-19 knowledge and associated predictors among university students in Vietnam.

Materials and Methods

A cross-sectional study was conducted on all students enrolling at Phenikaa University using a self-developed questionnaire consisted of 20 questions regarding COVID-19's risk factors, transmission routes, symptoms, and prevention.

Results

Among 728 participants, 40.9% were male, 63.2% studied health-related majors, and 18.1% lived alone. Correct response rates ranged from 25.3% to 98.9% across 20 questions. Only 51.9% (378/728) of participants had good knowledge levels. Studying health majors (adjusted odds ratio [AOR] 0.547, 95% confidence interval [CI] 0.398 - 0.751, P <0.001), and living with the seniors (AOR 0.612, 95% CI 0.389 - 0.963, P = 0.034) or with friends (AOR 0.405, 95% CI 0.252 – 0.650, P <0.001) were negatively associated with a poor level of COVID-19 knowledge.

Conclusion

The proportion of university students having good knowledge levels is suboptimal. It is essential to improve the quality of COVID-19 education with a more focus on not only the preventive measures, but also the disease itself. More studies are needed to improve the level of COVID-19 knowledge among those living alone or do not study health-related majors.

Impact of the COVID-19 pandemic on clinical research activities: Survey of study participants and health care workers participating in a hypertension trial in Vietnam

BACKGROUND

The COVID-19 pandemic has had a profound worldwide impact. Vietnam, a lower middle-income country with limited resources, has successfully slowed this pandemic. The objectives of this report are to explore the impact of the COVID-19 pandemic on the research activities of an ongoing hypertension trial using a storytelling intervention in Vietnam.

METHODS

Data were collected in a mixed-methods study among 86 patients and 10 health care workers participating in a clinical trial designed to improve hypertension control. Several questions related to the impact of COVID-19 on patient's daily activities and adherence to the study interventions were included in the follow-up visits. A focus group discussion was conducted among health care workers to discuss the impact of COVID-19 on research related activities.

RESULTS

Fewer patients in the intervention group reported that they faced difficulties in adhering to prescribed study interventions, wanted to receive a call from a dedicated hotline, or have a visit from a community health worker as compared with those in the comparison group. Most study patients are willing to participate in future health research studies. When asked about the potential use of mobile phones in health research studies, fewer patients in the intervention group felt comfortable using a mobile phone for the delivery of intervention and interviews compared with those in the comparison condition. Community health workers shared that they visited patient's homes more often than previously due to the pandemic and health care workers had to perform more virus containment activities without a corresponding increase in ancillary staff.

CONCLUSIONS

Both patients and health care workers in Vietnam faced difficulties in adhering to recommended trial interventions and procedures. Multiple approaches for intervention delivery and data collection are needed to overcome these difficulties during future health crises and enhance the implementation of future research studies.

TRIAL REGISTRATION

ClinicalTrials.gov. Registration number: https://clinicaltrials.gov/ct2/show/NCT03590691 (registration date July 17, 2018).

Epidemiology, clinical spectrum, viral kinetics and impact of COVID-19 in the Asia-Pacific region

COVID-19 has hit the world by surprise, causing substantial mortality and morbidity since 2020. This narrative review aims to provide an overview of the epidemiology, induced impact, viral kinetics and clinical spectrum of COVID-19 in the Asia-Pacific Region, focusing on regions previously exposed to outbreaks of coronavirus. COVID-19 progressed differently by regions, with some (such as China and Taiwan) featured by one to two epidemic waves and some (such as Hong Kong and South Korea) featured by multiple waves. There has been no consensus on the estimates of important epidemiological time intervals or proportions, such that using them for making inferences should be done with caution. Viral loads of patients with COVID-19 peak in the first week of illness around days 2 to 4 and hence there is very high transmission potential causing community outbreaks. Various strategies such as government-guided and suppress-and-lift strategies, trigger-based/suppression approaches and alert systems have been employed to guide the adoption and easing of control measures. Asymptomatic and pre-symptomatic transmission is a hallmark of COVID-19. Identification and isolation of symptomatic patients alone is not effective in controlling the ongoing outbreaks. However, early, prompt and coordinated enactment predisposed regions to successful disease containment. Mass COVID-19 vaccinations are likely to be the light at the end of the tunnel. There is a need to review what we have learnt in this pandemic and examine how to transfer and improve existing knowledge for ongoing and future epidemics.

A Cross-Sectional Study of Knowledge, Attitude, and Practice Towards Face Mask Use Amid the COVID-19 Pandemic Amongst University Students in Vietnam

Although Vietnam has been successful in the fight against the first wave of COVID-19, domestic outbreaks have continued to occur. Given university students constitute a significant proportion of the population in Vietnam, to improve the prevention and control of COVID-19 in Vietnam and comparable countries, we examined their knowledge, attitude, and practice (KAP) towards face mask use which is an important preventive measure and the association between the levels of COVID-19 knowledge and KAP towards face mask use. A cross-sectional survey was conducted on all students studying at Phenikaa University, Hanoi, using a self-developed questionnaire consisted of 42 questions regarding KAP towards face mask use as well as reuse of cloth mask, and COVID-19 knowledge. Among 728 participants, 40.9% (298/728) were male, 63.2% (460/728) were from health-related faculties, 46% (335/728) lived in urban areas, and 51.9% (378) had good levels of COVID-19 knowledge. Regarding face mask, most (89.7%, 653/728) participants had good knowledge scores, 72.8% (530/728) had positive attitudes, and 76.5% (557/728) had good practice scores. The most common types of masks used were surgical mask (57.6%, 419/728), followed by non-antibacterial cloth mask (23.1%, 168/728). Among 168 participants using non-antibacterial cloth mask, 43.5% reused masks (73/168), of whom 6.8% (5/73) did not wash their masks at least daily. Face mask use knowledge was statistically associated with COVID-19 knowledge (P < 0.001). Face mask use attitudes were statistically associated with education levels (P = 0.02), and COVID-19 knowledge (P < 0.001). Practice of face mask use was statistically associated with gender (P = 0.03), geographical distribution (P = 0.04), academic majors (P = 0.02), and COVID-19 knowledge (P = 0.01). The levels of KAP towards face mask use among Vietnamese university students are high. It is important to continue to enforce the mass masking policy, together with the ongoing community education with an emphasis on the route of COVID-19 transmission and how correct face mask use can stop the spread. To ensure the effectiveness of face masks, there is an urgent need to educate the community regarding the procedures for cloth masks re-use.