Not time yet for Vietnam to 'live with' Covid: experts

"Living with Covid" is a topic widely discussed in Asia, with several destinations making plans to open borders, following similar moves by the U.S. and Europe.

But experts said Vietnam should not do that, at least not now.

"For a country like Vietnam, it will be too early to say that people can live with Covid-19," Prof Yik Ying Teo, dean of the Saw Swee Hock School of Public Health, National University of Singapore, said, explaining, "Living with it means many people in the population are protected from the short-term and long-term health effects of infection."

A country's population could only feel secure when there was the confidence that when someone was infected they could be treated successfully or it was able to use vaccination to minimize the health effects of an infection.

Until Vietnam, like other countries, had the necessary vaccines, it was very important for it to continue with non-pharmaceutical measures such as border controls, strict quarantine and making sure that the country was able to trace infected people and contact trace.

Professor Suzanne Judd, School of Public Health, University of Alabama at Birmingham, the U.S, said Vietnam should wait until it got better access to vaccines to live with Covid.

When people lived with the pandemic, they were starting to travel again.

People from other countries could come to Vietnam for vacation or for work, and still bring the virus even if they came from locations with high vaccination rates.

"So it is not time yet for Vietnam to live with the pandemic."

Given the example of India, countries should maintain lockdowns to stop people from interacting with each other when new cases started increasing, Judd said.

Only around 3.9 million people in Vietnam, or 4 percent of the country's population, have received their first vaccine shots against the novel coronavirus, while the rate of people having got two shots is 0.2 percent. The country has been promised 105 million Covid-19 vaccine doses from multiple sources and is stepping up negotiations to secure another 45 million doses to reach 150 million, enough to cover 70 percent of the population this year.

Economic hardship

Teo said Vietnam and Singapore were among the few countries that acquired a good reputation last year for keeping Covid under control, but that was due to tough measures that caused a lot of economic hardship.

It meant that such measures were not sustainable any more unlike in 2020, when it was an emergent situation and they were deemed necessary.

So, in 2021, one of key measures to contain the pandemic was vaccination and countries needed to look at how they could get vaccines to open up safely.

While non-pharmaceutical intervention helped a nation keep infection numbers low, it came with a lot of economic hardship.

In Singapore, authorities saw that they needed to find a way to protect people and at the same time allow the economy to get back to normal, and agreed that the only way was through vaccination.

Sian Griffiths, Emeritus Professor at the Chinese University of Hong Kong, said Vietnam, like Hong Kong and Taiwan, adopted a zero-Covid strategy and tried to stop the spread in 2020, but when there were too many cases not everyone could be identified and isolated.

Vietnam is facing its most challenging Covid-19 wave which began late April. With the more transmissible variant, Delta, infections in the fourth wave now have topped 18,000, including 94 deaths, and spread to 55 of the country's 63 cities and provinces. Ho Chi Minh City is leading the number at 7,114 cases, with around 35 percent found in the community and the rest in locked down and quarantine areas.

Griffiths said that in any situation where the authorities don't know the chain of transmission or the source of infection for new cases and the disease is spreading in the community, population based public health strategies are needed.

"If new strains became dominant then vaccines would need to be adapted."

To what extent?

Teo warned that when the majority of the population was not vaccinated, it was "difficult and dangerous" to relax any of the preventive measures. Relaxing simply meant there would be an increased number of deaths from Covid.

Relaxing measures was a political and not public health decision, he said, pointing out the former took into account that joblessness and poverty were hurting the country more than the pandemic.

Then it would accept a certain fatality rate as the cost but even this was going to be for the "very short term" because once a country started to see the number of infections increase uncontrollably, it would realize it had to go back to a strict lockdown.

"So it would be unwise to try and open up before the country is ready."

Singapore planned to relax preventive measures but had not done so yet, and authorities intended to relax them in phases in conjunction with the vaccination rate.

The government expected to vaccinate all six million people in the country by the end of this year.

It was expected that by the middle of July or August it would be able to relax some measures, and then more over the subsequent months. With over 50 percent of its population vaccinated, it was able to ease the restrictions on gathering size.

With the immunization rate expected to soon reach 80 percent, the country could allow people to travel.

Griffiths, who is in the U.K. as an advisory member of the Board of Public Health England (PHE) and chair of the PHE Global Health Committee, said though the U.K. also had Delta variants of Covid, which caused the number of new cases to increase, the country had not seen a big rise in hospital numbers.

This was due to vaccination, and people could learn to live with the pandemic like they lived with flu.

"Vietnam should not relax some principal measures because its vaccination rates are so low. The big message is to really drive hard on vaccination."

Living with Covid is for the long term

Teo said living with Covid would be inevitable in the long term given the extent of its spread globally, and the world would never be able to get rid of it.

Non-pharmaceutical intervention like border control, mask wearing and social distancing were not sustainable in the long term, and countries instead needed to rely on vaccination to live with Covid, he said.

Global surveillance should be stepped up, and nations should keep in touch with what was happening in other parts of the world, including the emergence of new variants and whether vaccination continued to be effective against them.

Griffiths said people in the U.K. were talking about the third dose of vaccine in September to boost immunity. It was one way to live with Covid in future, and if new strains got stronger, people had to make new vaccines.

Concurring with Teo that Covid would become endemic, Professor Tuan Nguyen of the School of Population Health, University of New South Wales, Australia, said not just Vietnam but all countries in the world had to recognize the simple fact that the coronavirus would not disappear but would stay with people forever.

Since the 1980s people had modified their way of life due to the HIV epidemic.

"I expect that we have to accept that from now on, the way we live, work and socialize will never be the same as before Covid."

Tuan had predicted in a Facebook post that people would see social distancing as the norm in future and social distancing would affect every aspect of life from public transport and education to work and interaction between people.

It was likely that bus, train, and airplanes would have to be redesigned, people would work from home more often and there would be a surge in e-commerce and the digital economy.

"It is highly likely that in the name of public health, the government will continue to use surveillance technology to monitor the movement of people, and this prospect has raised a deep concern, even ire, that people are on the verge of losing their privacy and civil liberty."