Pham Quang D, Stuart Robyn M, Nguyen Thuong V, Luong Quang C, Tran Quang D, Pham Thai Q, Phan Lan T, Dang Tan Q, Tran Duong N, Do Hung T, Mistry Dina, Klein Daniel J, Abeysuriya Romesh G, Oron Assaf P, Kerr Cliff C
Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Department of Mathematical Sciences, University of Copenhagen, Copenhagen, Denmark; Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia.
Lancet Glob Health. 2021 Jul;9(7):e916-e924. doi: 10.1016/S2214-109X(21)00103-0. Epub 2021 Apr 12.
Vietnam has emerged as one of the world's leading success stories in responding to COVID-19. After a prolonged period of little to no transmission, there was an outbreak of unknown source in July, 2020, in the Da Nang region, but the outbreak was quickly suppressed. We aimed to use epidemiological, behavioural, demographic, and policy data from the COVID-19 outbreak in Da Nang to calibrate an agent-based model of COVID-19 transmission for Vietnam, and to estimate the risk of future outbreaks associated with reopening of international borders in the country.
For this modelling study, we used comprehensive data from June 15 to Oct 15, 2020, on testing, COVID-19 cases, and quarantine breaches within an agent-based model of SARS-CoV-2 transmission to model a COVID-19 outbreak in Da Nang in July, 2020. We applied this model to quantify the risk of future outbreaks in Vietnam in the 3 months after the reopening of international borders, under different behavioural scenarios, policy responses (ie, closure of workplaces and schools), and ongoing testing.
We estimated that the outbreak in Da Nang between July and August, 2020, resulted in substantial community transmission, and that higher levels of symptomatic testing could have mitigated this transmission. We estimated that the outbreak peaked on Aug 2, 2020, with an estimated 1060 active infections (95% projection interval 890-1280). If the population of Vietnam remains highly compliant with mask-wearing policies, our projections indicate that the epidemic would remain under control even if a small but steady flow of imported infections escaped quarantine into the community. However, if complacency increases and testing rates are relatively low (10% of symptomatic individuals are tested), the epidemic could rebound again, resulting in an estimated 2100 infections (95% projected interval 1050-3610) in 3 months. These outcomes could be mitigated if the behaviour of the general population responds dynamically to increases in locally acquired cases that exceed specific thresholds, but only if testing of symptomatic individuals is also increased.
The successful response to COVID-19 in Vietnam could be improved even further with higher levels of symptomatic testing. If the previous approaches are used in response to new COVID-19 outbreaks, epidemic control is possible even in the presence of low levels of imported cases.
Ministry of Science and Technology (Vietnam).
For the Vietnamese translation of the abstract see Supplementary Materials section.
越南已成为全球应对2019冠状病毒病的成功典范之一。在经历了长时间几乎没有传播的阶段后，2020年7月岘港地区出现了一起来源不明的疫情，但该疫情很快得到控制。我们旨在利用岘港2019冠状病毒病疫情的流行病学、行为学、人口统计学和政策数据，校准一个适用于越南的基于主体的2019冠状病毒病传播模型，并估计该国重新开放国际边境后未来疫情爆发的风险。
在这项建模研究中，我们使用了2020年6月15日至10月15日关于检测、2019冠状病毒病病例以及在一个基于主体的严重急性呼吸综合征冠状病毒2传播模型内的检疫违规情况的综合数据，以模拟2020年7月岘港的2019冠状病毒病疫情。我们应用这个模型来量化在不同行为场景、政策应对措施（即关闭工作场所和学校）以及持续检测的情况下，越南在重新开放国际边境后3个月内未来疫情爆发的风险。
我们估计，2020年7月至8月岘港的疫情导致了大量社区传播，而更高水平的有症状检测本可减轻这种传播。我们估计疫情在2020年8月2日达到峰值，估计有1060例活跃感染病例（95%预测区间890 - 1280）。如果越南民众继续高度遵守戴口罩政策，我们的预测表明，即使有少量但持续的输入性感染病例逃过检疫进入社区，疫情仍将得到控制。然而，如果自满情绪增加且检测率相对较低（仅对10%有症状的个体进行检测），疫情可能会再次反弹，预计3个月内将有2100例感染病例（95%预测区间1050 - 3610）。如果普通民众的行为能对本地新增病例超过特定阈值的情况做出动态反应，这些结果可能会得到缓解，但前提是对有症状个体的检测也要增加。
通过提高有症状检测水平，越南对2019冠状病毒病的成功应对措施可以进一步得到改善。如果采用以前的方法应对新的2019冠状病毒病疫情，即使输入病例数量较少，疫情防控也是有可能的。
越南科学技术部。
摘要的越南语翻译见补充材料部分。
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