The First 100 Days of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Control in Vietnam
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Abstract
Background
One hundred days after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Vietnam on 23 January, 270 cases were confirmed, with no deaths. We describe the control measures used by the government and their relationship with imported and domestically acquired case numbers, with the aim of identifying the measures associated with successful SARS-CoV-2 control.
Methods
Clinical and demographic data on the first 270 SARS-CoV-2 infected cases and the timing and nature of government control measures, including numbers of tests and quarantined individuals, were analyzed. Apple and Google mobility data provided proxies for population movement. Serial intervals were calculated from 33 infector-infectee pairs and used to estimate the proportion of presymptomatic transmission events and time-varying reproduction numbers.
Results
A national lockdown was implemented between 1 and 22 April. Around 200 000 people were quarantined and 266 122 reverse transcription polymerase chain reaction (RT-PCR) tests conducted. Population mobility decreased progressively before lockdown. In total, 60% (163/270) of cases were imported; 43% (89/208) of resolved infections remained asymptomatic for the duration of infection. The serial interval was 3.24 days, and 27.5% (95% confidence interval [CI], 15.7%-40.0%) of transmissions occurred presymptomatically. Limited transmission amounted to a maximum reproduction number of 1.15 (95% CI, .·37–2.·36). No community transmission has been detected since 15 April.
Conclusions
Vietnam has controlled SARS-CoV-2 spread through the early introduction of mass communication, meticulous contact tracing with strict quarantine, and international travel restrictions. The value of these interventions is supported by the high proportion of asymptomatic and imported cases, and evidence for substantial presymptomatic transmission.
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SciScore for 10.1101/2020.05.12.20099242: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources Apple mobility data13 and Google community mobility data14 provided proxies of population movements, with additional information provided in the Supplementary Appendix. Google community mobilitysuggested: NoneResults from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The limitations are that the data are descriptive, contain relatively small numbers of confirmed cases, and only …
SciScore for 10.1101/2020.05.12.20099242: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources Apple mobility data13 and Google community mobility data14 provided proxies of population movements, with additional information provided in the Supplementary Appendix. Google community mobilitysuggested: NoneResults from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The limitations are that the data are descriptive, contain relatively small numbers of confirmed cases, and only include the first 100 days of an epidemic that is likely to continue for many months. It is therefore impossible to conclude definitively which of these control measures have resulted in the current control of SARS-CoV-2 in Vietnam and whether they will continue to work in the future. There are, however, two distinctive features of Vietnam’s response. First, the Government acted quickly, educating and engaging the public, placing restrictions on international flights, closing schools and universities, and instituting exhaustive case-contact tracing from late January, well before these measures were advised by WHO. Second, they placed the identification, serial testing, and minimum 14-day isolation of all direct contacts of cases, regardless of symptom development, at the heart of the response. Our findings suggest the latter measure was likely to be especially effective given nearly half of those infected did not develop symptoms. In summary, Vietnam has controlled SARS-CoV-2 spread by acting early, maintaining clear and consistent public communications, introducing meticulous contact-tracing and quarantine, and implementing progressive international travel restrictions. The value of these interventions in controlling the infection is supported by the high proportion of asymptomatic cases and imported cases, and evidence for substantial pre-symptomatic transmission...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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