Nuts and bolts of HCMC's lockdown - two months or more?

HCMC imposed strict social distancing order requiring people not to leave home except for buying food or seeking medical care on July 9 and has announced plans to extend it by one or two more weeks from the end of this month.

Starting Monday, the city has also banned people from going out between 6 p.m. and 6 a.m. the next day.

Professor Jin Dhong-Yan, The University of Hong Kong, said: "HCMC will not need to apply the lockdown for (many) months, until you have sufficient vaccine. You can do it for around two months like Taiwan has done."

Jin said the situation in HCMC and Taiwan was similar with a rapid surge in new cases though the former had a bigger scale of infection than the latter.

Taiwan announced it would ease its Covid-19 restrictions on Monday, after more than two months (from mid-May) as rapidly falling case numbers gave authorities confidence to further lower the coronavirus alert level, Reuters reported.

HCMC has been Vietnam’s Covid-19 epicenter in the ongoing fourth wave, with nearly 79,000 cases of the national total of 119,812.

Police officers check people going out after 6 p.m. on Hoang Minh Giam Street, Phu Nhuan District, HCMC, July 26. Photo by VnExpress/Thanh Nguyen.

Jin suggested that Vietnam could also emulate Japan, focusing on avoiding the so-called "Three Cs" (closed spaces, crowded places, and close-contact settings) to prevent a strong outbreak while seeking to revive the economy without stringent lockdowns. Three Cs are major risk factors that could lead to the occurrence of Covid-19 clusters.

However, he noted that it may not be easy for HCMC to implement the "Three Cs" strategy because of its population density of people, which puts people into close contact with each other and put them at high risk of contracting the virus.

Jin said the HCMC administration may not know the scope of the pandemic yet, if they have tested sufficient numbers of people or not. It is possible that there are many people who are infected but not diagnosed. For example, in Wuhan, China, 80 percent of the cases were asymptomatic, even during mass testing. With current developments in HCMC, the pandemic numbers can go much higher, creating a "challenging" situation for Vietnam, he said.

Agreeing with Jin that the lockdown status in HCMC does not have to last long, Dicky Budiman, an epidemiologist with the Griffith University Australia, said it may be in effect for four to six weeks, or twice the incubation period.

Besides, authorities should make their moves depending on epidemiological indicators like hospital bed occupancy, the increasing number of deaths and the growth in the number of patients. They need to see if the city’s healthcare facilities are overwhelmed, and whether the current cluster could become bigger.

If the rate of people testing positive for the virus is less than 5 percent for at least two weeks, it is one indicator that the epidemic is under control, he said, citing criteria published by the World Health Organization (WHO) in 2020.

Budiman noted that a lockdown should not be seen as the main intervention. The focus should be on strengthening measures like testing, contact tracing, quarantining and early treatment.

He also said that HCMC and Vietnam should avoid the "lockdown trap" of repeating this measure over and over again, imposing huge burdens on the economy and society at large.

Worrying situation

Expressing "deep concern" about the situation in HCMC in particular and in Vietnam in general, Dr Thu Anh Nguyen, Epidemiologist and Country Director, Woolcock Institute of Medical Research, said the key issue was people’s compliance.

She suggested that the authorities establish a mechanism to measure the percentage of people wearing masks and avoiding crowds in order to assess the effectiveness of lockdown.

Thu Anh felt the social distancing period in HCMC could be extended to October this year and the total number of infections increase to around 270,000.

In the worst scenario, she said HCMC will reach "herd immunity" by the number of people infected instead of by vaccination, and the death rate could be around 2-14 percent, depending on the capacity of the healthcare system, she said.

Thu Anh recommended that authorities in HCMC not talk about the "pandemic peak" as the number of new cases keeps rising continuously.

"They should consider turning social distancing on and off until vaccine sufficiency is achieved."

Local authorities should change the testing method to reduce crowds, allowing people to test themselves at home to reduce the risk of transmission, she said.

Around 1.3 million people in HCMC, home to 13 million people, has received Covid-19 vaccine, although less than 50,000 have received two shots.

Take care of people

Jin stressed that the Vietnamese government should take due care of people affected by the lockdown. There are people who need food and those that should be compensated for the economic loss suffered. Citizens will also need psychological support, he said.

He said a humane approach was needed to gain people’s support in containing the pandemic. If people do not understand the seriousness and cooperate willingly, it would be impossible to stop the transmission of the virus. People’s impatience during the lockdown is "dangerous," Jin said.

Some regulations can be loosened in order to help people withstand the hardships, he suggested. For instance, people who have been vaccinated or tested negative can be allowed to do "several things."

Thu Anh suggested that HCMC and other provinces can use civil society more effectively to care for people at the community level. Vietnam already has different associations for labor unions, veterans, women and other groupings that can be used to support affected people in all areas including counselling and providing guidance for infected people and their close contacts to monitor their health status at home. This can help reduce the burden on the healthcare system, she said.