Impacts of COVID19 on work of healthcare workers and some associated factors in hanoi in 2020

TW jfcfc «s> «> *4:


ACKNOWLEDGEMENT
I am indebted to my mentor. Assoc.Prof.Le Thi Thanh Xuan from the

Depaitment of Occupational Health. School of Preventive Medicine and

Public Health for her exemplary guidance,

monitoring and constant

encouragement throughout the course of this thesis. I also wish to take this

opportunity to express a deep sense of gratitude to the Board of Directors,
Training Department of School of Piex entire Medicine and Public Health for

their cordial support. valuable information and guidance which helped me in

completing this task through various stages. 1 would like to express my
deepest thanks to the Managing Board. Department of Training. Hanoi

Medical University who had created a favorable and wonderful environment
in the school for the past 6 years, I wish to thank all the teachers in the

Department of Occupational Health. School of Preventive Medicine and
Public Health. Hanoi Medical University for their valuable information

pres ided by them in their respective fields and allow me to use data for my
dissertation. I am grateful for their cooperation during the period of my

assignment. Lastly. I would like to express my deepest thanks to my loving

family, relatives and friends for their constant encouragement without them
this thesis would not be possible.

The result of my thesis is pan of the data from the survey which was
implemented from April 2020 to December 2020 by the Department of

Occupational Health. The data extraction has been approved by project
members My main role in this project was support in cleaning data and data

analysis. Through this role. I would like to describe the occupational burden
of Covid-19 pandemic on health worker and some associated factors in
Hanoi.2020. The data of this project has not been publicly available
anywhere.

Student

Nguyen Huy Hoaug


SOCIALIST REPUBLIC OF VIETNAM
Independence-Freedom

Happiness

CONFIRMATION

To:

Management Board of Hanoi Medical University.
- Department of Undergraduate Training Management and Department

of Student Affairs, Hanoi Medical University.
- School of Preventive Medicine and Pdblic Health. Hanoi Medical

University.

-

Department of Occupational Health. School of Preventive Medicine
and Public Health.

Examination Committee for Graduation Thesis 2020-2021

I hereby declare that this research was originally done by myself. Tire data

handling and analysis were objectively completed with honesty. The results of
this stud)' have not been published in any document.

Hanoi. May 2O2Ỉ

Student

Nguyen Hu) Hoang


ABBREVIATION

HCWs

: Healthcare worker

PPE

: Personal protective equipment

CDC

: Control diseases center

ILO

: International Labour Organization

EFA

: Exploratory factor analysis

WHO

; World Health Organization

-w .•* CN «G


TABLE OF CONTENTS

ACKNOWL EDGEMENT

CONFIRMATION
ABBREVIATION
ABSTRACT

INTRODUCTION

1

CHAPTER 1; LITERATURE REVIEW—....... .-.

4

1(1 c otic epts
The Healthcare Worker—............

4

L1J. Workload

4

1.13. Working conditions......... .................................. ....... ..................

4

1.2 Characteristics of pathology and prevention. treatment of COXTD 19....4
12.1

Definition and origin of Covid-19.......................... ..................

4

122 Transmission characteristics and diagnosis............ -..................
123. Treatment and pre ention ã III ritiirtII!I till Ifiifii Ifiiiim ItiMt IIô|||ôIIIIHIII

13. The epidemiological situation of COVID-19.................

1.4. Impacts ofCOVTD-19 on work of healthcare workers...

16

1.4.1. In die world........

16

1.42. In Vietnam.

17

1.5. Associated factors of COVID-19 impacts on work of healthcare workers 18
1.5.1.

Workplace Factors...

If IIIIWtlMllllllltlf ItlttllKWIIIMI

.. 18

1.52 Personal Characteristics.... .................................. ....... .................

19

1.53 Organizational Factors.....

20

CHAPTER 2: RESEARCH SUBJECTS AND METHODOLOGY

-21

2.1. Study subjects.............. -....................... 22. Study time and study sites.....................

TW jfcfc «s. ■>

21


2.3. Methodology.....

21

2.3.1 Study design

21

2.3 J Sampling.....

22

2.33 Variables and indicators........

22

2.4. Data collection tool and technique
2-4.1 Technique for data collection..

25

t

♦r

25

»»

2.4.2 Tool for data collection...........

25

2.5. Potential Errors and Solutions

• •• ••

•••••••.27
as r

2.6. Data management and analysts
2.7. Ethical consideration

••

28

CH APTER 3: RESULTS

29

3.1. Characteristics of research subjects

29

3.2. Impacts on respondents’ work due to ( OVID-19..

34

33. Some associated factors with perception on work impacts due to
COVID-19

39

CHAPTER 4 DISCUSION™.

63

4 1. Impacts on healthcare worker' work due to COVID-19.

63

4.2. Some associated factors to impacts on work of HCWs due to

COVID-19

65

4.3. Strengthen and limitation of this stud}’............................ ...............

CONCLUSION

70

RECOMMENDATION

™71

REFERENCES

APPENDIX 1

TWM*M«K>

*4:


LIST OF TABLES

Table 2.1 Variables and indicators..........................................

22

Table 3.1. Demographic characteristics of study participants.......................... 29

Table 3.2. Occupational characteristics of study participants........................... 30
Table 3.3. Working department of study participants.................. .................... 31

Tabic 3.4. The construct validity of the questionnaire with respect to the
impacts of COVID* 19 work of hospital staff. ...........................37
Table 3.5. Correlation between level of hospitals and avoidance of healthcare
workers work due to COM D-19.................

39

Table 3.6 Correlation between genderand avoidance of healthcare worker’s

work due to COVID-19................................

39

Table 3.7. Correlation between job title and avoidance of healthcare worker’s
work due to COMD-19................................

40

Table 3.8. Conelation between risk of exposure and avoidance of healthcare
workers work due to COMD-19........................ .......................... 41

Table 3.9 Corrđation between marital status and avoidance of health care

worker s work due to COX1D-19................................................... 41

Table 3.10 Correlation between living withand avoidance of health care
worker’s work due to COVID-19.................

42

Table 3.11 Correlation between educationand avoidance of health care
worker's work due to COVID-19.................

42

Table 3.12. Correlation between age group and avoidance of health care

worker s work due to COVID* 19.................

43

Table 3.13. Correlation between occupational age occupational age group and
avoidance of health care worker’s work due to COVID-19....... 44


Table 3.14. Con-elation between level of hospitals and good working
relationship of study participants.................

45

Table 3.15. Correlation between gender and good working relationship of

study participants................................................ ............................. 45
Table 3.16. Correlation between job title and good working relationship of

study participants

46

Table 3.17. Correlation between risk of exposure to coxid-19 and good
working relationship of study partkipants.................................... 46
Table 3.18. Correlation between marital status and good working relationship

of study participants.....................................................

4'

Table 3.19. Correlation between status living with and good working
relationship of study participants.................

47

Table 3.20. Correlation bemwn education and good working relationship of
study participants...... ~...................................

43

Table 3.21. Correlation between group ages and good working relationship of
study participants iiriMMin timtf Iifiiif I mint Mil tun IIIMI ti

..43

Table 3.21. Correlation between working year group and good working
relationship of study participants
Table 3.22. Correlation between le\-el of hospitals and increased work

pressure due to COVID-19.......................... ...........

50

Table 3.23. Conelation between gender and increased "Ork pressure due to

COVID-19.

tniMimivittm timimiimmmmiimmmiiMi mmtiiiimit

Table 3.24. Correlation between job title and increased work pressure due to
COVID-19....................

51

Table 3.25. Correlation between risk of exposure and increased woik pressure

due to COVID-19.

-w .ã* CN ôG


Table 3.26. Correlation between marital status and increased work pressure
due to COVID-19........

32

Table 3.27. Correlation between Living with and increased work pressure due
to COVID-19

Table 3.28. Correlation between education and increased work pressure due to

COVID-19.
Table 3.29. Correlation between age group and increased work pressure due
to COVID-19 ã Me ããããããããããããããããããããããããããããããããã

ôãôãããããããããããããã ãããããã 53

Table 3.30. Correlation between working year group and increased work

pressure due to COVID-19...........................

54

Table 3.31. Multivariate regression for identifying factors associated with
avoidance of heahh care worker's work due to COVID-19........ 55

Table 3.32. Multivariate regression for identifying factors associated with
good working relationship of study participants.......................... 57

Table 3.33. Multivariate regression for identifying factors associated with
increased work pressure due to COVID 19.... -............................60

-w .ã* CN ôG


LIST OF FIGURES

Figure

1.1

Drivers

of transmission of coronavirus (COVID-19)

infection consist of short-range, large-droplet transmission
(>5

pm

in

diameter,

traveling

<1

meter):

close,

unprotected, direct contact; and indirect contact with

contaminated surfaces.

•••.■••• ••••••*■ •••■>■•6

Figure 1.2: 5K messages recommended by tile Ministry of Health.................. 12
Figure 13 Map of COVID-19 cases in Vietnam from April 27 to May 10,

2021.............................

Figure 3.1 Risk of exposure to COVID-19 of subjects

15

.......................... 32

Figure 3.2 Provided with necessan goods duiing COVID-19.........................32
Figure 3.3 Pro'ided with personal protective equipment during COVID-19 33
Figure 3.4 Organize advocacy activities...........................

33

Figure 3.5 Avoidance of healthcare worker's work due to COVID-19......... 34

Figure 3.6 Good working relationship of study partidpaits........................... 35
Figure 3.7 Increased work pressure due to COVID-19 of study participants. 36

-w .ã* CN ôG


Abstract

-

Reason for writing: Healthcare workers are front-line responders

facing a disproportionate increase in occupational responsibilities during the

covn>19 pandemic. Added work-related stress anKMLg healthcare personnel

may lead to personal and work-related repercussions, such as burn-out or
decreased quality of care for patients
-

Problem: Tire aim of ths study was to describe the impacts of Covid-

19 on work of tire healthcare worker in Hanoi in 2020 and analyze some

factors associated with the impacts of Covid-19 on work of research subjects.

-

Methods: A cro6S-sectional web-based study was carried out to collect

respondents' demographic data and job impacts in Hanoi in 2020. Snowball

sampling technique was applied to recruit 1621 healthcare worker. The

exploratory factor analysis (EFA) was used to examine tire validity’ of the
instrument.

Results: Of the 1621 respondents, 13.5% agreed that "working spirit
was maintained well.” followed by 11% of respondents reported that there
were “enough employees at work " Only 4.9% of respondents agreed that
“their work w as appreciated by society”. Being female (coef. = -0.069, 95%

CI= -0.12 to -0.018) had a negative correlation with ’good working

relationship of studs’ participants", comparing to those bemg male while
people with more ages were more increased work pressure due to COVID-19
(Coef. - 0.02; 95% CI - 0.006 to 0.034).
-

Conclusion: Our findings revealed marginal impacts of the COVID* 19

pandemic on the work and life of hospital staff in Vietnam. This studs’ finally

characterizes targeted demographics that may benefit from appreciation by
employers and society during a national pandemic.
Key word: COMD-19. workload, healthcare worker


1

INTRODUCTION

Despite the remarkable achievements in the 20th century. infectious

diseases still have negative effects around the world. On March 11, 2020. the
World Health Organization (WHO) officially declared COVID-19 a pandemic
and it was the first pandemic caused by coronavirus. The current COVID-19

virus, officially known as SARS-CoV-2, was placed by rhe International

Comnnssien on Virus Classification (ICTV). SARS-CoV-2 is a new strain of

the Corona virus. lire COVID* 19 virus spread more rapidly than its two
ancestors. SARS-CoV and MERS-CoV. but had a lower mortality rate [ 1]

As of May 9. 2021. the COVID-19 situation had many complicated

developments. The pandemic has spread to 274 countries and territories,
reporting 158.302.232 cases and 3.295.975 deaths due to the SARS-CoV-2

X HUS causing acute respiratory infections Coxid-19. USA. India and Braãl are

tire 3 countries With tile highest number of cases (2|. In Vietnam as of May 9.

2021. there were 3412 cases of COVID-19; 35 deaths and 2659 recovery
eases, ranking 163/274 countries and territories with cases in the world. Hai
Duong. Da Nang. Ha Not and Ho Chi Minh City are the provinces with the

highest number ofCOVID-19 cases in Vietnam [3].
COVID-19 has a significant impact on public health and poses a
challenge for health workeis iHCWs). especially frontline HCWs in direct

contact with patients with COVTD-19. Studies wound the world show that the
COVID-19 pandemic could affect the health status of health workers by

increasing the rate of COVID-19 infection and increasing tlie rate of

insomnia. fatigue, anxiety. depression or suffering for the liealtli worker. To

date, the impacts of the COVID-19 pandemic on the health, life and work of
healthcare workers have been investigated. Prexious studies evaluating


health-related effects of the pandemic revealed significantly increased
incidence of aiwiety and stress among litis workforce [4-7]. Regarding

working challenges. Schwartz el al. indicated that ill China, the fear of being
infected and work-related pressure were tile key motivations for several
healthcare workers to find other jobs [8]. Additionally, the healthcare woikers

expected That their families would sympathize their woTtang environment and
not be Obsessed with the probability of being infected by’ them. However,

healthcare staff admitted that they fell insecure due to the shortage of personal

protective equipment (PPE) and feeling lielpless when treating severe patients
with poor prognosis [9.10].

These mental health issues not only affect the health workers' attention,
bin also understanding and decision-making ability. This could hinder the

fight against COVĨD-2019. In addition, the COVID-19 pandemic also lias

long-term effects on overall health as well as on tile quality of life aikl work
of the health worker [11]. For instance, in Vietnam particularly. Bach Mai
Hospital, a leading comprehensive general hospital in the North of Vietnam,

was an epicenter of a c OVID-19 outbreak, contributing to further spread in

the community. The whole hospital was then quarantined from March 28 to
April 12 [12]. Given limited financial and human resources for health care,

alongside the underdeveloped health infrastructure in Vietnam. besides higher
infected risks compare to the general population. Vietnamese healthcare

workers might face with adversities including the shortage of PPE. increasing
workload and .added responsibilities [13.14]. During the nationwide partial

lockdown, healthcare woikets spent more lime al tire hospitals, wliich might
cause a lack of contact with their families. isolation. burn-out, frustration, and
discrimination [11.14.15].


3

To the best of my knowledge. most of the research related to this

outbreak have focused on the epidemiological identification and clinical
characteristics

of

patients

with

the

disease

[16][17].

the

genomic

characteristics of the virus [IS], and challenges for glcbal health governance
[ 19]. However. limited research has been available on the impacts of CO\1D19 on work of the healthcare workers in Vietnam. So I do the research natred

"Impacts of Covld-19 on work or the healthcare workers and some
associated factors in Hanoi In 2020" with two following spedfic objectives:

1. To describe the unpacts of Covid-19 on work of the healthcare worker

in Hanoi, year 2020.
2. To analyze some factors associated with the impacts of Ccrcid-19 on

work of above research subjects.


4

Chapter 1

LITERATI RE REVIEW
1.1 Concepts
l.JJ. rhe Healthcare Worker

According to WHO (2006). healthcare workers are people whose job it is
toprotect and improve the health of their communities [20]

J. J J. WprWood

According to 11.0. woildoad is regularly assess time requirements and
assign reasonable deadlines ensure that working hours are predictable and

reasonable (21 J.

Ỉ.U. Working conditions

According to ILO working conditions are at the core of paid work and
employment relationships. Generally speaking, working conditions cover a

broad range of tojtics and issues, from working time (hours of work, rest
periods, and work schedules) to remuneration. as well as the physical
conditions and mental demands that exist in the woricplace(22].

1.2 Characteristics or pathology and prevention, treatment 0ÍCOMD-19

Ỉ.2.I Definition and origin of cOlid-19

J.2J.1 Origin of COVJD-J 9

In 2003. the Chinese population was infected with a virus causing Severe
Acute Respiratory Syndrome (SARS) in Guangdong province. The virus was

confirmed as a member of the Beta-coronavirus subgroup and was named

SARS-CoV (23], [24], The infected patients exhibited pneumonia symptoms
with a diffused alveolar injury which lead to acute respiratory distress syndrome

(ARDS). SARS initially emerged in Guangdong. China and then spread rapidly
around the globe with more than sooo infected persons and 776 deceases. A
decade later in 2012. a couple of Saudi Arabian nationals were diagnosed to be
infected with another coronavirus- The detected virus was confirmed as a

member of coronaviruses and named as the Middle East Respiratory Syndrome


5

Coronavirus (MERS-CoV). The World health organization reported that MERScoronavirus infected more than 2428 individuals and $38 deaths [25]. MERS-

CoV is a member beta-coronavirus subgroup and phylogcncticalty diverse from
other human-CoV. The infection of MERS-CoV initiates from a mild upper
respiratory- injury' while progression leads to severe respiratojy disease. Similar

to

SARS-coronavirus.

patients

infected

with

MERS-coronavirus

suffer

pneumonia, followed by ARDS and renal failure [26]
At the end of 2019. WHO was notified by the Chinese government of

several cases of pneumonia with an unfamiliar cause. The outbreak started

at the Hunan seafood market in China s Wuhan city and quickly infected

more than 50 people. Live animals axe commonly sold at the Hunan
seafood market such as bats, frogs, snakes, birds, marmots and rabbits [27].

On January 12. 2020. the Chinese National Health Commission released
more details on the epidemic, proposing viral pneumonia [27]. At that time.

Wuhan an emerging business hub of China experienced an outbreak of a
novel corona virus that killed mote than eighteen hundred and infected over

seventy thousand individuals within the first fifty days of the epidemic.
This virus was reported to be a member of the ft group of coronaviruses

The novel virus was named as 2019 novel coronavirus (2019-nCov) by the

Chinese researchers. The International Committee on Taxonomy of Viruses

(ICTV) named the virus as SARS-CoV-2 and the disease as COVID19 [28].[29],[30]. SARS-CoV-2 is the third known coronavirus after SARS

axid Middle East respiratory syndrome (MERS). SARS - CoV and MERS
CoV are also in the coronavirus group [31].

J.2.J.2 Definition ofCOVID-i 9
COVID-19 is an acute respiratory disease caused by an emerging type

of corona\irus. other members of this virus family have been identified,
including SARS-CoV in 2003. HCoV NL63 in 2004. HKLT in 2005. and

MERS-CoV in 2012. Most of these have caused pandemics of respiratory

6

infections. The case was severe, typically the 2003 SaRS pandemic. COVID19 is now officially known as SARS-CoV-2 and has been established by the

International Commission on Virus Classification ỢCTV). This newly
discovered coronavirus has a genome similar to the virus that caused the 2003

SARS epidemic (SARS-CoV) by more than 701®. The SARS-CoV-2 virus
spread more rapidly than its two ancestors. SARS-CoV and MERS-CoV. but
had a lower mortality rate (I].

1.2.2 Trans mission characteristics and diagnosis
1.2.1.1

Transmission characteristics

A thorough understanding of the routes of SARS CoV-2 transmission is
essential for prevention and biosafety. Tile major routes of transmission of

SARS-CoV-2 are believed to be person-to-person transmission through
respiratory droplets, close unprotected contact with an infectious individual,

and touching items that hove been contaninated(Flg ].l)[32-34]

COVIIM9 tranNntaloa min; dropke*. direct cvntaci. aiMl indirect conlnct

Figure 1.1 Drivers of transmission of cơronavừus (COI 'ID-19)
infection consist of short-range, large-droplet transmission c>s ftm

in diameter, traveling <1 meter); close, unprotected, direct contact;

and indirect contact wừh contaminated surfaces.
Droplet transmission is spread by small droplet nuclei >5 urn in diameter

«s> ■>


7

that can Travel in the air through a short distance (usually <1 meter). Ait home
transmission (dioplet nuclei <5 tun in diam- eter and trawling >1 meter) is

currently not evident but may play a role if certain aerosol-generating

procedures are conducted.5 s The fecal-oral route is not a significant driver of
COVID-19 transmission. but it warrants further investigation[351-

J.2J.2

Diagnosuand prognosis

Commonly reported clinical symptoms in infected cases were fever

(88%), dry cough (68%). fatigue (38%). sputum (33%), dyspnea (19%), sore
throat. (14%), headache (14%) and myalgia or joint pain (15%) [36]. Less

common symptoms were dĩanbea (4%) and vomiting (5%x About 80% of

reported cases in China had mild to moderate illness (including cases without

pneumonia and with pneumonia). 13.8% were seriously ill and 6.1% were

very critically ill (respiratory failure, septic shock and Ỉ or multiple organ
dysfunction / failure) [37]. Cases of asymptomatic viral infection have also
been reported [38Ị. Based on data horn China, the WHO report indicates that

up to 75% of cases without initial symptoms will progress to clinical
symptoms [36].
Groups most frequently reported to have severe illness and higher

mortality* include people over die age of 60. men. people with underly ing
medical conditions such as hypertension, diabetes, cardiovasculai disease, and

respiratory illness, chronic autoclaving and cancer [39J. There is no evidence
of a negative outcome in a newborn with COVID-19 pneumonia from the
mother and this virus was not found in breast milk [40]. Available

information indicates that children are as likely to be infected as adults and

experienced mainly mild clinical manifestations [40].
In data on COVID-19 diagnosed cases in China. Italy and South Korea,

the mortality rates were 2.3% 2.8% and 0.5% respectively [42]. The


8

mortality rale increases with a^ in all countries, with the highest mortality

among those over 80 years old (14-S^ft. 8.2% and 3.7%. respectively). Current

estimates suggest an average uicubation period of five to six days for COVID-

19. with a range of 1 to 14 days. The majority (97.5%) of people with clinical
manifestation of COVID-19 will develop symptoms within 11.5 days (95CI%

■ 8 2 to 15.6 days). RNA viruses have been identified in the respiratory

specimens, feces, whole blood, serum, saliva, and urine of patients with

symptoms {36}. Patients infected with COVID-19 with conjunctivitis have
detected RNA viruses in tears and conjunctival secretions [41].

1.23. Jreafment and prevention
1.23.1. Treatment

Currently, there is currently no specific treatment for COVID-19 disease
Scientists around the world are working to find and develop treatments for
COVID-19(43]. The treatment of patients with Co\id-]9 infection is mainly

symptomatic treatment. Huang et afs study reports that the most common
complications in patients with 2019-nCoV infection are acute respiratory'

distress syndrome, followed by anemia, acute heart injury, and secondary
infection [44], Therefore, empirical anibiotics. antiviral therapy (oseltamivir)
and systemic
corticosteroids are often used for treatment. Patients with
•

untreated hypoxaemia receive invasive mechanical ventilation. Holshue et al

used remdesivir in the treatment of patients infected with Covid-19 and
achieved good results [45 J.

1.23.2. Prevention method

The World Health Organization (WHO) recommends that in order to
protect yourself from COVID-19. the following preventive measures should
be well done [46J:


9

-

Wash your hands regularly and thoroughly. wash your hands with an

alcohol-based quick antiseptic solution 01 wash your hands with soap and

water. Washing your hands with soap and water or using an alcohol-based
hand tub will kill Vituses that may be on your hands.

-

Maintain social distance: Maintain a distance of at least 1 meter (3 feet)

from anyone who is coughing or sneezing. When someone coughs or sneezes,
they spray droplets of liquid from their nose or mouth that can contain the

virus. If you are too close, you can inhale water droplets, including CƠVID-

19 virus, if the cough is ack
-

Avoid touching ey es, nose and mouth: Hands touch many surfaces and

can be infected. Once contaminated, hands can transmit the vims to the eyes,
nose or mouth. From there, the ũrus can enter the body and cause illness.
-

Practicing respiratory hygiene: Make sure you and those ar-ound you

adhere to good respiratory hygiene This means covering your mouth and

nose with your elbow or a tissue wlren you cough or sneeze. Then throw awayused papei immediately. Viruses spread by droplets. By adiering to good
respiratory hygiene protects those around you from viruses Like colds, flu and
COVID-19.

-

If you have a fever, cough and have trouble breathing, see your doctor

early. Stay home if you feel unwell. If you have a fever, cough and have
trouble breathing, see your doctor and call first. Follow the instructions of

your local Irealth authority. The national and local governments will have the
most up-to-date information on the situation in tire region. Calling aliead will
allow the healthcare proc ider TO get the health care provider quickly and to the
right facility. This will also protect and help prevent the spread of viruses and

other infections.


10

-

Regularly update your medical situation and follow advice given by

J OUT healthcare provider, national and local public health authorities, or be

proactive about bow to protect yourself and others from COVID-19. National
and local governments will have the most up-to-date information on whether

covn> 19 has spread in the region.
I. 2J.3. Recommendation for people who have been or visited recently (last
Ỉ 4 days) tn areas where COVID-I9ts spreading

-

Follow thei nstructions outlined above.

-

Stay home if you begrn to feel unwell, even with mild symptoms such

as headache and mild ninny nose, until you recover. Avoiding contact with

others and visiting health facilities will allow them to operne more efficiently

and help protect yourself and others from COXTD-19 and other viruses.
-

If you have a fever, cough and have trouble breathing, seek medical

advice promptly as this could be due to a respiratory infection or other serious
condition. Call in advance and report on any recent travel- Calling aliead will

allow your health department to quickly get to the correct facility . This will
also help prevent the spread of COVID-19 and other viruses.

J. 23.4. Regulations and policies for responding to pandemic COVID-19

The COVID-19 epidemic is an important issue in global health security
[18] and it also creates an urgent need for national and provincial

preparedness in Vietnam, for disease prevention and coordinated responses to

quell the new epidemic as quickly as possible. While scientists are working
hard to develop new vaccines and treatments for this emerging disease [4749], effective preventive measures for affected countries like Vietnam are

needed.

The WHO’S strategic objective for the response to COVID-19 is [50]:


11

-

Intermptions of person-ro-person transmission include reduction of

secondary infection between close contacts and medical personnel, prevention
of transmission amplification events, and further prevention of global spread.

-

Early identification, isolation and care, including optimal care for

infected patients,

-

Identify’ and reduce transmission from animal sources;

-

Address

key unknowns

related to

clinical

severity.

degree of

transmission and infection, and accelerate the development of diagnosis,

therapy and vaccines;

-

Communicate risk and event important information to all communities

and combat ntisinfonnation;
-

Minimize social and economic impacts through multidisciplinary

partnerships.

In Vietnam, in April 2O2Ũ. the Vietnamese government issued
Directive No. 16/CT-TTg[5l|, implementing social gap. keeping distance
between people in order to minimize the risk of community infection, ask
people to stay at home, minimize going out. except in necessary cases:

-

Purchase of food. food, medicine and other essential goods and

services;
-

In urgent cases such as: emergency care, medical examination and

treatment: natural disasters fires....

-

Work at state agencies, units. anned forces, diplomatic missions and

authorized establishments.

-

hl case of leaving the house, they must wear a mask, wash their hands

with soap or antiseptic solution; Do not gather more than 2 people in public

places, outside of offices, schools, hospitals and must keep a minimum
distance of 2 meters. Basically, stop the public passenger transport, except for


12

eases of public senice reasons, workers transport vehicles, experts, isolators,

vehicles transporting production materials. goods. Minimize die operation of
personal vehicles.

The Ministry of Health has officially announced a message featuring
5K [52] (in Vietnamese) Khau trang (facemask)- (Khu khuan) disinfection(Kboang each) distance- (Không ni tap) no crowded

(Khar bao y te) health

declaration IO help citizens get used to lúi ng safely with lhe COVID-19

pandemic in ‘new normal’ state.

ĩ

RỨAUYTNlKMCXVYtN
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Figure L2ĩ 5K messages recommended by the Ministry of Health
Under tike message, the Ministry of Health encourages people to
regularly wear face masks at public places and crowded areas, wear medical

masks at medical facilities and quarantine areas. People are recommended to

regularly wash hands with soap or hand sanitizers: clean surfaces and

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13

frequently contacting objects (doorknobs, mobile phones. tablets, tables, and
chairs). People are also asked to keep safe distance with each other and avoid
mass gatherings. They are called on to conduct health declaration on NCOVI

app. install BlueZone which will help detect the risk of COVID-19 infection.

1.23.5. Prevention in medical/aciĩưíes
On December 2, 2020. the Ministry of Health issued official Letter No.
6649 / BYT-KCB to units on strengthening COVID-19 epidemic prevention

at medical examination and treatment establishments (53].
-

For the hospital

Review and re-evaluate all measures to prevent and control epidemics

at medical examination and treatment establishments according to documents,
directives, directions, and hospital safety criteria set of the National Steering

Committee for Disease Control. COVID-19, the Ministry of Health and the
Administration of Examination and Treatment issued

Strictly implementing file screening, separation, isolating and testing all
suspicious cases. Absolutely do not let people at risk of COVID-19 infection
entering the hospital. Review departments with high-risk patients such as

intensive care, elderly treatment, hemodialysis. cardiovascular, respiratory...
Tightly control people in and out. not allow or limit maximum care for

the potient's family.

•

For the Department of Health

+ Direct affiliated hospitals to re-evaluate the hospital criteria set for safety
against COVID-19 epidemics and acute respiratory infections in accordance
with Decision No. 30S8 / QD-BYT dated July 16.2020.

+ Continue to strengthen the inspection and supervision of affiliates and

units in the area according to two sets of safety criteria. Strictly comply with
the entry of full test results on the online software using the account of the


14

Department of Health for the Ministry of Health to monitor, inspect and

supervise. To suspend the operations of collectives and individuals and units
that do not comply with die set of criteria for hospitals and safety clinics.

+ Directing facilities that treat positive COVID-19 cases to focus on
treating patients, not to let serious progression and death: make daily case
reports on specific test results, clinical developments, and treatment prognosis

on case management software cdc.kcb.vn.
1.3.

The epidemiological situation of COVID-19
As of May 9. 2021. the COVID-19 Situation bad many complicated

developments. The pandemic has spread to 274 countries and terntories.
reporting 158302.232 cases and 3.295.975 deaths due TO the SARS-CoV-2

virus causing acme respiratory infections Covid-19. USA. India and Brazil are
tlie 3 countries with the liighesi number of cases [2]. In Vietnam as of May 9.

2021. there were 3412 cases of COVTD-19; 35 deaths and 2659 recovery
eases, ranking 163/274 countries and territories with cases in the world. Hai
Duong. Hanoi. Da Nang. Ho Chi Minh City are the provinces with the highest

number of COVID-19 cases in Vietnam [2]. Hanoi is the city with the third

highest number of COVID-19 infections in Vietnamp] and is also home to
frontline hospitals treating COVĨD-19. During the 4th outbreak of COVID-19
in Vietnam, from April 27 to May 10. 2021. Hanoi was the city haring tile

most infections in Vietnam with 141 cases[3], especially the cluster of cases
in two central hospitals were National Hospital of Tropical Diseases 2 and K.

hospital[3]