The End Game for Covid-19 in Vietnam?
From: Greg Nagle <gnagle2000@gmail.com>
Sent: Thursday, July 29, 2021 4:43 PM
To: Vietnam Studies Group <vsg@u.washington.edu>
Subject: Re: [Vsg] The end game for covid 19 in Vietnam??
V\According to U.S. Centers for Disease Control and Prevention (CDC) data, U.S. states have administered 52.36 million fewer Covid-19 vaccine doses than they've received. Jennifer Kates, director of global health at the Kaiser Family Foundation, told STAT that even after accounting for reporting delays, wastage, and unadministered second shots, a conservative estimate suggests that states are currently sitting on around 26 million unused doses.
Meanwhile, stockpiles of vaccines continue to build at the federal level. The U.S. has bought 1.41 billion doses in total, and has so far distributed around 390 million across the country. An additional 562 million Moderna, Pfizer, and Johnson & Johnson vaccines are expected to arrive in the U.S. from July 2021 until the end of the year, according to Airfinity, a life sciences analytics firm.
Last month, the Biden administration also committed to purchasing and donating 500 million doses of the Pfizer-BioNTech Covid-19 vaccine to more than 100 countries over the coming year, https://www.commondreams.org/news/2021/07/21/us-drowning-unused-doses-who-chief-laments-horrifying-injustice-covid-19-vaccine?
Greg Nagle
PhD Forest and watershed science
Cornell University
Hanoi, Vietnam
On Thu, Jul 29, 2021 at 6:35 PM Greg Nagle <gnagle2000@gmail.com> wrote:
Carrl,
Australia has already sent 1.5 million doses to VN with more probably to come.
But covid is far worse in Malaysia and Indonesia and I would send more doses there, Both those countries relied mostly on Chinese vax. Bad reports on that but hard to judge it fairly.
Use of a 3rd dose with the AZ vax on top of the 2 doses of Chinese may allay some serious problems.
Greg Nagle
PhD Forest and watershed science
Cornell University
Hi Greg,
Ah. I assumed you were in Hanoi. Hoi An has been basically completely open during your stay, so I can understand the feeling that maybe this is a pain in the butt but will be over one of these days. In fact, over the past couple of months, as the screws have tightened in Da Nang, many people--foreign and local--have relocated from Da Nang to Hoi An. I believe An Bang beach has been accessable. I know old town has, and without the hordes of tourists. These recent positive tests sound like they will change the situation there, but I'm not sure how much.
The reason I asked about Hanoi is that it seems my entire neighborhood is united in the belief that Hanoi is and will continue to receive special treatment: i.e. more vaccines, less onorous restrictions on movement, etc. It sounds like this might simply be a misconception based on regional prejudice.
I'm troubled by the lastest news, that a nightly curfew is to be enacted in Da Nang from 8:00pm-6:00am. It is still only a proposal up for a vote, but I expect it will be passed. I don't see much utility from such a curfew other than reminding people who is in charge. We've had police sweeping neighborhoods at least twice daily to make sure nobody is walking or riding bikes, and although those sweeps seem to have become less frequent over the past day or two, the curfew is indeed troubling.
Ben, AUV
On Thu, 29 Jul 2021 at 18:29 Greg Nagle <gnagle2000@gmail.com> wrote:
ben,
I have been stuck in Hoi An since May 4, I. was coming here from Hue since renewing my 30 day visas was fast and easy but not my choice to be here when my work is along Lao border and NW highlands. The visa situation is a torture for many but not bad here in Hoi An, But who knows if I get mine renewed again and whether I am ordered to leave within 15 or 30 days,
I can offer no good insights about covid in Hanoi such as you have about Danang. But I am sure glad I am not in Hanoi now, even moving through there to fly back to the US looks like a real challenge, No grab, tight restrictions on leaving home, you need a ticket to shop a few times a week. Just getting around to get a pre flight covid test looks like a headache
Well, actually there are a few taxi companies allowed to operate.
Only 3 cases here in Hoi An in last 3 months with some areas closed off, and I cannot exit the city, Not bad here, But I see no end to this so maybe time to leave VN.
But HCM looks awful which is why I needed the perspective of a good epidemiologist on what we might expect. How will this play out in coming months with something as infectious as delta and so embedded now in population?
I would like to do an analysis on what is being done well in VN and what is weak.
I do think the testing is done well enough (?), much better than many ?other places, But how can it be improved.? it needs to be understood that some infected and exposed people need to be tested 3 times so that reduces the number of tests which can be done in larger population,
Yesterday, 4000 infected people were released from quarantine in HCM since testing showed low viral loads.
That is a very smart move,
This is from recent issue of the New Yorker,
Since we are less worried about asymptomatic spread among vaccinated people, should we be moving toward a testing regime that is more about testing viral loads than testing the presence of covid-19 in someone’s body? Is that feasible, and is it possible, and is it desirable?
Yes, yes, yes. It is feasible. You can do that both with P.C.R. and antigen tests. Antigen tests won’t give you a viral load, but you can get a threshold that makes sure that you know that somebody has a high enough viral load for the results to matter. And it is absolutely desirable in the sense that what you want to know, especially for vaccinated people, is whether someone is contagious. If they have a little virus in their nose, that’s not compelling, and that’s not necessarily all that meaningful. You really need to have a much better sense of quantification. We’re not spending enough time thinking about that. https://www.newyorker.com/news/q-and-a/life-in-a-half-vaccinated-country?
Greg Nagle
PhD Forest and watershed science
Cornell University
Hanoi, Vietnam
Hanoi, Vietnam
On Thu, Jul 29, 2021 at 4:56 PM Ben Quick <bnquick74@gmail.com> wrote:
Sorry. D'Capitale.
On Thu, Jul 29, 2021 at 4:51 PM Ben Quick <bnquick74@gmail.com> wrote:
Greg,
I'm curious as to the overall state of affairs in L'Capitale. I'm not talking about covid case numbers, but rather restrictions or lack of restrictions on mobility, sectors of the economy--both formal and informal--remaining operational, and whether or not there is optimism that the city's people will be at the top of the list when mass vaccinations begin. It feels as though there may be less urgency from Hanoi because the social and economic fabric of the city has not been impacted in the way it's been in HCMC or even Da Nang. For example, is Grab allowed to operate? Things like this.
Best,
Ben, AUV
On Thu, Jul 29, 2021 at 4:43 PM Carl Robinson <robinsoncarl88@gmail.com> wrote:
Well, why doesn't Vietnam approach Australia for a few million doses of Astra Zeneca which many here don't want because of those blood clotting issues and governments are begging people to use in face of a growing Delta outbreak? Pzyzer remains the first choice but supply is slow while AZ is manufactured here.
Hanoi should approach Canberra and get a shipment or two up there more or less immediately. They could also throw in a few steaks, lobsters and wines that Beijing has banned after Australia called for an investigation into the origins of COVID.
Please help spread the word -- and I am serious here.
Best regards
Carl Robinson
Calderwood, NSW
USOM/USAID 1964-68; AP Saigon '68-75
On Thu, 29 Jul 2021, 19:13 Greg Nagle, <gnagle2000@gmail.com> wrote:
Delta changed things completely, and the Viets may have been over confident given past success with containing covid . I might have been too but I usually carry dread with me and might have grabbed eagerly for any vax available,
I contend yet once again, and I promise for the last time, that the problem a few months ago was the scarce availability of vaccines other than the Chinse which the Viets chose not to use.
The Chinese vax is not working out too well but other vax also have problems with the new delta variant. The Chinese vax gets a worse rap than they deserve, but it is correct to say that Vietamese public's ill opinion of Chinese products made the government choose not to use it. Hard to judge that now but it is the principal reason why Viet vaccination rates have been much lower,
I looked for the graphics showing the source of vaccines across SE Asia a few months ago but can't ferret it out again, Chinese vax was by far the dominant one then but less now,
Where exactly were the Viets supposed to get other vaccines until recently? They might have gotten a few but vax all over the world was scarce, outside N America and the EU. Now that those places have their people covered more vax is being released to the rest of the world, This is not to blame anyone but the vax manufacture had to ramp up, Not as if those vax were sitting around, the excess vax was simply "reserved production" not actual doses in cold storage. And happily more vas is pouring into Vietnam with about 10 mlllion more in last week, 15 million doses now with 11 million of those donated, with 5 million from the US. And they even started vaccinating Tay in Hanoi
it looks like the Russian sputnik vax will be the most widely used here with 40-60 million doses expected.
but, cough cough, recent research is not too cheerful about how well it works with new covid variants.
Please wake me up when this is all over,
https://www.nature.com/articles/s41467-021-24909-9?
Greg Nagle
PhD Forest and watershed science
Cornell University
Hanoi, Vietnam
On Thu, Jul 29, 2021 at 3:12 PM Ben Quick <bnquick74@gmail.com> wrote:
Dear Greg,
My experience in Vietnam is that, like in any other part of the world, people will generally do what they can get away with. If a reasonable policy of social distancing were to be enacted and enforced, people would adhere to the rules. But there is simply no way around it: the vaccination rate in Vietnam is abysmal. This cannot be blamed on the West or China or bad luck or anything else. We have the lowest rate of full vaccination in SE Asia and one of the lowest, if not the lowest rate of full vaccination in the world. It's startling.
Best,
Ben
Ben Quick
American University in Vietnam
Da Nang
AUV
On Thu, Jul 29, 2021 at 12:12 PM Greg Nagle <gnagle2000@gmail.com> wrote:
The Covid-19 breakout has killed the hustle and bustle of Saigon, leaving the city echoing sounds thought long gone.
https://www.facebook.com/VnExpressInternational/posts/5812289732133364
And my Vietnamese friend's response to this uplifting video.
The video is very positive. But people are frightened. The death stat is suppressed. Many deaths at home take days to be moved. Photos and videos of facilities where 50 people share 1 bathroom, sleeping next to trash cans. They are too disturbing to show here. We are not equipped like the West and are overwhelmed already.
It can be argued this wave is caused by easing restrictions on April 30th holidays and the election in May. The restriction is harsh indeed: walking alone in a park is not allowed. But the problem with Vietnam is if you let 1 person walk in the park then 100 will show up. Remember this is where few people obey the traffic law. No respect for the common good.
The Trump presidency shows that democracy is a mess and local authority has more excuses to argue security over liberty in this case.
Greg Nagle
PhD Forest and watershed science
Cornell University
Hanoi, Vietnam
On Wed, Jul 28, 2021 at 3:23 PM Greg Nagle <gnagle2000@gmail.com> wrote:
I am starting a new thread since the many personal and group responses to my last covid post made it too easy to get lost in the thread.
I always use a laptop, I have no idea how people navigate such a flood on a phone..
But I encourage people to look at what Joe Buckley and Ben Quick said about what they are seeing in Da Lat and Danang. They raise important questions I have put their responses below for ease of reading them.again.
And continue to read Mike Tatarsky's columns from HCMC,
https://vietnamweekly.substack.com/p/the-covid-19-crisis-deepens?
I have no idea what the end game is for Vietnam since delta now makes the rules,
. I do not want to be seen as a knee jerk champion of Vietnam and some of their past flag waving about success with covid seemed naive, _ A cute way of describing it now is herding cats, but perhaps a more realistic way is walking into a room with many snakes hiding . An overstatement but important to understand that in this battle around HCMC, and the rest of the world battered by delta, the Viets have their back to the wall, ( hard not to slip into cliches but....)
Once again, I ask if anybody can point to a country that has done any better??
Vietnam has had 113,000 cases while Malaysia with about 1/3 the population has over a million,
S.Korea reports highest COVID-19 daily count amid fourth wave
And where was Vietnam supposed to get more vaccines earlier.? Pfizer doses were $28/dose with Vietnam in competition with other countries, but now at $20/dose, It seemed wise to wait for the gouging to subside, The last I heard, Pfizer was looking at a $26 billion profit this year. But we will soon see many more vaccines available, We have now 8 in use, 10 more authorized, and 32 more in final phase 3 trials. But not as if they can be made like fritos, takes awhile to ramp up production,
The Russian sputnik vax is $10/dose
Astrazaneca is $4/dose,
The Cuban and Viet ones will be the least expensive.
I am not sure about the others
https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html
I would get the Chinese vaccine but fortify it later with another mRNA vax which is what they are doing in other places, The Chinese has been used widely around the world, probably the most used,
Even with vaccines, I do not see an end to it. People might be following the recent news about delta breakthrough infections in vaccinated people which has been most closely studied in Israel, much milder cases and few very sick but those mildly infected vaxed people can still pass it on. But much of the world is hungry for vaccines, They do help a lot but....
I have no clear idea where the many new cases are coming from around HCMC. With social contacts much reduced, I might assume these new cases were passed on inside the home since time after exposure to infection is shorter,. Delta viral loads said to be 1000X higher than previous covid variants and more concentrated in upper respiratory tract, aerosol transmissions seem most likely source, And those photogenic street cleaning military trucks do look like a PR effort. But it does look good.
Other districts have managed to suppress covid recently but I think only because it is not delta (??), I would like to know but I have not seen anything about the genetics recently,
this is a very useful site to follow changes across Vietnam. You will note how much cases have fallen in some places which is instructive,
https://vnexpress.net/covid-19/covid-19-viet-nam?
Awhile back I posted an insightful twitter feed to VSG by the Harvard affiliated US epidemiologist in Hanoi. He seems like someone who can offer deeper perspective, Maybe Michael Tatarksi can interview him? Or perhaps Chuck Searcy in Hanoi can reach out to him,
This is what I had on him a few months ago
A lot of different mutations happen as the virus is transmitted and most of them are not of clinical significance,” said Todd Pollack, a Hanoi-based infectious-disease expert for Harvard Medical School. “Just because they say [the new variant] has features of one and the other … doesn’t mean they got together in one patient and spit out some combined hybrid ‘supervirus.’
https://www.washingtonpost.com/world/2021/05/29/vietnam-hybrid-variant-covid-virus/
https://twitter.com/toddmpollack?r
Todd Pollack, MD, is the Country Medical Director, providing in-country management to the HAIVN project offices in Hanoi and HCMC
From Ben Quick
Dear Greg and VSGers,
I feel the need to provide a different point of view regarding this topic. I have serious problems with the manner in which Vietnam has handled this fourth wave of covid. My Vietnamese neighbors generally feel the same. And I'm in Da Nang, where things are looser than they are in Saigon. Of course we are a bit resentful at having so far received a meager 1170 vaccines for a population of well over one million. To blame the west for the lack of a coordinated vaccination program feels wrong. The ball has simply been dropped, and we are seeing some very real threats to civil society I personally thought we had moved past. I'll just say people have suffered tremendously and needlessly during this latest lockdown, and out of respect for my host country, I'm going to leave it there.
Best,
Ben Quick
Da Nang
From Joe Buckley
Here in Đà Lạt, there has only been one detected coronavirus case since the April 27 outbreak began (a few dozen in Lâm Đồng as a whole), yet we have been under strict restrictions for weeks; most places, including the night market, have been closed for a long time. Cafes and eateries are take away only. Walking in public parks and outdoor spaces, including around Xuân Hương lake, is banned.
There is a fair amount of disquiet among the city's population as to why restrictions seem to be so disproportionate compared to case numbers. A number of theories, some of which are somewhat conspiratorial, are flying around, but I think it speaks to a lack of transparency and open communication from authorities; a major contrast with COVID-19 prevention measures in 2020.
Beyond Đà Lạt, but also related to a lack of transparency, I've also noticed some scepticism and confusion over death statistics; why they seem to be released so sporadically, and why, for example, there are cases such as the Korean national who was cremated without anybody being told. Then, of course, there is also the recent scandal of Vingroup "borrowing" 5,000 vaccine doses.
Joe Buckley
GregNagle
PhD Forest and watershed science
Cornell University
Hanoi, Vietnam