Shift focus from infection rate for HCMC to reopen: experts

Their call comes in the wake of Ho Chi Minh City achieving several positive results but falling short of all the targets set by the Ministry of Health. The city is far from being able to say it has brought the outbreak under control.

The city announced last week that it would continue imposing Directive 16 through the second half of September, saying controlling the outbreak by September 15 as targeted by the central government was not feasible.

Directive 16 is the toughest social distancing rule in the country, prohibiting everyone from going out except for "essential purposes."

Localities would be deemed to have "basically" put an outbreak under control on meeting three basic criteria set by the health ministry.

First, the number of new infections in the community has decreased continuously compared to the previous two weeks and by at least half compared to the peak week of the outbreak.

Second, the rate of positive samples out of the total number of PCR test samples has decreased continuously for 14 days and a week without any new infection chains forming in the community.

Third, localities must halve the proportion of districts and communes with "very high risk" and "high risk" classification by half. This rate is currently 30 percent for HCMC.

Luong Hoai Nam, a member of the Vietnam Tourism Advisory Board, said that in HCMC, Covid-19 has "spread deeply and widely" in the community, making it difficult to achieve the ministry's criteria, and the goal of eradicating Covid-19 and having no infections in the community is almost "impossible."

Nam said the number of cases recorded each day may not fully reflect the actual spread of the disease, because it depends on the number of tests and the areas where the samples are taken.

"It would be very difficult for the city to achieve the criteria of reducing the number of infections compared to the highest week in the ongoing wave, because the city has to conduct mass testing regularly to do that."

The criteria of having no new clusters for a week would not last long in HCMC because even in countries where a majority of the population has been fully vaccinated, such as Israel and those in Europe and America, herd immunity has still not been achieved and new clusters have continued to appear.

"The criteria set by the Ministry of Health can put the city in a situation where it cannot claim to have controlled the outbreak even after reaching a high vaccination rate and made a lot of progress in the treatment of Covid-19 patients.

"Given such a situation, people will have to continue to stay at home, and the city cannot resume its economic and social activities," Nam said.

HCMC has almost completed vaccinating all adults with the first shot and around 30 percent of them have had got two injections.

The city’s Covid-19 death toll has dropped from more than 300 cases per day to around 200 or less per day.

"Although the daily infection tally is still high, the number of severe cases and deaths in HCMC has decreased. However, this important criterion has not been updated to assess the city's level of disease control," Nam said.

He said the modification of disease control criteria is of great significance for drawing a roadmap for opening the economy, society, services, and other activities so that HCMC can start moving towards the "new normal" of coexisting safely with the virus.

Alternative criteria

Nam proposed that four criteria be applied for disease control in the city.

First, the new set of criteria would still be based on epidemiological indicators such as the total number of new infections and the number of community cases; the number of hospitalizations, and the number of deaths (with separation between the vaccinated and unvaccinated).

The second criteria should gauge the readiness of the healthcare system to treat Covid-19; and the third and fourth criteria would involve the ability to manage meetings in public places and the application of technology in disease prevention.

"If HCMC has been able to reduce the burden on the health system, continues to improve its treatment ability, ensuring that people practice Covid-19 prevention protocols in public spaces (wearing masks, keeping distance and avoid crowds), and apply technology to fight Covid-19, it can start reopening immediately, starting with the essential sectors first and then gradually increase the reopening level in line with the coverage of the second vaccine dose," he said.

People in HCMC's Go Vap District get Covid-19 vaccine, August 14, 2021. Photo by VnExpress/Quynh Tran

Epidemiologist Truong Huu Khanh, a consultant with the infectious and neurological diseases department at the city's Children's Hospital, agreed that the Health Ministry should make adjustments to the criteria on pandemic control for HCMC.

The city has covered almost all adults with the first vaccine shots and therefore, "it is not the number of new infections in the community that matters, but how many severe cases are needing to be hospitalized and how many deaths are happening."

Khanh proposed two basic criteria to evaluate disease control not only for HCMC but also Hanoi and other localities.

The first is vaccine coverage, which clearly states the rate of single and double dose administration.

"In particular, it is necessary to take into account the vaccination rate for the high-risk population, including the elderly and those with underlying diseases."

The second criterion would be to see if the healthcare system is overloaded with the number of serious Covid-19 cases.

"Once the targeted vaccination coverage is completed, localities only need to pay attention to the number of severe cases, and see how to avoid overloading the treatment system," Khanh said.

Deputy Health Minister Nguyen Truong Son said that for now localities still need to apply the ministry’s criteria to assess the level of disease control.

These criteria have been formed in consultation with the World Health Organization (WHO), international organizations, and other countries, he said.

However, the ministry will study new developments in the Covid-19 situation and make adjustments depending on the actual situation, he added.

In the latest Covid wave that hit Vietnam almost five months ago, HCMC has been hit hardest.

The city of 13 million has had more than 320,800 cases and 12,636 deaths, while the nation’s tally stands at 651,727 cases and 16,390 deaths.

It has gone through several different levels of Covid-19 restrictions since late May.