Decision No. 963/QD-BYT dated March 18, 2020 promulgation of “Interim Guidance for monitoring, prevention and control of COVID-19”

• Official number: 963/QD-BYT
• Legislation Type: Decision
• Organization: The Ministry of Health
• Signer: Do Xuan Tuyen
• Issued Date: 18/03/2020

MINISTRY OF HEALTH -------	SOCIALIST REPUBLIC OF VIETNAM Independence - Freedom - Happiness ---------------
No. 963/QD-BYT	Hanoi, March 18, 2020

DECISION

PROMULGATION OF “INTERIM GUIDANCE FOR MONITORING, PREVENTION AND CONTROL OF COVID-19”

MINISTER OF HEALTH

Pursuant to the Government's Decree No. 75/2017/ND-CP dated June 20, 2017 defining functions, tasks, entitlements and organizational structure of the Ministry of Health;

At the request of Director of General Department of Preventive Medicine - the Ministry of Health,

DECIDES:

Article 1. “Interim Guidance for monitoring, prevention and control of COVID-19” is promulgated together with this Decision.

Article 2. “Interim Guidance for monitoring, prevention and control of COVID-19” shall be applied at preventive medicine facilities and other health facilities nationwide.

...

...

...

Article 4. Chief of the Ministry Office, the Ministerial Chief Inspector, Directors of Departments of the Ministry of Health, Directors of Institute of Hygiene and Epidemiology and Pasteur Institutes; heads of health departments of other ministries and relevant units are responsible for implementation of this Decision./.

PP MINISTER
DEPUTY MINISTER




Do Xuan Tuyen

INTERIM GUIDANCE

FOR MONITORING, PREVENTION AND CONTROL OF COVID-19
(Promulgated together with Decision No. 963/QD-BYT dated March 18, 2020 of the Ministry of Health)

I. GENERAL CHARACTERISTICS

COVID-19 is a Group A acute contagious disease caused by SARS-CoV-2. This disease spreads by human to human transmission. The incubation period is about 14 days. Symptoms include fever, cough, sore throat, shortness of breath; may cause serious pneumonia, acute respiratory failure and death, especially in people with underlying medical conditions or chronic diseases. Detection of SARS-CoV-2 infection can be hard due to unclear symptoms in certain cases. There have been no cure and vaccine for this disease.

...

...

...

In Vietnam, there are 66 confirmed cases in 13 provinces throughout the country, including 41 cases from foreign countries and 25 cases from secondary transmission within the country.

This document contains guidelines for provincial authorities and relevant units on monitoring, prevention and treatment of the disease according to epidemic situation.

II. MONITORING

1. Cases and close contacts

1.1. Suspected cases

A suspected case is a person has at least one of the symptoms including fever, cough, shortness of breath or pneumonia, and:

- Has visited/stayed in/transited through/returned from a country or territory with local transmission of Covid-19 within 14 days from the date of entry according to information from WHO;

- Has visited/stayed in/returned from an affected area in Vietnam within 14 days before onset of symptoms. Epidemiology Institutes and Pasteur Institutes shall send daily lists of affected areas to General Department of Preventive Medicine, which will be informed to local government.

- Has come into close contact with a suspected case or confirmed case within 14 days before onset of symptoms.

...

...

...

A confirmed case means a suspected case or any person who tests positive for SARS-CoV-2 by a laboratory assigned by the Ministry of Health to perform confirmatory tests for SARS-CoV-2.

1.3. Close contacts

Close contacts are persons who have come into contact within 2 meter with a suspected case or confirmed case while having symptoms, including:

a) People in the same household or house as a confirmed case or a suspected case while having symptoms.

a) People in the same working group or room as a confirmed case or a suspected case while having symptoms.

c) People in the same travel group, business trip group, party, meeting etc. as a confirmed case or a suspected case while having symptoms.

d) People sitting in the same and the next two rows in the same road/rail/air trip as a confirmed case or suspected case while having symptoms. In some cases, health authorities will decide to expand the list of close contacts in a vehicle.

dd) Other persons who have come into close contact with a suspected case or confirmed case while having symptoms in other cases.

2. Cluster

...

...

...

2.2. A cluster is considered inactive when there are no new confirmed cases for 28 days since the last case is quarantined.

3. Monitoring contents

Developments of the epidemic can be very different in different provinces of Vietnam. While confirmed cases have been reported in some provinces, other provinces are still unaffected. Monitoring contents shall vary according to epidemic situation in each province. To be specific:

- Combine monitoring at border checkpoints with monitoring at health facilities and in communities, especially at border checkpoints for inbound travelers from affected countries and territories by taking body temperature, observation and other methods as instructed by the Ministry of Health.

- Carry out monitoring, epidemiological investigation, collecting specimens; make a list of all suspected cases, confirmed cases and close contacts according to Forms 1, 2, 3, 4, 5 and 6 enclosed herewith.

- Close contacts shall be quarantined and closely monitored for 14 days from the last date of contact.

- Monitor through early detection of suspected cases.

- Report according to 3.5. of this document.

3.2. Where there is a confirmed case and the disease has not widely spread in the province

...

...

...

- Maintain monitoring to detect suspected cases at border checkpoints, health facilities and communities as instructed by the Ministry of Health.

- Carry out monitoring, epidemiological investigation, collecting specimens; make a list of all suspected cases, confirmed cases and close contacts according to Forms 1, 2, 3, 4, 5 and 6 enclosed herewith.

- Enhanced monitoring of severe acute respiratory infections (SARI) at health facilities; monitor through early detection of suspected cases in communities. Specimens from these cases must be collected and tested for SARS-CoV-2.

- Report according to 3.5. of this document.

3.3. In case of widespread transmission of the disease

Widespread transmission is when there are more than 50 confirmed cases caused by secondary transmission in 02 districts, district-level cities or district-level towns (hereinafter referred to as “districts”) or more in 14 days.

Ensure early detection and elimination of new clusters while maintaining control of existing clusters; minimize the spread of the disease. Monitoring contents:

- Maintain monitoring to detect suspected cases at border checkpoints, health facilities and communities as instructed by the Ministry of Health.

- In unaffected districts: carry out monitoring, epidemiological investigations, collect and test specimens, quarantine all suspected cases and close contacts.

...

...

...

+ Carry out monitoring, epidemiological investigation, collect of specimens to confirm at least 5 infection cases from the new cluster. Next cases shall be tested as requested by Epidemiology Institutes and Pasteur Institutes.

+ Suspected cases in active clusters shall be considered confirmed cases and subject to epidemic control measures.

- Close contacts shall be closely monitored for 14 days from the last date of contact.

- Enhance monitoring of SARI at health facilities. Specimens from these cases must be collected and tested for SARS-CoV-2.

- Report according to 3.5. of this document.

3.4. Collection, preservation and transportation of specimen: See Appendix 1 hereof.

3.5. Communication and reporting

Data shall be reported every 24 hours at 8 am.

- Disease control centers of provinces shall list and monitor health status of every confirmed case, suspected cases, close contacts and people having contact with close contacts, quarantined people in their provinces (including all treating facilities in the province); submit daily reports (Form 7) and lists of confirmed cases and suspected cases (Form 4) to Epidemiology Institutes and Pasteur Institutes before 11:00.

...

...

...

- General Department of Preventive Medicine shall submit daily consolidated reports on number of confirmed cases, suspected cases, close contacts and quarantined people to the Office of the Ministry of Health before 15:00

- Laboratories shall submit daily reports on test results, number of specimens collected, number of tests run, etc. to Epidemiology Institutes and Pasteur Institutes in their areas before 11:00. Epidemiology Institutes and Pasteur Institutes shall submit daily consolidated reports on test results, number of specimens collected, number of tests run, etc. (Form 8) to General Department of Preventive Medicine before 13:00. General Department of Preventive Medicine shall submit daily reports to the Steering Committee before 16:00.

- Laboratories shall inform negative results to the units that sent the specimens.

- Regulations on communications and reporting of Group A infectious diseases in Circular No. 54/2015/TT-BYT dated December 28, 2015 on declaring and reporting infectious diseases shall apply.

III. PREVENTIVE MEASURES

1. Non-specific preventive measures

Recommended preventive measures include:

- Avoid going to affected areas. Avoid crowds. In case a crowd is unavoidable, personal protective measures such as wearing facemasks and washing hands with soap, etc. should be applied.

- Avoid direct contact with people with acute respiratory diseases (fever, cough, shortness of breath); wear facemasks properly and maintain a 2-meter distance when contact is necessary.

...

...

...

- Maintain personal hygiene; frequently wash hands in water stream with soap or common antiseptic solution for at least 20 seconds; use mouthwash; avoid placing hands on eyes, nose and mouth to avoid infection.

- Cover the mouth and nose when coughing or sneezing, best with a cloth or napkin or sleeve to minimize spread of respiratory fluids; wash hands with soap or sanitizer right after coughing or sneezing. Do not spit in public places.

- Ensure food safety, only eat cooked food.

- Do not buy, sell or come into contact with wild animals.

- Keep the body warm; improve health by eating, resting, exercising and healthy lifestyle.

- Increase ventilation in houses by opening doors and windows; avoid using air conditioners.

- Frequently clean the floor, door knobs, surfaces in houses and offices, schools and factories, etc. with soap and common detergents or other antiseptic solutions as instructed by health authorities.

- Frequently clean and sanitize vehicles: airplanes, trains, vessels, automobiles, etc.

2. Specific preventive measures

...

...

...

3. Quarantine at borders

- Monitor and request inbound travelers to make health declarations in accordance with the Government's Decree No. 89/ND-CP dated June 25, 2018 and instructions of the Ministry of Health.

- Quarantine and response actions at border checkpoints shall be carried out in accordance with the Government's Decree No. 101/2010/ND-CP, which elaborates some Articles on quarantine, quarantine enforcement and epidemic control of the Law on Prevention and treatment of infectious diseases.

4. Medicines, supplies, chemical and equipment for epidemic control

Provincial governments shall ensure adequate supply of medicines, supplies, chemical and equipment for epidemic control in their provinces.

IV. EPIDEMIC CONTROL MEASURES

1. Implement the preventive measures specified in (III)

2. Implement the following measures:

2.1. Quarantine and response actions

...

...

...

- Implement strict quarantine and treatment at health facilities to minimize complications and deaths.

- Minimize movement of patients except when strictly necessary to avoid transmission of the disease, unless the case is beyond the treatment capacity of the current facility.

- Treatment shall be provided according to instructions of the Ministry of Health.

- The quarantine shall last until the patient recovers and is discharged from hospital.

2.1.2. Close contacts

Carry out investigation and compile a list of close contacts. The list shall contain their names, addresses, phone numbers, names and phone numbers of their family members. Quarantine process:

- A close contact shall be quarantined at a health facility for 14 days from the last date of contact with a confirmed case. In case the health facility is full, people in the same household or house with the confirmed case shall be quarantined at the health facility, and the close contacts shall be quarantined at a separate quarantine zone for close contacts.

- Specimens from these cases must be collected and tested for SARS-CoV-2.

+ Close contacts who test positive for SARS-CoV-2 shall be treated as confirmed cases.

...

...

...

2.1.3. People having contact with close contacts shall be:

- Instructed to carry out self-quarantine and self-monitoring pending test results of close contacts and:

+ If the close contact tests positive for SARS-CoV-2, be quarantined as a close contact; or

+ If the close contact tests negative for SARS-CoV-2, released from quarantine.

2.1.4. Suspected cases

Suspected cases shall wear facemasks and be promptly quarantined at a facility separated from the treatment facility for confirmed cases. A suspected case shall be handled according to the result of the SARS-CoV-2 test. To be specific:

- + If a suspected case tests positive for SARS-CoV-2, he/she shall be quarantined and treated as a confirmed case.

- + If a suspected case tests negative for SARS-CoV-2, he/she shall be quarantined at a separate facility for people who tests negative for SARS-CoV-2. If the patient no longer has symptoms after 14 days from the first day of contact with an infection source, he/she will be discharged from hospital. If the patient still has symptoms after 14 days from the first day of contact with an infection source, he/she will be tested for the second time. If the second test result is still negative, his/her symptoms will be treated as a normal disease.

2.1.5. People having close contact with suspected cases

...

...

...

- + Be quarantined as close contacts ff the suspected case tests positive for SARS-CoV-2; or

- + End the quarantine if the suspected case tests negative for SARS-CoV-2.

2.1.6. Other cases

People who participate in the same event or on the same vehicle as a confirmed case without close contact shall be requested by health authorities by phone, messaging, social network, media to contact the local health authority to receive instructions on self-monitoring and to inform health authorities in case of suspected infection.

2.2. Infection prevention for health workers

- Always use personal protective equipment such as medical facemasks, goggles, gloves, protective clothing, shoe covers, etc. when coming into contact with patients.

- Wash hands with soap and antiseptic solution before and after every visit to a patient and the patient room.

- Avoid close contact and minimize duration of contact with patients.

- Compile a list to monitor daily health status of health workers coming in close contacts with patients. Health workers who have symptoms shall be put in quarantine and tested as prescribed.

...

...

...

2.3. In patients’ households:

- Implement the preventive measures specified in III.1

- Maintain hygiene and ventilation of the house; frequently clean the floor, doorknobs and surfaces in the house with common detergents such as soap and other antiseptic solutions.

2.4. In communities, schools, factories and offices

- Implement the same preventive measures as households.

- Closure of schools, offices, factories, construction sites, etc. shall be decided by the President of the People’s Committee cum Chief of Epidemic Control Committee of the province in consideration of epidemic situation.

- Do not hold events that attract crowds.

- Restrict or suspend activities posing high risks of infection at places such as: cinemas, bars, dance clubs, game centers, massage parlors, theaters, karaoke bars, tearooms, gyms, stadiums that involve many people in a closed area, etc.

2.5. Prevention of infection at treatment facilities

...

...

...

2.6. Sterilization and environmental recovery in clusters

- The patient’s home and adjacent houses shall be sterilized by cleaning the floor, doorknobs and surfaces with 0,05% chlorine solution for 10 minutes or 0,1% chlorine solution for 01 minute. Other areas such as the kitchen, bathroom, yard, surrounding area, etc. shall be cleaned with 0,1% chlorine solution. The amount of solution used will vary according to the seriousness of contamination in the cluster.

- The front gate/door of the patient’s house should be closed to prevent people from entering and leaving the house while the patient and his/her family is being quarantined at a health facility.

- The means of transport of the patient shall also be sterilized with 0,1% chlorine solution.

- Other relevant areas shall be sprayed with 0,1% active chlorine solution as decided by epidemiological officials based on epidemic situation. Every contaminated area and areas suspected of or at risk of contamination shall be sterilized.

The Ministry of Health shall keep updating and revising these guidelines according to the epidemic situation, results of epidemiological investigations and epidemiological studies, virological studies, clinical symptoms and recommendations of WHO./.