Up until a few months ago, Vietnam could boast of one of the world’s most successful COVID-19 responses. The country virtually eradicated the virus from the country’s borders even as it flummoxed governments and ravaged health systems in richer countries like the U.S. But this summer, Vietnam’s victory over COVID was inundated by a Delta-driven wave of infections.

In the past week, Vietnam has reported record-high infection rates, with new cases averaging 10,680 per day and COVID-related deaths surging to 360 per day. In total, 263,543 of the country’s 358456 infections have been reported in the past month, according to Johns Hopkins. Meanwhile, 8,296 of the country’s 8,666 deaths from COVID-19 have occurred in the past month.

“No one [here] has really experienced anything like this before,” says Guy Thwaites, director of the Oxford University Clinical Research Unit (OUCRU), who also works in COVID-19 wards in Ho Chi Minh City. “The outbreak has definitely stretched [Vietnam’s health care system] enormously.”

U.S. Vice President Kamala Harris, due to arrive in Vietnam on August 24, will encounter the country at its most dire point in battling the pandemic. Harris plans to coordinate with the government on its COVID-19 strategy, but Vietnam may not have a clear path out of its current crisis beyond weeks of extended lockdowns and a renewed effort to accelerate its fledgling vaccination campaign.

The Delta variant

For much of 2020 and early 2021, Vietnam lived relatively free of COVID-19. The country deployed a mixture of border restrictions and quarantines, intensive contact tracing teams, and localized lockdowns to keep the virus at bay.

Vietnam’s success in containing the virus allowed it to become one of the only countries in the world to grow its economy last year.

In 2020, the country’s GDP expanded by 2.9%, as virus containment measures allowed businesses and factories to remain open even as neighboring countries like Indonesia and Malaysia endured strict lockdowns.

But in May, Vietnam reported a cluster of over a hundred cases tied to a church in Ho Chi Minh City. Authorities locked down parts of the city and conducted a mass testing campaign, but cases continued to climb. By June and July, Vietnam began reporting hundreds and then thousands of new infections per day, not just in Ho Chi Minh City but throughout the country.

Thwaites says that the virus was likely introduced at multiple points into Vietnam, and the highly transmissible Delta variant simply overwhelmed Vietnam’s once airtight system.

“It’s a Delta-driven surge,” says Thwaites. “The country has done enormously well, but it was always vulnerable…It doesn’t surprise me, unfortunately, that something like [COVID-19] can evolve this quickly and cause this degree of harm and disruption.”

Vaccinations

The principal reason that Vietnam remains vulnerable to such a deadly outbreak is that much of its population remains unvaccinated. As of August 24, Vietnam had fully vaccinated just 1.9% of its population, while 15.8% of the country’s 98 million citizens have gotten at least one jab.

Vietnam’s slow vaccine rollout is due, in part, to the fact that wealthy nations gobbled up the majority of early vaccine supplies.

This week World Health Organization Director-General Tedros Adhanom Ghebreyesus, who has castigated wealthy countries for hoarding vaccine supplies, called for a two-month moratorium on nations distributing booster shots in order to prioritize sending existing supplies to countries that need the jabs.

But Vietnam may have also gotten complacent about securing jabs while the country lived relatively free of COVID-19 this spring.

Vietnam launched its vaccination campaign in March using doses from British vaccine maker AstraZeneca as well as Russia’s Sputnik V vaccine, and it has deployed over 11.5 million AstraZeneca shots since then. But the country did not bolster its supply until July, when health officials cleared the way for distribution of doses supplied by Chinese vaccine maker Sinopharm and the American firms Pfizer and Moderna. In total, Vietnam has now secured over 100 million vaccine doses, and recently rolled out a plan to vaccinate 50% of its population by the end of the year.

Huong Le Thu, a senior analyst and Southeast Asia policy expert at the Australian Strategic Policy Institute, says the U.S. has donated 5 million Pfizer and Moderna vaccines to Vietnam, more than any other country. But she notes that Harris’s visit could help alleviate Vietnam’s current crisis if it leads to more vaccines. “Any amount of vaccines arriving immediately would be welcomed,” Le Thu says. She adds that Harris is expected to launch a new U.S. Centers for Disease Control and Prevention office in Vietnam this week, a positive sign that the U.S. is interested in deeper engagement on public health issues in Vietnam.

Lockdowns

While Vietnam’s vaccination campaign has lagged, the country has imposed strict lockdowns to contain the surge of infections. In response to the latest outbreak, the government has issued strict stay-at-home orders in major cities like Ho Chi Minh City and Hanoi. On August 23, the government dispatched the military to Ho Chi Minh City to enforce the lockdown and hand out food supplies. Ho Chi Minh City also announced on August 24 that it plans a citywide testing campaign for its 9 million residents.

Meanwhile, Vietnam’s neighbor Thailand announced this week that it will shift away from a COVID-zero strategy to one that tolerates the virus amid its own wave of new infections and a similarly lagging vaccine campaign.

Le Thu says that Vietnam will eventually have to learn to live with the virus and accept some level of infections spreading through the country in order to reopen. But for now the government appears set on sticking to its COVID-zero strategy and reducing the spread of the disease at all costs.

“[Living with the virus] is probably the future course for Vietnam,” Le Thu says. “But at the moment there are no such messages yet [from the government] because the urgency is on controlling the spread and vaccinating the population.”

Thwaites says that Vietnam’s health care system is on the brink, and strict social distancing measures may be necessary until cases begin to fall.

“I think lockdowns are the only measure in the short term to keep the health care system from falling over,” says Thwaites.