Lessons learned from Vietnam’s COVID-19 response: the role of adaptive behavior change and testing in epidemic control
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Abstract
Background
Vietnam has emerged as one of the world’s leading success stories in responding to COVID-19. After prolonged zero-low transmission, a summer outbreak of unknown source at Da Nang caused the country’s first COVID-19 deaths, but was quickly suppressed. Vietnam recently reopened its borders to international travelers. Understanding the attendant risks and how to minimize them is crucial as Vietnam moves into this new phase.
Methods
We create an agent-based model of COVID-19 in Vietnam, using regional testing data and a detailed linelist of the 1,014 COVID-19 cases, including 35 deaths, identified across Vietnam. We investigate the Da Nang outbreak, and quantify the risk of another outbreak under different assumptions about behavioral/policy responses and ongoing testing.
Results
The Da Nang outbreak, although rapidly contained once detected, nevertheless caused significant community transmission before it was detected; higher symptomatic testing could have mitigated this. If testing levels do not increase, the adoption of past policies in response to newly-detected cases may reduce the size of potential outbreaks but will not prevent them. Compared to a baseline symptomatic testing rate of 10%, we estimate half as many infections under a 20% testing rate, and a quarter as many with 40-50% testing rates, over the four months following border reopenings.
Conclusions
Vietnam’s success in controlling COVID-19 is largely attributable to its rapid response to detected outbreaks, but the speed of response could be improved even further with higher levels of symptomatic testing.
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SciScore for 10.1101/2020.12.18.20248454: (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
Antibodies Sentences Resources Despite Vietnam’s aggressive response to the early waves of COVID-19, tests of 895 blood donors in Ho Chi Minh City in August showed low but non-zero prevalence of neutralizing antibodies against SARS-CoV-2 (2/895 ∼ 0.2%). SARS-CoV-2suggested: NoneSoftware and Algorithms Sentences Resources Next, we used Covasim’s inbuilt methods to construct four distinct contact networks that assign these agents to households, schools, workplaces, and communities based on their ages. Covasim’ssuggested: NoneResults from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the …SciScore for 10.1101/2020.12.18.20248454: (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
Antibodies Sentences Resources Despite Vietnam’s aggressive response to the early waves of COVID-19, tests of 895 blood donors in Ho Chi Minh City in August showed low but non-zero prevalence of neutralizing antibodies against SARS-CoV-2 (2/895 ∼ 0.2%). SARS-CoV-2suggested: NoneSoftware and Algorithms Sentences Resources Next, we used Covasim’s inbuilt methods to construct four distinct contact networks that assign these agents to households, schools, workplaces, and communities based on their ages. Covasim’ssuggested: NoneResults from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has a number of limitations. Firstly, since we use an agent-based model, our results are based on underlying assumptions about the ways in which these agents interact. We modelled agent interactions over four networks (households, schools, workplaces, and community), but did not explicitly model large gatherings that could potentially become super-spreader events. Such events are known to have potential for sparking outbreaks.30,31 Our estimates of the potential scale of an outbreak in Vietnam may therefore be conservative, especially given the proximity of the 1-week Tet holidays (Vietnamese Lunar New Year) in early February, and the National Congress of the Communist Party of Vietnam in late January 2021. Superspreading is also partly driven by overdispersion of viral load among individuals, a factor which is included in the model (e.g. in Seattle, we estimate that 50% of transmissions are caused by ∼10% of infected people32). Another limitation is that we assume that the population is homogeneous in terms of behavior and quarantine compliance. In general, not including variability in model inputs means that it is also not included in the model’s outputs. For example, when models assume that mask-wearing reduces everyone’s transmission risk by a certain percentage, this population-level summary actually incorporates a range of individual behavioral changes that may adjust individual-level transmission risk by varying amounts. The possibility of pockets of variatio...
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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