THE MINISTRY OF HEALTH ___________ No. 5053/QD-BYT | THE SOCIALIST REPUBLIC OF VIETNAM Independence - Freedom - Happiness _____________ Hanoi, December 03, 2020 |
DECISION
Promulgating the “Handbook for tracing people in contact with SARS-CoV-2 positive cases”
___________
THE MINISTER OF HEALTH
Pursuant to the Government's Decree No. 75/2017/ND-CP dated June 20, 2017, defining the functions, tasks, powers and organizational structure of the Ministry of Health;
At the proposal of the Director of the General Department of Preventive Medicine under the Ministry of Health,
DECIDES:
Article 1. To promulgate together with this Decision the “Handbook for tracing people in contact with SARS-CoV-2 positive cases”.
Article 2. The “Handbook on tracing people in contact with SARS-CoV-2 positive cases” shall be applied nationwide.
Article 3. This Decision takes effect on the date of its signing.
Article 4. Mr./Ms.: The Chief of Ministry Office; the Chief of Ministry Inspectorate; Directors and Directors General of Departments and Directorates of the Ministry of Health; Directors of hospitals of the Ministry of Health; Directors of Institute of Hygiene and Epidemiology, Pasteur Institute, National Institute of Malariology Parasitology and Entomology, and Institute of Public Health; Directors of Health Departments of provinces and cities; heads of medical units of ministries and branches and heads of relevant units shall be responsible for the implementation of this Decision./.
| FOR THE MINISTER THE DEPUTY MINISTER Do Xuan Tuyen |
THE MINISTRY OF HEALTH
HANDBOOK FOR TRACING PEOPLE IN CONTACT WITH SARS-COV-2 POSITIVE CASES
(Attached to the Decree No. 5053/QD-BYT dated December 03, 2020, of the Ministry of Health)
Hanoi, 2020
INTRODUCTION
COVID-19 is a group-A contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This disease can be transmitted from person to person, with an incubation period of about 14 days. Infected persons may have variable clinical symptoms such as fever, cough, sore throat, body aches, fatigue, decrease or loss of smell and taste, shortness of breath, possible severe pneumonia, acute respiratory distress, and death, especially in people with underlying and chronic medical conditions, and the elderly. There is a high percentage of people infected with the SARS-CoV-2 virus, who show no clinical symptoms (about 40%) and the source of transmission may have appeared in the community, making it difficult for monitoring and preventing the pandemic.
The first person who has a positive SARS-CoV-2 test result (hereinafter referred to as the confirmed case) was recorded in Wuhan city, Hubei province, China on December 03, 2019. The World Health Organization (WHO) on March 11, 2020, has declared the COVID-19 outbreak a global pandemic. As of October 27, 2020, many cases have been recorded in 217 countries/territories, and the number of cases still tends to increase despite the efforts of many countries/territories to implement many prevention measures. Vietnam has recorded cases of invasive diseases and diseases in the community.
Until now, there is no specific treatment for COVID-19, and the vaccine is widely used in the community. Currently, surveillance, early detection, tracing, zoning and isolating source of transmission are still the main measures in preventing the pandemic from spreading in outbreaks.
In order to guide health staff to track people in contact with the confirmed case to organize quarantine, timely provide treatment and prevent the pandemic from spreading to the community, and on the basis of experiences gained from dealing with the outbreaks in Vinh Phuc, Hanoi, Hai Duong, Da Nang, and other localities, in recent times, the Ministry of Health develops this Handbook to disseminate to agencies and localities for implementation.
CONTENTS OF THE HANDBOOK FOR TRACING
PEOPLE IN CONTACT WITH SARS-COV-2 POSITIVE CASES
I. Objectives:
To trace persons in contact with infected cases for organizing quarantine, providing timely treatment, and preventing the pandemic from spreading.
II. Requirements:
1 - Quickly and thoroughly tracing contact cases without exception.
2 - The provincial-, district-, and commune- level Steering Committees for Pandemic Prevention and Control and relevant agencies and units must mobilize all resources to ensure fast and effective tracing.
III. Principles:
1 - Tracing as soon as possible, immediately after receiving information about the confirmed case.
2 - First, identify “epidemiological milestones”, then carry out contact tracing.
3 - Using multiple tracing forces at the same time for quick tracing according to identified “epidemiological milestones”.
4 - Taking many tracing measures; Measures can collect duplicate information but complement each other, help to trace contacts fully and systematically.
5 - Spending resources and time to complete tracing F1 cases as soon as possible; F2 cases shall only be traced after the F1 tracing is basically completed.
6 - The “epidemiological milestones” and information about close contacts of confirmed case (F1 cases) within a period of 03 days before the time of onset until the time when the confirmed case is quarantined must be traced.
7 - People conducting tracing tasks must take measures to prevent infection.
IV. A number of terms used in contact tracing
1 - F1 case: Is a person who has been in close contact within 02 meters with a confirmed case within a period of 03 days prior to the onset until the confirmed case is quarantined. The onset of a case is the day when the patient has the first unusual health symptoms, which can be one of the following: fever, fatigue; body aches, chills; decrease or loss of taste or smell; fever; cough; sore throat, etc. If he/she is a healthy carrier (who does not have any symptoms), the date of onset is the date when the specimen is collected and tested positive for SARS-CoV-2.
2 - F2 case: is a person who has been in close contact within 02 meters with the F1 case from the first day the F1 case in contact with the confirmed case (within 03 days before the onset) until the F1 case is quarantined.
3 - Epidemiological milestone: is the place, event that the confirmed case went to or attended in about 03 days before the onset until the patient is quarantined.
Note: The investigation to find the transmission source within 14 days before the onset shall fall within the scope of the basic epidemiological investigation and is not covered by this guidance.
V. Methods of tracing F1 cases
1 - Step 1: Identifying “epidemiological milestones”
- Investigators: Investigation officers of the Centers for Disease Control (CDC) at the provincial level or medical centers at the district level and local authorities and grassroots health facilities.
- Requirements: List of “epidemiological milestones” according to Form 1.
- Methods of tracing:
+ Asking the patients directly or through the phone
+ Asking through relatives/friends/neighbors/neighborhood groups
+ Referring to medical records/records
- Contents need to retrieve "epidemiological milestones”
Asking for the "epidemiological milestones" that the patient has participated or traveled to within 03 days before the onset until the patient is quarantined according to the checklist (Checklist 1). Clearly stating the name/location/time of “epidemiological milestones” according to Form 1.
Checklist 1: Common “Epidemiological milestones” to be investigated
EPIDEMIOLOGICAL MILESTONES (CONFIRMED CASES HAVE BEEN VISITED OR PARTICIPATED) |
1 | Weddings, funerals, death anniversaries, birthdays, housewarming | □ |
2 | Crowded food festivals | □ |
3 | Frequent places (family relatives, friends, etc.) | □ |
4 | Supermarkets, shopping malls, etc. | □ |
5 | Markets, wholesale markets, temporary markets, etc. | □ |
6 | Retail/grocery stores | □ |
7 | Discotheques/bars | □ |
8 | Restaurants, cafes | □ |
9 | Public places of mass gatherings | □ |
10 | Amusement parks, parks, etc. | □ |
11 | Theaters, cinemas, stages | □ |
12 | Pagodas, temples, churches, etc. | □ |
13 | Meetings (retirement, class reunions, clubs, teams. etc.) | □ |
14 | Hotels, motels, etc. | □ |
15 | Schools, educational centers, etc. | □ |
16 | Offices, companies, workplaces, etc. | □ |
17 | Hospitals, private clinics, medical establishments, etc. | □ |
18 | Taxis, buses, cars, trains, airplanes, cruise ships, etc. | □ |
19 | Places that provide car repair services, haircuts, beauty, etc. | □ |
20 | Travel/visit/business trips | □ |
21 | Other (specify)................................................................ | □ |
2 - Step 2: Notifying “epidemiological milestones” for tracing coordination department (coordination department)
The coordination department should be located at the Department of Infectious Disease Control of the provincial-level Center for Disease Control at the provincial level or the district-level medical establishment.
- After identifying the "epidemiological milestones", the investigator should immediately notify the coordination department by the fastest means (such as phone, text message or take a picture of Form 1 and send it via Zalo, Viber, etc.).
- The coordination department shall immediately notify local administrations, surveillance systems, and grassroots health facilities where there are "epidemiological milestones", and at the same time, mobilize many tracing teams to such "epidemiological milestones" and conduct F1 tracing with local forces. In case where a number of "epidemiological milestones" are located outside the management area, the coordination department shall contact and notify the "epidemiological milestones" to relevant units to coordinate in the investigation.
3 - Step 3: Tracing F1 cases
Simultaneously conducting F1 tracing by several methods: asking the patient; tracing in the community where the patient lives; tracing at “epidemiological milestones”; tracing through media mass; tracing through Bluezone and Vietnam Health Declaration applications.
3.1. F1 tracing by asking patients
- Investigators: Investigation officers of the Centers for Disease Control (CDC) at the provincial level or medical centers at the district level mentioned in Step 1, after identifying and reporting epidemiological milestones, shall continue to cooperate with local administrations and grassroots health facilities in tracing F1 cases by asking patients or their families or concerned persons,
- Requirements: Lists of F1 cases made according to Form 2
- Methods of tracing:
+ Asking the patient about his/her daily activities for F1 tracing (asking from the nearest day to the farthest according to his/her memory).
+ Making a list of F1 cases according to Form 2.
+ Asking the patient to cover again the groups of close contacts according to the checklist to avoid omission (Checklist 2), continuing to add F1 cases to Form 2.
Checklist 2: Group of F1 cases that need to be asked (investigated) to avoid omitting:
CLOSE CONTACTS (F1 CASES) |
1 | Those who live in the same house/room/household with the confirmed case | □ |
2 | Partners/Lovemates | □ |
3 | Relatives | □ |
4 | Neighbors | □ |
5 | Close friends (those regularly meet the confirmed case) | □ |
6 | People in contact with the confirmed case through work/daily activities | □ |
7 | Co-workers/colleagues | □ |
8 | People traveling for business together or attending the same meeting with the confirmed case | □ |
9 | Classmates/schoolmates | □ |
10 | People in the same tour group, visiting group, or outing group | □ |
11 | People in the same club (poetry, sports, etc.) | □ |
12 | People who go out to have fun/party/drink/play cards with the confirmed case | □ |
13 | People with the same religious activities | □ |
14 | Persons traveling on the same vehicle with the confirmed case | □ |
15 | People in the same department/treatment room with the confirmed case | □ |
16 | Service staff and caregivers of patients in a medical establishment | □ |
17 | Health staff | □ |
18 | Other (specify)................................................................ | |
| | | | | |
+ Continuing to investigate and fill “epidemiological milestones” in Form 1 (if any)
+ Continuing to give Form 2, pen, and phone number to the patient to add more close contacts in the following days. Instructing the patient to send messages via Zalo, Viber, etc., or phone to investigators when adding more F1 cases.
+ Investigating in the following days in case of necessity.
3.2. Tracing F1 cases in the community where the patient is living
- Investigators: Provincial-/district-/commune- level tracing teams or enhanced tracing force (medical school students; other forces) and local administrations, police forces, residential groups/villages/neighborhoods, COVID community team, local officers, organizations, and other relevant forces.
- Requirements: Lists of F1 cases made according to Form 3
- Tracing methods:
+ Going to every alley, knocking on every door, tracking every subject according to the method of tracking the patient's house first, then expanding to trace the surrounding houses in the residential area where the patient lives to make a list of close contacts according to Form 3.
+ Announcing on loudspeakers of residential areas information about the confirmed case as well as definitions of close contacts (F1 cases) and those who are F1 cases are required to proactively report to local administrations and commune health facilities.
3.3. Tracing F1 cases at “epidemiological milestones”
- Investigators: Provincial-/district-/commune- level tracing teams or enhanced tracing force (medical school students; other forces) and local administrations, police forces, residential groups/villages/neighborhoods, COVID community team, local officers, organizations, and other relevant forces.
- Requirements: List of close contacts (F1 cases) made according to Form 3.
- Methods of tracing:
+ Contacting the persons in charge at the “epidemiological milestones”.
+ Choosing a convenient place to work (hall, meeting room, open space).
+ Requiring the responsible person to widely announce information about the confirmed case and the purpose and requirements of the tracing at the “epidemiological milestones” and notifying where the investigation team works so that those involved can take the initiative to come declare. Making sure not to gather in crowds and keeping a safe distance when in contact at the place of investigation.
+ Directly asking concerned people.
+ Retrieving recording devices at epidemiological milestones (if any)
+ Checking work schedule/work diary at epidemiological milestones (if any)
+ Checking the lists of concerned people at epidemiological milestones such as wedding invitation list, party invitation list, housewarming invitation list, etc. (if any).
- Notifying on mass media about the confirmed case, the "epidemiological milestones" and asking the concerned people to proactively report to the local administrations and health agencies.
- Providing e-mail address, the phone number to receive information.
- Making the list of F1 cases according to Form 3 detailing each "epidemiological milestone" assigned to conduct tracing.
Note: One person may be in contact with a confirmed case at the different epidemiological milestones, and he/she shall be named in different lists. All these contacts need to be put on the list and shall be filtered for duplicates later.
3.4. Tracing F1 cases through mass media
- Announcing on mass media about the confirmed case such as “epidemiological milestones” with time and location.
Guiding the people to self-declare and provide F1 cases for local administrations and health agencies.
- Local administrations, provincial-level Centers for Disease Control, or district-level medical centers shall provide the phone number or hotline of the Centers for Disease Control, receive declared information after announcing on mass media.
- Tracing teams shall continue to identify and supplement missing information about F1 cases.
- Additionally synthesizing the list of F1 cases according to Form 3.
3.5. Tracing F1 cases through Bluezone and Vietnam Health Declaration applications.
Bluezone application installed on the smartphone helps detect the Bluezone users who have been in close contact with the COVID-19 patient (if the patient also uses Bluezone). Tracing units are required to register for use with the Ministry of Health for instructions, management, and tracing at the website: https://cdc.bluezone.gov.vn/. In addition, the Vietnam Health Declaration application can be used to determine the travel, quarantine, and stay history of people entering Vietnam and moving inside the country.
4 - Step 4: Reviewing and completing the List of F1 cases
- All tracing teams shall send the F1 lists quickly to the coordination department. Such lists should be sent to the coordination department according to the schedule with the principle of “information is sent immediately upon investigation” and continue to be updated until the tracking is completed (the tracing teams shall take a photo of the F1 lists with a smartphone and then send them via Zalo, Viber, etc. to the coordination department).
- The coordination department shall immediately aggregate the F1 list from the investigation teams and enter it into the computer using Microsoft Excel or other applications. Using Microsoft Excel software or other applications to screen, filter duplicates, and make a list of all traceable F1 cases.
- Immediately notifying the traceable F1 cases to local administrations and the Steering Committees for pandemic prevention and control at all levels for quarantine and handling as prescribed.
5 - Step 5: Organizing the quarantine and taking specimens
- The Steering Committees for pandemic prevention and control and local administrations shall organize and arrange vehicles to transport F1 cases to the quarantine establishments in accordance with the Ministry of Health's regulations. When organizing to transfer F1 cases to quarantine establishments, local health agencies, local administrations and other forces at localities shall continue to review and screen to ensure quarantine measure is applied to the right person as prescribed.
- F1 cases’ specimens shall be collected for the first time at medical establishments as soon as possible, and transferred to the qualified testing establishments as prescribed by the Ministry of Health. F1 cases’ specimens should not be collected in the community to avoid confusion and loss of time.
VI. Methods of tracing F2 cases
After basically completing F1 tracing, F2 cases shall be traced according to the following methods:
1 - Providing Form for F1 case so that he/she can declare information about F2 cases (Form 4).
2 - Concentrated quarantine establishments, local administrations, and grassroots health facilities shall continue to investigate and track F2 cases in the community as well as collecting information from F1 cases at concentrated quarantine establishments.
3 - Sending the list of F2 cases to the local authorities for quarantine at home as prescribed.
* All Appendices are not translated herein.
Vietnamese
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