Nghe An actively and proactively prevents and combats dangerous epidemics

Nghe An Newspaper reporter had an interview with Dr. Chu Trong Trang - Director of Nghe An Province Center for Disease Control about related issues.

PV:After the Covid-19 epidemic was controlled, what diseases have emerged in Nghe An, sir? How has the Nghe An Health Department implemented the work of preventing and fighting these diseases?

Mr. Chu Trong Trang:In recent years, the Covid-19 pandemic has been the top concern in the prevention and control of Covid-19, which seems to have "overshadowed" other diseases. However, in reality, other dangerous infectious diseases still occur and the prevention and control of these diseases is always taken seriously. And when the Covid-19 pandemic has been controlled, we have also seen more clearly the presence and threat of infectious diseases.

In 2022/2023, in Nghe An, many infectious diseases besides Covid-19 emerged, such as: Influenza syndrome, dengue fever, Japanese encephalitis, chickenpox, hand - foot - mouth disease, rabies... even diseases that were previously rare such as diphtheria and whooping cough also appeared sporadically in localities in the province. The disease with many people infected is dengue fever. In 2022, the number of dengue fever cases was 2,670 (with 95 outbreaks/19 localities) and in 2023 it was 1,195 cases (with 72 outbreaks/13 localities). The emergence of many dangerous diseases after the Covid-19 pandemic is a special and worrying phenomenon.

In preventing and combating infectious diseases, Nghe An's health sector has been very proactive and active. In 2022/2023, the whole province has done a good job of vaccinating against Covid-19. Nghe An received 76 allocations from the Central Government, did not return vaccines, and ensured timely, safe and effective use of vaccines for people in the province. Nghe An's rate of fully vaccinating all basic doses is 12th out of 63 provinces and cities. This is the premise for the number of cases to decrease sharply and sustainable control to become favorable.

With the motto of being one step ahead, one level higher, Nghe An Health Sector has resolutely taken action from the beginning, aiming to provide effective solutions in epidemic prevention and control. When the epidemic broke out, dangerous infectious cases appeared, the Department of Health and the Provincial Center for Disease Control directly worked with the Steering Committee for epidemic prevention and control of districts, towns and cities to provide specific solutions for each unit, plans to mobilize the community and the political system to participate, solve difficulties, synchronously deploy medical measures, and establish a daily reporting regime.

Thanks to that, outbreaks and cases have been contained and promptly treated, preventing widespread spread. The situation of infectious diseases in general has been basically controlled throughout the province, preventing major epidemics from occurring. In 2023, the area has not recorded any cases of group A infectious diseases such as H5N1, H7N9, Mer-CoV, Ebola.

PV:Obviously, the disease model has changed a lot. What is the forecast for the epidemic situation in 2024? What should Nghe An do to prevent and combat dangerous epidemics?

Mr. Chu Trong Trang:In the coming time, the Covid-19 epidemic situation may still be unpredictable with many different variations, so it is still necessary to be proactive in management and control. For many dangerous infectious diseases, Nghe An has a source of disease in the community. Along with that, the province is located in a geographical location favorable for trade and travel, so there is a possibility of many imported cases entering, so the risk of disease outbreaks is very high.

In 2023, like other localities across the country, Nghe An suffered a shortage of some basic vaccines in the expanded immunization program due to a supply crisis. The vaccine gap has left many children unvaccinated, creating active immunity. This is the risk that some previously “extinguished” diseases may return.

Faced with the risk of an outbreak, we must not be subjective but continue to fully and synchronously implement measures and solutions to prevent and control the epidemic.

The first, for direction and management work, it is necessary to be decisive, timely, in the right direction, comprehensive, proactive, flexible, and appropriate to the actual situation.

MondayIt is necessary to prevent and control epidemics according to the "4 on-site" principle (prevention; on-site isolation and treatment - facilities; equipment, medicine; on-site protection - on-site funding - on-site human resources).

Tuesday, improve the ability to identify and forecast epidemics by proactively monitoring and evaluating old outbreaks, monitoring vectors and the environment monthly to promptly make assessments, warnings and have specific solutions.

Wednesday,Develop good scenarios for epidemic prevention and control. Specifically, based on the number of cases recorded annually in the area, the progress of the epidemic cycle, and the actual situation, localities need to proactively develop scenarios, in which, specify human resources, time, material resources, and specific equipment to respond to epidemic prevention and control.

Thursday, promote communication work with the principle of communication being one step ahead, continuous and diverse communication.

FridayIt is necessary to strengthen training, short-term and long-term training, new training and retraining for officials working in disease prevention and control at all levels, ensuring adequate provision of knowledge and skills necessary to respond to and handle epidemics.

Final, must provide adequate and ready equipment, medicine, chemicals. Ensure timely arrangement, sufficient funding and stable, long-term reserve funding, ready to respond to epidemic situations.

For the Provincial Center for Disease Control, district-level medical centers need to play a good role in advising the Department of Health and People's Committees at all levels on plans to prevent and control infectious diseases. In professional activities, it is necessary to proactively conduct zoning, isolation, and early treatment; strengthen monitoring and support for disease prevention and control for units; regularly have rapid response teams to ensure response and support for localities when necessary; analyze, assess, forecast and propose appropriate disease prevention and control measures for each stage.

PV:Can you tell us more about the shortage of vaccines in the expanded immunization program in 2023? By 2024, has the shortage of vaccines been resolved?

Mr. Chu Trong Trang:In 2023, implementing the expanded immunization program, Nghe An has 4/9 targets that have met the set plan, including the rate of tuberculosis vaccination; newborn hepatitis B vaccination; pregnant women receiving 2 doses of tetanus; Japanese encephalitis vaccination. 5/9 targets that have not been met are the rate of full vaccination; diphtheria, tetanus, whooping cough vaccination for 18-month-old children; measles vaccination for 9-month-old children; full polio vaccination; measles/rubella vaccination.

The reason for the failure to meet vaccination targets is the interruption of vaccine supply. Up to now, the supply of vaccines under the expanded immunization program has been entirely dependent on central sources. In 2023, this supply will be interrupted. On April 20, 2023, the National Institute of Hygiene and Epidemiology (Ministry of Health) issued Official Dispatch No. 700/VSDTTU-TCQG announcing that 2/10 types of vaccines for children will be out of stock by February 2023 and DPT vaccines will be out of stock by April 2023. In October 2023, the National Institute of Hygiene and Epidemiology stopped providing 9/10 types of vaccines in the expanded immunization program (except for Japanese encephalitis vaccine).

In the first quarter of 2023, the Ministry of Health assigned the People's Committees of the provinces to balance their budgets to purchase free vaccines for people. The Nghe An Department of Health has compiled an estimate of the number of vaccines and vaccination supplies needed in the last months of 2023 and the entire year of 2024; proposed and advised the Provincial People's Committee to purchase vaccines and vaccination supplies. However, the Central Government later realized that if the provinces were to purchase vaccines, there would be many shortcomings, so the Government assigned the Ministry of Health to continue providing expanded vaccination sources for localities. The Central budget continues to implement vaccination to ensure vaccine supply.

Faced with the difficulties of lack of vaccines for vaccination, the Department of Health has directed the Provincial Center for Disease Control to deploy many synchronous solutions to both receive maximum vaccines from the Central Government and increase the vaccination rate. The Department of Health has worked with the National Institute of Hygiene and Epidemiology to discuss solutions to provide maximum vaccines available at the institute to serve the expanded vaccination program; conduct regular and continuous reviews of vaccine needs, based on children's vaccination schedules to receive maximum remaining vaccines, in order to increase vaccination coverage of all types; organize many campaigns for catch-up vaccination, mop-up vaccination, and supplementary vaccination for areas with low vaccination rates/epidemics.

In addition, the Nghe An Health Department has also strengthened communication and propaganda activities for people about the supply of vaccines in the coming time, helping people understand, agree and proactively choose the appropriate vaccination form for vaccination subjects. (The service vaccination system in Nghe An has developed very strongly in recent times. There are 48 non-public vaccination facilities and 22 public health facilities participating in service vaccination. People can participate in service vaccination to prevent diseases in time).

With the initiative, cooperation and consensus of the preventive health system, in the context of the difficult supply of expanded vaccination vaccines, Nghe An's expanded vaccination activities in 2023 overcame difficulties and achieved remarkable results compared to other localities nationwide.

In 2024, the shortage of vaccinations has been overcome. At the beginning of the year, the National Institute of Hygiene and Epidemiology provided 9/10 types of vaccines to Nghe An province. The quantity of these 9 types of vaccines is enough to vaccinate children who have not been vaccinated in 2023 and children who are scheduled for vaccination in the first 6 months of 2024...

To proactively ensure good vaccine supply in the coming time, Nghe An Health Sector will strive to effectively implement the work of developing a plan to investigate, review, collect statistics, synthesize reports and manage vaccination subjects well, organize catch-up vaccination, catch-up vaccination, and campaign vaccination for areas with low vaccination rates due to vaccine shortage or epidemics; proactively propose maximum vaccine demand to receive maximum and effectively implement vaccination for the locality; mobilize resources to ensure vaccination activities; strengthen inspection, management and preservation of vaccines at all levels; promote communication to local people about the benefits of vaccination, so that people can proactively choose the appropriate form of vaccination for their children.

PV:Practice has shown that: “Prevention is better than cure”; The preventive health care system needs more attention and investment. In your opinion, what should we do to further improve the current preventive health care capacity?

Mr. Chu Trong Trang:The scale of the preventive health system in the province includes the Provincial Center for Disease Control, the Provincial Food Safety and Hygiene Department; in the district, there are health departments and health centers; in the commune, there are health stations and village and hamlet health workers. To improve the operational capacity of this system, all levels and sectors need to pay more attention to investing in facilities, equipment and human resources. Up to now, agencies and units performing preventive health tasks have been facing many difficulties in equipment and facilities. For example, the Provincial Center for Disease Control lacks testing machines and biological products due to difficulties in bidding.

Along with that, we need to have investment solutions to improve the quality of human resources, improve the capacity of medical staff through training and guidance on knowledge and skills in disease prevention and control. Pay more attention to the salary and living conditions of the team of preventive medical staff so that they can meet the requirements of their work well (the salary of this team is currently quite low, while the preventive units are public health, with no revenue).

It is necessary to ensure the cohesion of the preventive health system at all levels from the central to provincial, district and communal levels so that reporting and direction of disease prevention and control activities are complete and consistent. During the operation, the units in the preventive health system themselves need to focus on enhancing their analytical capabilities to promptly make assessments, warnings and proactively advise all levels to develop response scenarios for possible disease situations.

Disease prevention and control is not only the responsibility of the health sector but also of the whole community. Each individual needs to actively participate in disease prevention and control by improving their knowledge of disease prevention, going to a medical facility immediately when seeing unusual signs of health for advice and guidance; practicing a healthy lifestyle and activities to control factors leading to the risk of non-communicable diseases (high blood pressure, diabetes, cancer, etc.).

PV:Thank you!