Alexey Clara1, Anh T P Dao2, Quy Tran2, Phu D Tran3, Tan Q Dang3, Huong T Nguyen3, Quang D Tran3, Peter Rzeszotarski4, Karen Talbert4, Tasha Stehling-Ariza2, Frances Veasey5, Lynne Clemens5, Anthony W Mounts2, Hannah Lofgren1, S Arunmozhi Balajee6, Trang T Do2. 1. Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. 2. Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA. 3. General Department of Preventive Medicine, Under the Vietnam Ministry of Health, Hanoi, Vietnam. 4. Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, USA. 5. Analytic Services, Inc (ANSER), Virginia, USA. 6. Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. fir3@cdc.gov.
Abstract
BACKGROUND: Simulation exercises can functionally validate World Health Organization (WHO) International Health Regulations (IHR 2005) core capacities. In 2018, the Vietnam Ministry of Health (MOH) conducted a full-scale exercise (FSX) in response to cases of severe viral pneumonia with subsequent laboratory confirmation for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) to evaluate the country's early warning and response capabilities for high-risk events. METHODS: An exercise planning team designed a complex fictitious scenario beginning with one case of severe viral pneumonia presenting at the hospital level and developed all the materials required for the exercise. Actors, controllers and evaluators were trained. In August 2018, a 3-day exercise was conducted in Quang Ninh province and Hanoi city, with participation of public health partners at the community, district, province, regional and national levels. Immediate debriefings and an after-action review were conducted after all exercise activities. Participants assessed overall exercise design, conduction and usefulness. RESULTS: FSX findings demonstrated that the event-based surveillance component of the MOH surveillance system worked optimally at different administrative levels. Detection and reporting of signals at the community and health facility levels were appropriate. Triage, verification and risk assessment were successfully implemented to identify a high-risk event and trigger timely response. The FSX identified infection control, coordination with internal and external response partners and process documentation as response challenges. Participants positively evaluated the exercise training and design. CONCLUSIONS: This exercise documents the value of exercising surveillance capabilities as part of a real-time operational scenario before facing a true emergency. The timing of this exercise and choice of disease scenario was particularly fortuitous given the subsequent appearance of COVID-19. As a result of this exercise and subsequent improvements made by the MOH, the country may have been better able to deal with the emergence of SARS-CoV-2 and contain it.
BACKGROUND: Simulation exercises can functionally validate World Health Organization (WHO) International Health Regulations (IHR 2005) core capacities. In 2018, the Vietnam Ministry of Health (MOH) conducted a full-scale exercise (FSX) in response to cases of severe viral pneumonia with subsequent laboratory confirmation for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) to evaluate the country's early warning and response capabilities for high-risk events. METHODS: An exercise planning team designed a complex fictitious scenario beginning with one case of severe viral pneumonia presenting at the hospital level and developed all the materials required for the exercise. Actors, controllers and evaluators were trained. In August 2018, a 3-day exercise was conducted in Quang Ninh province and Hanoi city, with participation of public health partners at the community, district, province, regional and national levels. Immediate debriefings and an after-action review were conducted after all exercise activities. Participants assessed overall exercise design, conduction and usefulness. RESULTS: FSX findings demonstrated that the event-based surveillance component of the MOH surveillance system worked optimally at different administrative levels. Detection and reporting of signals at the community and health facility levels were appropriate. Triage, verification and risk assessment were successfully implemented to identify a high-risk event and trigger timely response. The FSX identified infection control, coordination with internal and external response partners and process documentation as response challenges. Participants positively evaluated the exercise training and design. CONCLUSIONS: This exercise documents the value of exercising surveillance capabilities as part of a real-time operational scenario before facing a true emergency. The timing of this exercise and choice of disease scenario was particularly fortuitous given the subsequent appearance of COVID-19. As a result of this exercise and subsequent improvements made by the MOH, the country may have been better able to deal with the emergence of SARS-CoV-2 and contain it.
Entities:
Keywords:
Early warning and response; Full scale exercise; Vietnam
Authors: Alexey Clara; Anh T P Dao; Trang T Do; Phu D Tran; Quang D Tran; Nghia D Ngu; Tu H Ngo; Hung C Phan; Thuy T P Nguyen; Christina Bernadotte-Schmidt; Huyen T Nguyen; Karen Ann Alroy; S Arunmozhi Balajee; Anthony W Mounts Journal: Health Secur Date: 2018
Authors: Alexey Clara; Trang T Do; Anh T P Dao; Phu D Tran; Tan Q Dang; Quang D Tran; Nghia D Ngu; Tu H Ngo; Hung C Phan; Thuy T P Nguyen; Anh T Lai; Dung T Nguyen; My K Nguyen; Hieu T M Nguyen; Steven Becknell; Christina Bernadotte; Huyen T Nguyen; Quoc C Nguyen; Anthony W Mounts; S Arunmozhi Balajee Journal: Emerg Infect Dis Date: 2018-09 Impact factor: 6.883
Authors: Alexey Clara; Anh T P Dao; Anthony W Mounts; Christina Bernadotte; Huyen T Nguyen; Quy M Tran; Quang D Tran; Tan Q Dang; Sharifa Merali; S Arunmozhi Balajee; Trang T Do Journal: Global Health Date: 2020-04-30 Impact factor: 4.185
Authors: S Arunmozhi Balajee; Omer G Pasi; Alain Georges M Etoundi; Peter Rzeszotarski; Trang T Do; Ian Hennessee; Sharifa Merali; Karen A Alroy; Tran Dac Phu; Anthony W Mounts Journal: Emerg Infect Dis Date: 2017-10 Impact factor: 6.883