Adjusting approaches to fight the COVID-19 pandemic

Two focuses and a three-layer treatment model

As of 6:30 pm on August 18, as many as 301,957 cases of COVID-19 infection had been recorded in the whole country. Vietnam ranks 73rd out of 222 countries and territories in its number of cases and 170th out of 222 countries and territories in terms of its rate of infections per one million people (3,071 infections per one million people).

The total number of deaths caused by COVID-19 in Vietnam was reported at 6,770 by the end of August 18, accounting for 2.2% of the total number of cases and equal to the COVID-19 death rate in the world.

Ho Chi Minh City has experienced three months of fighting the pandemic with the participation of the whole political system, departments, agencies, and a large number of health workers across the country. However, the city is still recording the highest number of new cases per day as well as the highest accumulated number of cases, accounting for more than half of the total number of cases in the country.

With the number of new cases and deaths continuing to be high, the city has made changes in its response to the pandemic in order to gradually lower the number of infections and fatalities.

Deputy Director of the Ho Chi Minh City Department of Health Tang Chi Thuong said the city will pay attention to two areas, including the application of a home health care package for people infected with COVID-19 (F0) who are eligible for home isolation and the implementation of emergency and treatment for COVID-19 patients at hospitals.

Regarding the treatment of COVID-19 patients, the city has adjusted its treatment model from a five-layer to a three-layer one, with the first layer providing treatment to F0 cases isolated at home and at 153 concentrated isolation facilities in Thu Duc city and in 22 districts. The second layer includes the treatment of 74 city-level hospitals while the third includes eight COVID-19 resuscitation hospitals and five intensive care centres run by the Ministry of Health in the city.

Ho Chi Minh City will increase the number of beds and medical equipment for hospitals in the second layer while improving its capacity for receiving calls and transporting emergency patients as well as using more specific antiviral drugs against SARS-CoV-2 at the second and third-layer hospitals.

Experts say that the expansion of the first layer will help ease the overload on the second and third treatment layers. According to Health Minister Nguyen Thanh Long, regarding healthcare for F0s at home, it is important to carry out on-site testing, and if any household detects F0, they will be isolated. They will be provided with medicines for home care and treatment and necessities. On-site testing, on-site care, and on-site welfare will contribute to reducing infections, helping limit the progression of the disease.

At the same time, it is necessary to expand the second and third treatment layers, in which the second layer must have oxygen as well as anticoagulant and anti-inflammatory drugs.

In addition, hospitals in the third layer are required to hold daily professional exchanges with second layer hospitals while sending medical teams to provide continuous professional support to the second layer to both screen and transfer severe patients to the third layer when needed.

On August 18, the Tan Binh multi-layer COVID-19 treatment field hospital, operated by Thong Nhat Hospital, officially went into operation. Notably, this is the first field hospital in Ho Chi Minh City to treat all three levels of the COVID-19 disease (mild, moderate and severe disease).

Of the total 1,000 beds, there are 50 beds for resuscitation, 150 beds for severe patients, 500 beds for moderate patients and 300 beds for patients with mild symptoms. Depending on the real situation, the hospital will make the appropriate adjustments to achieve the highest level of efficiency in treating patients.

In a recent meeting with Binh Duong province, the leaders of the Ministry of Health also suggested the province study and follow the five focuses in fighting the pandemic, including the strict implementation of social distancing, the implementation of on-site social security, early testing to isolate F0 cases from the community, reduction of the number of COVID-19 fatalities, and the acceleration of vaccination.

Equipment checks before the COVID-19 intensive care centre (under the Ministry of Health) is put into operation in Vinh Long at the end of August. (Photo: VNA)

Early testing to detect F0

One of the five issues that Health Minister Nguyen Thanh Long suggested Ho Chi Minh City focus on is early testing to detect the source of infection, separating F0s from the community in order to avoid widespread contagion.

Accordingly, Ho Chi Minh City will continue to implement testing in two directions. Firstly, people can take quick tests by themselves, if positive, the result will be reconfirmed by PCR testing. Secondly, the city will proactively scan residential areas by pooled testing or by reviewing high-risk areas.

The Ministry of Health is going to send 10 testing vehicles to Ho Chi Minh City, with a daily testing capacity of 2,000 to 3,000 samples each. The Ministry of Health will arrange human resources for the testing vehicles while their operation is under the control of Ho Chi Minh City.

Large-scale screening and testing is also one way many localities are promptly detecting and separating F0 cases from the community. Hanoi took 313,010 test samples and detected 29 positive cases of SARS-CoV-2 in five districts from August 10-15. Thus, the city decided to implement its second phase of testing for high-risk areas and 13 high-risk groups with one million samples per day from August 18-20. The goal of this second phase is to detect and isolate F0 in the community.

Many localities in the Mekong Delta region such as Vinh Long, Bac Lieu, and others are also taking advantage of the seven-day period of the third phase of social distancing to increase testing and screening for COVID-19 cases.