In summary, this outbreak investigation identified six cases of COVID-19 resulting from transmission in Vietnam. On March 5, she sought care at a local hospital in Hanoi, where an oropharyngeal swab sample was taken and tested; SARS-CoV-2 infection was confirmed by real-time reverse transcription PCR on March 6. Dr. Khanh is an epidemiologist at the Department of Communicable Diseases Control, National Institute of Hygiene and Epidemiology. This means that without an approved visa for Vietnam, you will not be granted entry. In early March 2020, there was no evidence of community transmission of SARS-CoV-2 in Vietnam (18). Transmission on flight VN54 was clustered in business class, where seats are already more widely spaced than in economy class, and infection spread much further than the existing 2-row (36) or 2 meters (37) rule recommended for COVID-19 prevention on airplanes and other public transport would have captured. Go to COVID-19 hub. Please choose an arrival airport. Click here to sign in with Vietnam is challenging China's dominance of coronavirus diplomacy with the donation of medical supplies to Europe and Southeast Asia and even … We conclude that the risk for on-board transmission of SARS-CoV-2 during long flights is real and has the potential to cause COVID-19 clusters of substantial size, even in business class–like settings with spacious seating arrangements well beyond the established distance used to define close contact on airplanes. Daily science news on research developments and the latest scientific innovations, The latest engineering, electronics and technology advances, The most comprehensive sci-tech news coverage on the web. Sir, Recently, a new coronavirus was identified as the cause of the severe acute respiratory syndrome (SARS). Among the 217 passengers and crew members on a direct flight from London to Hanoi in early March 2020, we identified a cluster of 16 laboratory-confirmed COVID-19 cases. Source: A.I. It is the most populous nation to suffer zero COVID-19 deaths despite its border with China. Covid-19 takes a heavy toll on Vietnam aviation industry. Vietnam’s COVID-19 test kits have passed European standards and have been granted the CE marking and Certificate of Free Sale (CFS), allowing the test kits to be sold in the European Economic Area, including the UK. A 27-year-old businesswoman from Vietnam, whom we identified as the probable index case (hereafter case 1), had been based in London since early February. For example, Apple and Samsung have already begun operating in the country. According to a report by the Department of Agricultural Products Processing and Market Development, Vietnam exported 895,000 tons of rice worth $410 million in the first two months of the year, a 27 percent increase in volume and 32.6 percent rise in value year … Flight. We were able to quarantine, interview, and collect swab specimens for PCR testing from all passengers and crew members who remained in Vietnam. Her signs and symptoms (fever, sore throat, fatigue, and shortness of breath) progressed further after arrival, and she self-isolated at her private residence in Hanoi and had contact with household personnel only. Of the 12 additional cases in business class, symptoms subsequently developed in 8 (67%); median symptom onset was 8.8 days (interquartile range 5.8–13.5) after arrival (Figure 2). On January 24, Vietnam suspended air travel from mainland China, Hong Kong, and Taiwan and, as the epidemic spread worldwide, gradually expanded travel bans, mandatory quarantine, and testing measures to incoming passengers from other countries (10). Seating proximity was strongly associated with increased infection risk (risk ratio 7.3, 95% CI 1.2–46.2). Duong, L.T.Q. As soon as the travel history of the probable index case became evident, the passenger list and flight manifest for flight VN54 was obtained from the Bureau of Immigration and the Civil Aviation Administration and sent to all provincial Centers for Disease Control with instructions for local health staff to trace all passengers and crew members of flight VN54. Although testing had not been implemented on a large scale nationwide at that time (19), community transmission in the United Kingdom was not yet widely established (20), making the presence of multiple persons on board incubating the illness unlikely. In-flight transmission has been hypothesized but not substantiated sufficiently in a non–peer-reviewed report of a cluster of 10 flight-associated cases in China in February (N. Yang et al., unpub. Search for … Despite expectations of high rates of … Boston. In Vietnam, as of September 19, 2020, there were 1,068 laboratory-defined cases of the coronavirus disease (COVID-19) and 35 deaths. 1 In the absence of a specific treatment for SARS, the possibility that vitamin C may show non-specific effects on severe viral respiratory tract infections should be considered. We defined cases of SARS-CoV-2 infection according to Vietnam Ministry of Health guidelines in place at the time of our investigation (12). Featured destinations from . Apart from any fair dealing for the purpose of private study or research, no BOS. Second, long flights not only can lead to importation of COVID-19 cases but also can provide conditions for superspreader events. The short-term impact of coronavirus outbreak (i.e., 2019-nCov) on Vietnam’s economy could be significant, as high 6-10 percent of monthly output, but short-lived if the outbreak is rapidly contained. China and Vietnam share a land border that stretches nearly 800 miles, allowing freight to travel between the countries by road. By using our site, you acknowledge that you have read and understand our Privacy Policy Nguyen Ngo Quang from the health ministry said 60 participants will receive the vaccine in the first phase of the trial. The 2019 novel coronavirus – now formally known as COVID-19 – has massively restricted that as both nations try to limit the spread of the virus, which to date has killed 1,800 people. Outbreak investigation for COVID-19 in northern Vietnam Lancet Infect Dis. Khanh N, Thai P, Quach H, et al. Specifically, we defined suspected flight-associated COVID-19 cases as passengers or crew members on board flight VN54 landing in Hanoi on March 2 who reported fever and cough, with or without shortness of breath, during March 1–16. We found no strong evidence supporting alternative transmission scenarios. Through these efforts, we identified an additional 15 PCR-confirmed COVID-19 cases, 14 among passengers and 1 among crew members, resulting in a total of 16 confirmed flight-associated cases. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. On the 2-row rule for infectious disease transmission on aircraft. Vietnam is widely reported to have successfully minimised the economic damage from Covid-19 and according to figures and analysis from the International Monetary Fund (IMF) earlier this month, its economy is projected to have grown 2.4% this year – the only country in Southeast Asia on track for 2020 growth. No evidence indicated that the regular air conditioning and exchange system on flight VN54 were malfunctioning. Any symptomatic person was isolated immediately until the test result was received. Khanh, N., Thai, P., Quach, H., Thi, N., Dinh, P., Duong, T....Anh, D. (2020). This finding also concurs with transmission patterns observed for influenza virus (38) and is generally in line with the mounting evidence that airborne transmission of SARS-CoV-2 is a major yet underrecognized transmission route (39,40). You will be denied boarding if you are unable to show an approved visa at check-in. Similar results with similar limitations have been reported from flights arriving in France (31,32) and Thailand (33) in January and February. Figure 2. Before July, Vietnam’s entrepreneurs thought that the worst of the coronavirus pandemic was behind them and that the economy was well on its way to … As of March 1, 2020, only 16 cases of COVID-19 had been reported in Vietnam, and 17 days had passed since the last reported case (case 1 reported here became Vietnam case no. Perhaps most remarkably, unlike South Korea, which has spent considerable funds on aggressive testing, or Singapore, which has established strong epidemiological surveillance, Vietnam has followed a budget-friendly approach that has proven equally effective. A Vietnamese pharmaceutical company began testing a coronavirus vaccine on volunteers in Hanoi on Thursday, as developing countries jostle with richer nations to access affordable inoculations. Probable aircraft transmission of Covid-19 in-flight from the Central African Republic to France. Before July, Vietnam’s entrepreneurs thought that the worst of the coronavirus pandemic was behind them and that the economy was well on its way to a recovery. Vietnam's response to COVID-19 has been praised by many, with the official death toll at zero. We also note that cases 3 and 14 experienced symptom onset 17 days after flight VN54. Get weekly and/or daily updates delivered to your inbox. All‐of‐government response to the COVID‐19 pandemic: The case of Vietnam. Guidelines, law, and governance: disconnects in the global control of airline-associated infectious diseases. Domestic flights largely returned to normal by the end of May, but airlines still face a tough environment. China and Vietnam share a land border that stretches nearly 800 miles, allowing freight to travel between the countries by road. Ages of affected persons ranged from 30 to 74 years (median 63.5 years); 9 (>50%) were male, and 12 (75%) were of British nationality (Table 1). The best pockets of recovery are domestic travel in Taiwan, Thailand and increasingly, Vietnam, said John Brown of Agoda, a subsidiary of Booking Holdings. Log in to earn and spend Skywards Miles. Initial Virus Shedding in SARS-CoV-2, Utah, USA, https://www.medrxiv.org/content/10.1101/2020.03.28.20040097v1.full.pdf, https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports, https://www.iata.org/contentassets/5c8786230ff34e2da406c72a52030e95/safely-restart-aviation-joint-aci-iata-approach.pdf, https://ec.europa.eu/commission/presscorner/detail/en/ip_20_1035, https://www.vietnam-briefing.com/news/covid-19-vietnam-travel-updates-restrictions.html, https://moh.gov.vn/web/dich-benh/huong-dan-chuyen-mon/-/asset_publisher/NxZAa8ST2KXb/content/quyet-inh-so-343-q-byt-ngay-07-02-2020-ve-viec-ban-hanh-huong-dan-tam-thoi-giam-sat-va-phong-chong-benh-viem-uong-ho-hap-cap-do-chung-moi-cua-vi-rut-c, https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions, https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200327-sitrep-67-covid-19.pdf?sfvrsn=b65f68eb_4, https://www.iata.org/en/pressroom/pr/2020-05-05-01/, https://www.iata.org/contentassets/4cb32e19ff544df590f3b70179551013/roadmap-safely-restarting-aviation.pdf, https://apps.who.int/iris/handle/10665/331488, Transmission of SARS-CoV 2 During Long-Haul Flight, U.S. Department of Health & Human Services, Khanh N, Thai P, Quach H, Thi N, Dinh P, Duong T, et al. In-depth epidemiologic investigations strongly suggest that 1 symptomatic passenger (case 1) transmitted SARS-CoV-2 infection during the flight to at least 12 other passengers in business class (probable secondary cases). This site uses cookies to assist with navigation, analyse your use of our services, and provide content from third parties. … The business class was exclusively reserved and separated from the premium economy and economy classes by a service/toilet area (Figure 1). Latest travel advice for Vietnam, including how to stay safe during the coronavirus (COVID-19) pandemic and information on returning to the UK. Please choose a departure airport . Contact with case 1 might also have occurred outside the airplane at the airport, in particular among business class passengers in the predeparture lounge area or during boarding. Similar conclusions were reached for SARS-CoV superspreader events on a flight in 2003, in which a high risk for infection was observed for passengers seated farther than 3 rows from the index case (4). 2019 Novel coronavirus (COVID-19) pandemic: built environment considerations to reduce transmission. Covid-19 cases in selected countries, as of 1 April 2020. In the absence of genomic analysis, we were unable to completely rule out alternative transmission routes. Evidence of airborne transmission of the severe acute respiratory syndrome virus. At that time, 1,593 persons had tested negative for SARS-CoV-2 infection in Vietnam, and according to official policy at that time, another 10,089 contacts and travelers returning from COVID-19–affected areas overseas were under preemptive quarantine directly at the time of arrival. Our interviews did not reveal that any of the additional persons with flight-associated cases had been exposed to SARS-CoV-2 before or after the flight during their incubation periods other than having taken the same flight as case 1, nor did they suggest exposure for any of the 4 travel companion couples after the flight (Appendix). Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. How COVID-19 regulations are changing landlord-tenant dynamics. She was seated in business class and continued to experience the sore throat and cough throughout the flight. Why … First imported case of 2019 novel coronavirus in Canada, presenting as mild pneumonia. Comment submitted successfully, thank you for your feedback. for Social Data Lab, Hanoi. We thank healthcare workers from provincial Centers for Disease Control and local authorities from cities and provinces in Vietnam for their great work with case finding, contact tracing, disease control, and prevention measures. This policy change eliminated the need for resource-intensive contact tracing of flight passengers altogether and enabled detection of another 106 cases among »5,000 passengers on 44 flights until all international flights were halted on March 28. Vietnam’s Ministry of Health recorded only one imported COVID-19 case on Monday, while detecting zero local infections in Ho Chi Minh City. A study of a COVID-19 cluster with 16 infected flight passengers from Singapore in February 2020 identified only 1 instance of potential in-flight transmission (28). … CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Search flights. First, thermal imaging and self-declaration of symptoms have clear limitations, as demonstrated by case 1, who boarded the flight with symptoms and did not declare them before or after the flight. The largest epicenter of the coronavirus outbreak in Vietnam - Volume 41 Issue 8 - Trang H.D. Affected persons were passengers, crew, and their close contacts. Face masks were neither recommended nor widely used on airplanes in early March, in particular not among travelers from Europe (24–26), who constituted the majority of passengers on flight VN54. See the map, stats, and news for areas affected by COVID-19 on Google News Whether either of these passengers could represent a separate index case in economy class is unknown. Furthermore, none of the 30 colleagues of case 4, who shared the same preflight travel history but were all seated in economy class, were infected (Appendix). Science X Daily and the Weekly Email Newsletter are free features that allow you to receive your favorite sci-tech news updates in your email inbox, Follow the latest news on the coronavirus (COVID-19) outbreak, Exploring the role of prefrontal-amygdala brain circuits in social decision-making, Smartphone camera used to diagnose viral infections, Best of Last Year: The top Medical Xpress articles of 2020, Study of relationship between poverty and mental health shows cash support can help, Superspreading events profoundly alter the course of an epidemic. Transmission of COVID-19 virus by droplets and aerosols: A critical review on the unresolved dichotomy. All told, the COVID-19 epidemic will result in an estimated loss of between $5.9 and $7 billion for Vietnam’s tourism in the next three months. Dat Huynh. H. Thi, F. Vogt), Ministry of Science and Technology, Hanoi (P.C. Transmission and control of an emerging influenza pandemic in a small-world airline network. Combating the COVID-19 Epidemic: Experiences from Vietnam. "All of us think that COVID is our enemy, so we are preparing for a battle... We have to prepare very carefully and we have to win (this battle)," he told reporters, describing the work on the clinical trial. All 12 additional cases in business class met the definition of probable secondary cases. None of the couples or individual cases traveled or stayed with another couple or individual case before the flight or after arrival in Vietnam. Blocking middle seats, currently recommended by the airline industry (7,35), may in theory prevent some in-flight transmission events but seems to be insufficient to prevent superspreading events. Of the 15 persons with flight-associated cases, 12 (80%) had traveled in business class with case 1, and 2 travelers (cases 14 and 15) and 1 flight attendant (case 16) had been in economy class (Figure 1). In-depth interviews were conducted with all persons with suspected or confirmed flight-associated cases; the specific focus was detecting any potential SARS-CoV-2 transmission events before and after the flight to investigate potential alternative scenarios for transmission other than during the flight. It has even managed to attract Indian companies to invest or increase investment in the country. First, we did not have genomic sequencing data available to support our hypothesis of in-flight transmission. Among passengers seated within 2 meters from case 1, which we approximated in business class to be <2 seats away, 11 (92%) were SARS-CoV-2–positive compared with 1 (13%) located >2 seats away (risk ratio 7.3, 95% CI 1.2–46.2) (Table 2). Our objectives were to estimate the probability that transmission of SARS-CoV-2 occurred on the flight in question and to identify risk factors associated with transmission. According to a report by the Department of Agricultural Products Processing and Market Development, Vietnam exported 895,000 tons of rice worth $410 million in the first two months of the year, a 27 percent increase in volume and 32.6 percent rise in value year … There were 4 traveling companion couples on board, and individuals within each couple sat next to each other in business class. Transmission of SARS-CoV 2 During Long-Haul Flight. We subsequently launched an extensive epidemiologic investigation that involved testing and isolation/quarantine of all traceable passengers and crew members of the identified flight. There are errors on this page. Investigation Team. We acknowledge important contributions and guidelines from the following committee and institutions: Vietnam National Steering Committee for COVID-19 Prevention and Control, Ministry of Health, Ministry of Science and Technology, and National Institute of Hygiene and Epidemiology. They presented with mild respiratory symptoms to their local health facilities at 4 days and 8 days, respectively, after arrival in Vinh Phuc. Nguyen, Danh C. Vu Outbreak investigation for COVID-19 in northern Vietnam Lancet Infect Dis. A total of 16 crew members and 201 passengers were on board. Last, we found a clear association between sitting in close proximity to case 1 and risk for infection (Table 2). Search for more papers by this author. The 274 seats on the airplane were divided into business class (28 seats), premium economy class (35 seats), and economy class (211 seats); there were 4 toilets for business and premium economy classes and 5 for economy. 2020 May;20(5):535-536. doi: 10.1016/S1473-3099(20)30159-6. Tu, D.D. The information you enter will appear in your e-mail message and is not retained by Medical Xpress in any form. Coronavirus (COVID-19) Check the latest information on risk from COVID-19 for Vietnam on the TravelHealthPro website. for Social Data Lab, Hanoi. Houston. These close contacts were also contacted, tested, and quarantined for 14 days. To assess the role of in-flight transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we investigated a cluster of cases among passengers on a 10-hour commercial flight. The tourism sector is only part of the problem. Furthermore, all persons with suspected or confirmed flight-associated cases were asked to identify persons with whom they had had close contact (<2 meter distance for >15 minutes) between arriving in Vietnam and the start of quarantine/isolation. Whether these cases reflect unusually long incubation periods or symptoms caused by conditions other than COVID-19 is unknown. Among >1,300 close contacts of VN54 passengers and crew members, 5 confirmed cases were identified, 3 of whom were household personnel linked to case 1. VietReader. Rationale for universal face masks in public against COVID-19. Identification and monitoring of international travelers during the initial phase of an outbreak of COVID-19—California, February 3–March 17, 2020. All successfully traced passengers and crew members were interviewed by use of a standard questionnaire, tested for SARS-CoV-2, and quarantined in designated facilities or at home. The aviation industry has experienced a sharp decrease in passenger volume this year. Initial investigations of the probable index case generated our working hypothesis of in-flight transmission and guided further investigations. Table of Contents – Volume 26, Number 11—November 2020. Our findings challenge these recommendations. On top of the complications posed by the Covid-19 outbreak, tea producers have also faced an unprecedented drought, added Rajadurai. The latest guidance from the international air travel industry classifies the in-flight transmission risk as very low (34) and recommends only the use of face masks without additional measures to increase physical distance on board, such as blocking the middle seats (7,35). Our study has several limitations. We defined confirmed flight-associated COVID-19 cases as passengers or crew members on flight VN54, regardless whether signs or symptoms developed, who had positive SARS-CoV-2 real-time reverse transcription PCR results from nasopharyngeal swab samples (13).