Covid patients may have severe respiratory damage without telltale signs: expert

Nguyen Trung Cap, deputy director of Hanoi’s National Hospital for Tropical Diseases, who has been in Dong Thap Province since July 1 to support local healthcare workers, said around 80 percent of cases in the province are asymptomatic but 5 percent are considered severe.

The Mekong Delta province has so far had 618 cases in the fourth wave that began in late April. It is currently the third worst hit in southern Vietnam after HCMC and Binh Duong Province.

Cap said doctors should pay special attention to asymptomatic cases. Just because a patient shows no or only mild symptoms does not mean their condition could not take a turn for the worse, and without close monitoring things could escalate quickly before doctors could react, he warned.

"In fact, many Covid-19 patients do not display significant symptoms at first, but after the seventh or eighth day their condition deteriorates very quickly, even leading to death."

Some patients show no sign of breathing difficulty despite the fact their lungs are severely damaged and respiratory failure is already underway, he said.

This phenomenon has been seen in previous coronavirus waves, and without experienced doctors and sufficient oximeters, the signs could be missed and patients could die, he said.

To detect early signs of severe Covid, doctors need to run various tests, but not all localities are sufficiently advanced to either do them or analyze their results, he said.

The best time to accurately distinguish between mild and severe cases is around day seven or eight, but since doctors have no way to anticipate whether a case could turn for the worse as the disease progresses, all cases should be treated as potentially severe, he pointed out.

The Ministry of Health recommends a treatment regime based on the severity of cases -- asymptomatic at local field hospitals, mild ones at hospitals and severe ones at specialized, fully equipped hospitals with ICUs.

Most new cases are treated as mild and sent to hospitals, and moved to field hospitals if the person’s condition does not deteriorate after seven or eight days.

But adopting this system has become a challenge for many localities because of a personnel or equipment shortage, Cap said.

Notably, many lack ICU capabilities and require support from either the central government or other localities, with only Hanoi, HCMC, Hue, Da Nang, and some other major places being sufficiently equipped, he said.

"If Covid-19 outbreaks spiral out of control, medical support might not be available and some localities may have trouble treating severe cases."

As of July 10 over 15,000 patients were being treated across Vietnam, according to data from the ministry. They include nearly 400 considered severe, many aged under 40 and without any underlying conditions.

The death tally so far is 123, including 88 in the fourth wave.