Applied Epidemiology during COVID-19 in Vietnam

This thesis presents projects I conducted between February 2020 to December 2021 to meet the competencies of the Master of Applied Epidemiology Program (MAE) of the Australian National University (ANU). During this period, I was employed at the Department of Communicable Disease Control of the National Institute of Hygiene and Epidemiology (NIHE) in Hanoi, Vietnam. Chapter 1 – Introduction. This chapter provides an overview of my field placement, describes how I met the different MAE requirements, and presents other side projects I have been involved in during my MAE that do not fall under the MAE competencies. Chapter 2 – Investigate an outbreak: In-flight transmission of SARS-CoV-2 in Vietnam: Results from an outbreak investigation and containment measures. This project covers the investigation of and response to an in-flight COVID-19 transmission event in Vietnam in March 2020. I took part in the investigations from the beginning which resulted in the publication of two journal articles: one on the in-depth investigation of the on-board transmission event (Journal Article 1), and another one describing the response activities to prevent community transmission (Journal Article 2). We found that one infectious passenger in business class very likely infected at least 12 other passengers during a 10-hour flight, many of whom were seated beyond the two-row/seat distance threshold that is usually used for contact tracing among airplane passengers. Timely, systematic and comprehensive contact tracing of all passengers and their close contacts was needed to prevent widespread community transmission. Chapter 3 – Analyze a public health dataset: Association of public health interventions and COVID19 incidence in Vietnam, January to December 2020. In this project I analyzed the relation between public health interventions and COVID-19 incidence in Vietnam over the course of 2020, which culminated in the publication of Journal Article 3. This analysis, which was the first of its kind in Vietnam and the region, identified important associations between the timing of public health interventions and changes in the reproductive number of SARSCoV-2. Chapter 4 – Evaluate a surveillance system: After action review of the COVID-19 surveillance system in Quang Ninh Province, Vietnam in 2020. For this project I conducted a Literature Review on the World Health Organization (WHO)’s After Action Review (AAR) toolkit, and used it to evaluate the effectiveness of the surveillance system in Quang Ninh province, Vietnam in preventing and controlling COVID-19. This evaluation, presented as a Final Report in this chapter, was part of a WHO-funded initiative to learn lessons from the COVID19 response in Vietnam. While central coordination and adaptive capacity during the emergency were identified as strengths, my evaluation also provides important recommendations on how to improve the surveillance system in Quang Ninh province, in particular through improved integration of different data systems and communication channels between health jurisdictions of Quang Ninh’s healthcare system. Chapter 5 – Design an epidemiological project: User-generated online information in response to a COVID-19 outbreak in Vietnam in July – September 2020. In this project I investigated so-called ‘infodemics’ related to a COVID-19 outbreak in Da Nang province, Vietnam between July and September 2020 by applying content analysis and semantic network analysis to publicly available user-generated information from the internet. I conducted two separate analyses: one on ‘infodemics’ related to COVID-19 incidence and mortality, which resulted in Submitted Article Manuscript 1; and another on ‘infodemics’ in relation to public health interventions, which resulted in Submitted Article Manuscript 2. Findings showed that public awareness and perceptions were highly correlated with the evolution of COVID-19 incidence and mortality (at first) during the outbreak, while misinformation and unverified information related to public health interventions that were implemented in response to the outbreak were also prevalent. Chapter 6 – Other MAE requirements. In this chapter I report on other MAE requirements which I completed during my fellowship, namely the publication of a Lay Audience Report, the Lesson From The Field, and the Teaching Experienc

COVID-19 in Vietnam: A lesson of pre-preparation

Background: Vietnam was slowing the spread of COVID-19 to 200 cases by the end of March. From perspective of a relatively vulnerable healthcare systems, timely interventions were implemented to different stage of pan-demic progress to limit the spread. Method:The authors compiled literature on different public health measures in Vietnam in compared to the progression of COVID-19 from January to March 2020.Results: Three stages of pandemic progression of COVID-19 were recorded in Vietnam. At 213 confirmed casesunder treatment and isolation, a range of interventions were enforced including intensive and expansive contact,mass testing, isolation, and sterilization. Many were in place before any case were reported. Conclusion: Preparation were key for Vietnam's healthcare system in the ever-changing landscape of COVID-19 pandemi

A Profile of Family Caregivers of Older Adults in Singapore

Research Brief Series161-3

Sex Differences in Clustering Unhealthy Lifestyles Among Survivors of COVID-19: Latent Class Analysis

BackgroundThe COVID-19 pandemic has underscored the significance of adopting healthy lifestyles to mitigate the risk of severe outcomes and long-term consequences. ObjectiveThis study focuses on assessing the prevalence and clustering of 5 unhealthy lifestyle behaviors among Vietnamese adults after recovering from COVID-19, with a specific emphasis on sex differences. MethodsThe cross-sectional data of 5890 survivors of COVID-19 in Vietnam were analyzed from December 2021 to October 2022. To examine the sex differences in 5 unhealthy lifestyle behaviors (smoking, drinking, unhealthy diet, physical inactivity, and sedentary behavior), the percentages were plotted along with their corresponding 95% CI for each behavior. Latent class analysis was used to identify 2 distinct classes of individuals based on the clustering of these behaviors: the “less unhealthy” group and the “more unhealthy” group. We examined the sociodemographic characteristics associated with each identified class and used logistic regression to investigate the factors related to the “more unhealthy” group. ResultsThe majority of individuals (male participants: 2432/2447, 99.4% and female participants: 3411/3443, 99.1%) exhibited at least 1 unhealthy behavior, with male participants being more susceptible to multiple unhealthy behaviors. The male-to-female ratio for having a single behavior was 1.003, but it escalated to 25 for individuals displaying all 5 behaviors. Male participants demonstrated a higher prevalence of combining alcohol intake with sedentary behavior (949/2447, 38.8%) or an unhealthy diet (861/2447, 35.2%), whereas female participants tended to exhibit physical inactivity combined with sedentary behavior (1305/3443, 37.9%) or an unhealthy diet (1260/3443, 36.6%). Married male participants had increased odds of falling into the “more unhealthy” group compared to their single counterparts (odds ratio [OR] 1.45, 95% CI 1.14-1.85), while female participants exhibited lower odds (OR 0.65, 95% CI 0.51-0.83). Female participants who are underweight showed a higher likelihood of belonging to the “more unhealthy” group (OR 1.11, 95% CI 0.89-1.39), but this was not observed among male participants (OR 0.6, 95% CI 0.41-0.89). In both sexes, older age, dependent employment, high education, and obesity were associated with higher odds of being in the “more unhealthy” group. ConclusionsThe study identified notable sex differences in unhealthy lifestyle behaviors among survivors of COVID-19. Male survivors are more likely to engage in unhealthy behaviors compared to female survivors. These findings emphasize the importance of tailored public health interventions targeting sex-specific unhealthy behaviors. Specifically, addressing unhealthy habits is crucial for promoting post–COVID-19 health and well-being