ECONOMYNEXT – Vietnam has kept mortality rate low in a Coronavirus crisis with zero deaths recorded as of April 28, pulling back aged patients from the brink of death with backed by external blood oxygenation using artificial lungs amid threats of multi-organ failure and blood coagulation disorders.
Vietnam probably has the lowest confirmed cases and mortality rate for a country of that size (95 million), while its neighbhour Cambodia, which is also contact tracing, has also reported low numbers.
Vietnam has been aggressively Contact tracing and using tests extensively (over 210,000 tests) to stop index cases going into big clusters and also using precautionary testing of high risk areas.
Vietnam has reported 270 cases 45 are still being treated and 225 have recovered according to health ministry data. But the country has found some relapses.
Vietnam completely killed the First Wave from China identifying 16 patients with Saigon’s Cho Ray hospital saving a 72-year old Chinese man who had a history of complications.
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Of the earliest victims of Wave II from third countries, Patient Number 19, a known as Madam LTH, was now making progress, Luong Ngoc Khue, a doctor in the medical team fighting Coronavirus was quoted as saying on Suckhoe and Doisong, a health promotion portal linked to the ministry of health.
She was the aunt of Patient 17, the first Second Wave patient in Vietnam who returned from Italy and UK, after the country completely stamped out Wave I epidemic from China.
Countries that did not close borders with China, did not contact trace returnees from the country, and allowed domestic community transmission to go uncheckded, exported their citizens to trigger the global Wave II pandemic.
Vietnam, Cambodia and Sri Lanka were among countries tightened controls on Chinese and other arrivals against World Health Organization advice at the time to keep numbers down and did not contribute to the pandemic by re-exporting citizens with the disease.
Too keep down mortality, Vietnam doctors kept medical resources free by extensively tracing contacts and tests.
Vietnam doctors are still battling to save three patients, two Vietnam nationals and one Briton.
As ventilators became less effective amid rising pneumonia, Vietnam doctors put the 64-year old Patient 19 on extracorporeal membrane oxygenation, the same technology used in used during transplants (heart lung machines) to take-over the functions of the heart and lung.
On April 04 it was reported that she was off the ECMO machine and was on ventilator only.
She had lung damage but showed improved blood oxygenation. Heart rhythm disorder had lessened, blood blood pressure is stable, and good perception, communication, inconsistent was being fed with a gastric tube, there was no no reflux, no bleeding.
She is now using a tracheotomy tube and doctors said they have begun the process of weaning her off the ventilator.
Patient No 161 was also on a ventilator with tracheostomy and was still ‘weakly postive’ for SARS-CoV-2, the report said. There was progress in the condition of her lung, heart and blood pressure was normal but had left spastic hemiplegia. Communication was slow.
Doctors are most concerned about Patient 91, a British national. Out of 270 confirmed cases about 160 were foreigners mostly index cases, and sometimes close (F1) contacts according to reports.
Patient 91, a UK pilot working for Vietnam Airlines was still on ECMO. He had no fever, had tested negative for Coronavirus three times but had lung damage.
The patient was overweight and already had sever lung damage when he was admitted to the Tropical Disease Hospital in Saigon.
He was put on oxygen, CPAP and then intubated and put on a ventilator. When the ventilator was no longer effective a medical team from Cho Ray hospital came to hook him to a ECMO inside a negative pressure room.
Vietnam’s top doctors of various specialties were called on video conference to stabilize as his condition deteriorated earlier in April, as complications mounted and blood coagulation which is believed to be linked to Coronavirus got worse.
Doctors were quoted as saying anti-coagulation drugs had to be imported from Germany.
At various times doctors in Vietnam had used drugs to fight fungal infections, stabilize blood pressure, constrict blood vessels and as well as fighting blood coagulation and keep critically ill patients alive long enough to beat the virus. (SB-Colombo/Apr28/2020)