Experience in responding to COVID-19 outbreaks from Vietnam

Uneven stigma loads: Community interpretations of public health policies, 'evidence' and inequities in shaping Covid-19 stigma in Vietnam

The infectious spread of COVID-19 has been accompanied by stigma in both global and local contexts, sparking concern about its negative effect on individuals, communities, and public health responses. The changing epidemiological context of the COVID-19 epidemic and evolving public health responses during the first year of the pandemic (2020) in Vietnam serve as a case study to qualitatively explore the fluidity of stigma.

We conducted in-depth interviews with 38 individuals, (13 cases, 9 close contacts, and 16 community members) from areas affected by local outbreaks. Thematic analysis was conducted iteratively.

Our analysis indicates that the extent and impacts of COVID-19-related stigma were uneven. Adapting the clinical term 'viral load' as a metaphor, we describe this variation through the wide range of 'stigma load' noted in participants' experiences. Individuals encountering more acute stigma, i.e. the highest 'stigma load', were those associated with COVID-19 at the start of the local outbreaks. These intensively negative social responses were driven by a social meaning-making process that misappropriated an inaccurate understanding of epidemiological logic. Specifically, contact tracing was presumed within the public consciousness to indicate linear blame, with individuals falsely considered to have engaged in 'transgressive mobility', with onward transmission perceived as being intentional. In contrast, as case numbers grew within an outbreak the imagined linearity of the infection chain was disrupted and lower levels of stigma were experienced, with COVID-19 transmission and association reframed as reflecting an environmental rather than behavioural risk.

Our findings demonstrate the role of public health policies in unintentionally creating conditions for stigma to flourish. However, this is fluid. The social perceptions of infection risk shifted from being individualised to environmental, suggesting that stigma can be modified and mitigated through attending to the productive social lives of public health approaches and policies.

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Those associated with COVID-19 experienced variable degrees of stigma - 'stigma load'.

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Those linked to COVID-19 at the start of outbreaks experienced highest stigma load.

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Misinterpretation of public health strategies contributed to blaming discourses.

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Stigma receded when risk framed as environmental not behavioural.

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Fluidity of stigma suggests potential to allay stigmatising effect of interventions.

Investigation of SARS-CoV-2 presence on environmental surfaces and waste in healthcare and non-healthcare facilities

Objective

The objective of the paper is to investigate the presence of SARS-CoV-2 on inanimate surfaces in four healthcare facilities treating patients with COVID-19 and four quarantine regiments of provincial military commands.

Methods

From August to October 2020, a total of 468 one-off environmental samples consisting of inanimate surfaces, garbage, and wastewater were collected. The real-time RT-PCR assay targeting E and RdRp genes to detect SARS-CoV-2 and checklist and questionnaire of disinfection practices were employed. If detected by RT-PCR, then positive samples are subjected to cell culture to determine viability.

Results

The test results showed all samples (100%) to be negative with SARS-CoV-2 resulting in unperformed virus culture. As for recent disinfection practices, chlorine-based products dissolved at a concentration of 0.1% (1000 ppm) in the general context or 0.5% (5000 ppm) for blood and body fluid spills are routinely applied twice a day and at the discharge of patients or quarantined people.

Conclusions

The finding may illustrate the importance of disinfection practices in removing pathogens or significantly reducing SARS-CoV-2 contamination on environmental surfaces and waste.

The prevalence of SARS-CoV-2 antibodies in quarantine workers and high-risk communities in Vietnam

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A low prevalence (2%) of SARS-CoV-2 antibodies was found among quarantine workers.

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A low prevalence of SARS-CoV-2 antibodies was found in communities with COVID-19.

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Vietnam had controlled the COVID-19 pandemic until mid-2021.

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This study preceded the widespread outbreak in Vietnam in mid-2021.

Objective

The aim of this study was to determine the seroprevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) antibodies in high-risk communities and quarantine workers in Vietnam.

Methods

The prevalence of SARS-CoV-2 antibodies was measured in household contacts, close contacts, community members, and migrant workers from two sub-communes in which COVID-19 outbreaks occurred in early 2021: Bac Ma 1 and Tien. The prevalence of SARS-CoV-2 antibodies was also evaluated among quarantine workers at two facilities responsible for quarantining of contacts of COVID-19 cases.

Results

Among 2069 participants from the two sub-communes, six individuals (0.3%) had detectable SARS-CoV-2 antibodies despite no history of COVID-19. This included one Vietnamese migrant worker, two community members, two household contacts, and one close contact of known COVID-19 cases. Among 50 workers at two COVID-19 quarantine facilities, including 15 health care workers (HCWs), one of the HCWs tested positive for SARS-CoV-2 antibodies (1/50, 2.0%) despite no known disease.

Conclusion

The prevalence of SARS-CoV-2 antibodies was low in Vietnamese ‘hotspots’, suggesting limited community transmission.

Retrospective Cohort Study of Effects of the COVID-19 Pandemic on Tuberculosis Notifications, Vietnam, 2020

We evaluated the effects of the coronavirus disease pandemic on diagnosis of and treatment for tuberculosis (TB) in Vietnam. We obtained quarterly notifications for TB and multidrug-resistant/rifampin-resistant (MDR/RR) TB from 2015–2020 and evaluated changes in monthly TB case notifications. We used an interrupted time series to assess the change in notifications and treatment outcomes. Overall, TB case notifications were 8% lower in 2020 than in 2019; MDR/RR TB notifications were 1% lower. TB case notifications decreased by 364 (95% CI −1,236 to 508) notifications per quarter and MDR/RR TB by 1 (95% CI −129 to 132) notification per quarter. The proportion of successful TB treatment outcomes decreased by 0.1% per quarter (95% CI −1.1% to 0.8%) in 2020 compared with previous years. Our study suggests that Vietnam was able to maintain its TB response in 2020, despite the pandemic.

Violence and sexual and reproductive health service disruption among girls and young women during COVID-19 pandemic in Nepal: A cross-sectional study using interactive voice response survey

INTRODUCTION

There is a paucity of data on the impact of COVID-19 pandemic on girls and young women. The study examines the prevalence and correlates of violence and sexual and reproductive health (SRH) service disruption among girls and young women during COVID-19 restrictions and lockdown.

METHODS

An interactive voice response survey was conducted among girls and women aged 18-24 years between 10th March to 24th April 2021. The survey enrolled 1314 participants. Descriptive analysis was used to assess prevalence of violence and SRH service disruption. Two sampled test of proportion was used to asses difference in prevalence of violence before and after the pandemic. Logistic regression was used to examine relationship between the outcome variables and socio demographic predictors.

RESULTS

The study did not find significant difference in prevalence of violence before and after the pandemic. Education was found to be protective against experience of both physical and sexual violence after the pandemic. Dalit participants were four times more likely to report physical violence after the pandemic than Brahmin/Chhetri participants (OR:3.80; CI:1.41-10.24). Participants from 22-24-year age group were twice as likely to experience sexual violence compared to girls and participants from 18-21year age group (OR:2.25; CI:1.04-4.84). Participants from urban municipalities were 29% less likely to report SRH services disruption than participants from rural municipalities (OR-0.71, 95% CI: 0.55-0.91). Participants with disability were twice as likely to report disruption than participants without disability (OR-2.35, 95% CI: 1.45-3.82).

CONCLUSIONS

To reduce violence against girls and women due to the pandemic, interventions should focus on Dalit women and on preventing education discontinuation among girls and women. SRH service during the pandemic needs to be improved for girls and women with focus on girls and women from rural municipalities and girls and women with disability.