Vietnam Covid19 Delta Updates: Vaccination, F0 hospitalisation treatments

Due to Covid19 delta variant spread in Vietnam, in july-2021, the Ascent building in HCMC District 2, was completely locked down. In the past few weeks so much disinformation and unrealistic expectations, we decided to share the latest facts and official information and in section 5- our survival advice from 30-years experience, since 1989, navigating Vietnam medical providers and government.

The HCDC (HCMC Center for Disease Control) discovered one positive case of F0 Covid infection. After all residents were tested, the count quickly became 6 for tower A  and another 5 F0. Weekly PCR testing were organized. Whenever a new Covid19 positive was found, the local HCDC health would reset the counter adding +14 days to our quarantine. We quickly found that the management team of 14 were contaminated with 4 F0 cases who in turn contaminated their colleagues F1. Every time a F1 became positive into a F0, the HCDC could extend our building lockdown infinitely. We totaled 24-days.

The residents organized themselves in 4 groups using Viber to exchange information and getting food supplies. The stress was mounting by the days in the Expats groups due to: ignorance of decision making by the police, the CDC managing the pandemics, the limited power and knowledge of building management, the poor healthcare system (in management, equipment and financially), the vaccines stakeholders and decision parameters, the language barrier, Vietnam is a communist country, Sovereignty, reciprocity etc…

We decided to share the key information one needs to make sense of the situation with data, facts, context, Vietnam culture and crisis situation political decisions as we experienced it since 1989. Based on our experience of the 1985 doi moi decision out of starvation, the stop and go early 1990, Asian crisis 1997, 2001 dot.com divestment, SARS 2003, 2008 financial crisis, 2014 anti-China protests, 2020 Coronas virus…

On Vaccinations decisions in Vietnam

Many people are asking: Why Vietnam took so long to buy and secure vaccinations for all while or 13-month they kept Covid at bay getting worldwide admiration?

To cut short, we would say the main reasons are probably: #1 over confidence on the strict confinement to successfully stop the Covid19 spreading and #2 working on the Nanocovax vaccine to show the world Vietnam capacity -not only to prevent the populations from contamination- but also to cure 100Mio Vietnamese with the ‘Made-In-Vietnam Nanocovax. 

 VIETNAM reminders: Covid Vaccine campaign

  • VN is a poor country; a lot of what VN gets as vaccines is free or sponsored

  • VN is communist and sovereign: only Vietnam laws and decrees apply

  • VN has its own decision criteria unknown to foreigners (and sometimes locals)

  • VN ministry of Health, centralizes and manage the supplies of vaccines

  • VN is short of vaccines what they buy or receive is what you get

  • Campaigns are decided by the central government

  • Some private initiatives (like the French government) may be authorized

  • Some business groups or private companies may get authorization under Ministry of Health patronage

  • Some campaigns may be reversed or interrupted due to shortage of vaccines

  • Some vaccines may change destination as a deadly outkreak shifts the urgency for vaccines.

Therefore all campaigns are subject to availability of vaccines. ‘Official’ vaccinations campaigns can be interrupted without notice. Of course, there is no possible guarantee you can choose: Moderna, Pfizer, Covax, Sinopharm, Sinovac, Veracell…

As we write, it is not excluded that the Vietnamese government extends vaccination centers to private arrangements on the French model or to private hospitals.

Made in Vietnam NanoCovax Covid19 vaccine
Vietnam Covid19 vaccine: NanoCovax

On Covid19 hospital treatment for F0 positive

The Vietnamese strict confinement strategy and tactics to curb the Covid19 pandemics is due to the very poor  and limited number of ICU hospital beds for proper treatment.

Below was the number of beds for Covid patients needing hospitalisation (the number beneath ‘giuong hoi suc’ means ICU-hospital bed Intensive Care Unit). 

We found out most foreigners in Vietnam know of the following fundamentalss to understand treatment available to  you, when declared Covid19 positive F0:

 

  • The Government list of F0-confinement centers are overloaded and now extended

  • The newly added F0-buildings for confinement are not treatment center, but meant to separate the F0 from the population and monitor them at best.

  • The government Covid19 nominated hospitals listed are overloaded, they started adding more in july-2021

  • F0-monitoring is no treatment but monitoring so that it ‘passes’ as a fever would do: due to overload of VN facilities, F0 are recommended to stay home and get telemedicine

  • A F0-hospitalisation may be required when breathing becomes almost impossible. This authorization to move to a hospital is the HCDC doctors’ decision

  • F0-ICU bed is overloaded, as we write the government tries to extend capacity. They may allow any hopsital wit capacity and doctors able to handle Covid patients to accept patients.

  • More on the latest additions of Covid authorized hospitals https://tuoitre.vn/4-benh-vien-tu-nhan-se-tiep-nhan-va-dieu-tri-benh-nhan-covid-19-20210727080739955.htm

  • Private hospitals can not treat for free as per government ‘strong preference’ therefore not listed as Covid19 treatment center…. under negotiation

You are Covid19 positive= F0 eligible to confinement center

Once you are tested Covid positive, you will be confined in isolation centers for self healing with medical supervision physically or tele-medicine.

Your first line family, friends, colleagues in contact in the past 15 days become F1 to be confined at home. Since the Covid delta ‘super contagious’, the 4th wave started early may-2021, the 2 types of authorized facilities became overloaded  with thousands of daily new cases. To government #1 nominated hospitals and #2 confinement centers, due to full capacity, the HCDC declared eligible 3 additional ‘confinement places’: 

  1.  Empty buildings turned overnight into confinement centers with little or no equipment and medical teams
  2. Offices and factories, where F0 needed to be isolated and tested by the companies who choosed to continue production
  3. Homes whatever the size and promiscuity.

You can follow the CDC instructions for Covid sick F0 

You may need to find telemedicine if you can not find any HCDC medical doctor or nurse for F0-monitoring.

Who decides when a F0-severely sick needs hospitalisation?

When monitoring fails, usually around 5-to-10 days after the first symptoms is when you really need treatment and get F0-hospitalization. You can not feed or drink, get dehydrated. You can not breath, every movement is tiring as your body lacks oxygen. 

At his critical point, wherever you are:

  1. you may not have a HCDC or tele-medical doctor to decide you need tio be picked up for hospital admission
  2. or you may have such a HCDC doctor to decide you need hospitalisation with the Covid hospitals teams and laisser-passer traffic authorizations 

As of 15-aug-2021, there are talks about allowing any medical facility to provide ‘treatment outside of hospitals‘ as defined by CDC whereby you need Intra-Veinus perfusion, medicines and rest for your body to continue fighting the virus.

At this stage, you need to find a Covid hospital listed by HCDC with ECMO or ICU-bed perhaps by mid-aug extended list to be announced…

When HCDC sends an ambulance for F0-hospitalisation

Unfortunately Vietnam hospitals are short of Covid ECMO-bed to help you breath and ICU-beds to keep you alive.

Extracorporeal membrane oxygenation (ECMO) is a method of providing heart and lung support to patients, usually following a heart attack, when the heart is no longer capable of pumping blood around the body sufficiently.

The government is trying hard to extend, but resources medical, equipment and financing are insufficient.

You will need connections and cash to get access to Authorized Covid hospitals ICU Intensive Care Units beds.

On Vietnam Covid19 death and mortal remains

On Thursday 29-july-2021, the government announced they will pay VND4.2Mio towards the cremation cost for any death by Covid19. Depending on the location, authorizations to move the body to HCDC center for register and procedure within 24hours of decease.

Read details of the announcement 

5- Advice and guidelines

To summarize the painpoints and what you could do to prevent a bad outcome. When the HCDC sends you an ambulance as you were tested F0 positive: 

  1. Be prepared with a suitcase for at least 3 weeks in a confinement center equiped with only a bed
  2. Leaving for the Confinement center: #21 get the full address, person in charge, name, phone, and director of the facility. #22 Inform your manager, family member, embassy #23 if the center is not properly equiped for F0-follow-up request for change for one in the list that you may know or near to home
  3.  Needing Hospitalisation= Access to IV perfusion, ECMO or ICU-beds. use your relationship network to find one as most hospitals are full, may not respond calls and the HCDC medical coordinator may leave you where you are, not knowing where to send you.
  4. Repatriation of Mortal remains: the official stance is Covid19 dead should be cremated within 24hrs. 

To conclude, let #51 your closest friend who knows Vietnam, #52 your boss, #53 a Vietnamse translator #54 A trusted doctor #55 your country consular officer know where and how you are at any one time.

STAY SAFE, STAY ALIVE.

By Mr Tâm & team advice@insuranceinAsia.com Helpline: +84 903 732 365