Quyết định 4800/QD-BYT

DECISION

PROVISIONAL GUIDELINES ON MEDICAL SPECIALTY FOR IMPLEMENTATION OF RESOLUTION NO. 128/NQ-CP DATED OCTOBER 11, 2021 OF THE GOVERNMENT ON PROVISIONAL GUIDELINES ON "SAFETY, FLEXIBILITY, AND EFFECTIVE CONTROL OF COVID-19"

MINISTER OF HEALTH

Pursuant to Law on prevention and control of infectious diseases dated 2007;

Pursuant to the Law on Medical Examination and Treatment in 2009;

Pursuant to Decree No. 75/2017/ND-CP dated June 20, 2017 of Government on functions, tasks, powers, and organizational structure of Ministry of Health;

Pursuant to Resolution No. 128/NQ-CP dated October 11, 2021 of the Government on provisional guidelines on "Safety, flexibility, and effective control of COVID-19";

At request of Director General of Health Environment Management Agency;

DECISION

Article 1. The provisional guidelines on medical specialty for implementation of Resolution No. 128/NQ-CP dated October 11, 2021 of the Government on provisional guidelines on "Safety, flexibility, and effective control of COVID-19" are attached hereto.

Article 2. This Decision comes into effect from the day of signing.

Article 3. Chief of Ministry Office, Chief of Ministry Inspectorate, Directors, General Directors of Departments and General Departments affiliated to Ministry of Health; Directors of Institutes affiliated to preventive medical system; directors of hospitals affiliated to Ministry of Health; Directors of Departments of Health, Centers for Disease Control of provinces and central-affiliated cities; heads of medical authority of ministries, heads of entities, and relevant agencies, organizations, and individuals are responsible for implementation hereof./.

PROVISIONAL GUIDELINES

ON MEDICAL SPECIALTY FOR IMPLEMENTATION OF RESOLUTION NO. 128/NQ-CP DATED OCTOBER 11, 2021 OF THE GOVERNMENT ON PROVISIONAL GUIDELINES ON "SAFETY, FLEXIBILITY, AND EFFECTIVE CONTROL OF COVID-19"
(Attached to Decision No. 4800/QD-BYT dated October 12, 2021 of Ministry of Health)

I. CRITERIA FOR ASSESSMENT OF EPIDEMIC LEVEL

1. Criteria

a) Criteria 1: Rate of new infected cases in community/population/time.

b) Criteria 2: Vaccine coverage.

c) Criteria 3: Capacity for receiving and providing treatment of medical examination and treatment establishments of all levels.

2. Requirements for criteria

2.1. Criteria 1: Number of new infected cases in community/100,000 people/week[1].

Number of new infected cases in community/100,000 people/week (new cases) shall be classified by 4 levels in ascending order according to guidelines of World Health Organization[2] (level 1: 0 - < 20; level 2: 20 - <50; level 3: 50 - <150; level 4: ≥150). Local governments may increase or decrease number of new infected cases accordingly.

2.2. Criteria 2: Percentage of individuals at 18 years of age or older receiving at least 1 dose of COVID-19 vaccine[3].

a) Percentage of individuals at 18 years of age or older receiving at least 1 dose of COVID-19 vaccine shall be classified into 2 levels (≥70% of individuals at 18 years of age or older receiving at least 1 dose of vaccine; <70% of individuals at 18 years of age or older receiving at least 1 dose of vaccine). Local governments may adjust percentage of vaccine coverage accordingly.

b) In October 2021, at least 80% of individuals at 65 years of age or older have received adequate number of COVID-19 vaccine doses. From October 2021, at least 80% of individuals at 50 years of age or older have received adequate number of COVID-19 vaccine doses.

2.3. Criteria 3: Capacity for receiving and providing treatment of medical examination and treatment establishments of all levels.

a) Provinces and cities shall develop plans for establishing facilities for accepting, providing treatment, and guaranteeing number of intensive care unit (ICU) beds in medical examination and treatment establishment affiliated to provinces and cities (including private medical entities) to ready for responding to level 4 epidemic[4].

b) Districts, communes, and townlets shall develop plans for establishing mobile medical stations and teams for taking care of COVID-19 patients in community, and plans for providing medical oxygen for medical stations of communes, wards[5] in case of epidemic outbreak.

3. Classification of epidemic level according to Resolution No. 128/NQ-CP dated October 11, 2021 of the Government is illustrated under the following schedule

* For criteria 1 and 2, may adjust number of new infected cases and percentage of individuals receiving COVID-19 vaccine doses in each level depending on local situations.

4. Adjustment of epidemic level:

- Failure to satisfy Criteria 3 will result in not being able to lower epidemic level.

- Increase epidemic level by 1 in case of failure to satisfy requirements under Point b Clause 2.2. Section 2 Part I (except for areas having epidemic level 4 or no infected cases at all).

5. Provinces and central-affiliated cities shall rely on practical situations regarding epidemic development, vaccine coverage, realistic condition (population density, socio-economic conditions, etc.), and adaptability to revise criteria and epidemic level appropriately according to Resolution No. 128/NQ-CP dated October 11, 2012 of the Government.

II. SPECIALIZED MEASURES

1. Prepare capacity for responding to COVID-19

In order to improve safety, flexibility, and effective control of COVID-19, provinces and central-affiliated cities shall prepare the followings:

a) Develop scenarios and solutions for guaranteeing medical operations serving COVID-19 management in each epidemic level; organize implementation in case of epidemic outbreak in the area.

b) Enhance training to improve capacity in tracing, testing, quarantining, and providing treatment in the area.

c) Improve capacity in accepting, providing treatment, and taking care of COVID-19 patients;

- Develop plans for accepting, taking care, and providing treatment for COVID-19 patients (F0), especially plans that satisfy ICU bed requirements. Update figures and manage reporting software of facilities for accepting and providing treatment for F0.

- Develop plans in case of epidemic outbreak: medical examination and treatment establishments from district levels or higher must develop liquid oxygen and/or compressed gas supply systems; medical stations of wards, communes are capable of providing medical oxygen; develop plans for organizing mobile medical stations and teams for taking care of F0 in community and managing F0 at home.

- Organize medical examination and treatment establishments to provide treatment for both regular patients and COVID-19 patients. Organize classification of suspected cases arriving at the establishments for medical examination and treatment to detect infected cases, manage closely, and avoid cross-contamination in the establishments.

2. Perform tests

a) Testing shall be performed in areas depending on risks.

- Test individuals who display any of the following symptoms: fever, coughing, fatigue, sore throat, loss of sense of taste and sense of smell, dyspnea, etc.

- Medical authority shall conduct regular and irregular screening tests in areas with high risks and crowded areas such as medical examination and treatment establishments, supply markets, bus stations, supermarkets, etc.; and for individuals with risks (who move around a lot, make contact with many people, etc.) such as vehicle operators, operators of passenger motorbikes, shippers, etc.

- In manufacturing facilities, service providers, commercial centers, supermarkets, workplaces, offices: organize random SARS-CoV-2 test for individuals having high risks of COVID-19 infection.

b) Do not designate testing for general movement of the general public; only test people arriving from areas with level 4 epidemic or areas under regional quarantine and suspected individuals or according to epidemiology inspection from areas with level 3 epidemic.

c) For individuals who have received adequate doses of vaccine or have relieved of COVID-19: only test according to epidemiology inspection requirements or when the individuals are placed under medical quarantine or medical monitor or when the individuals arrive from areas under level 4 epidemic or areas under regional medical quarantine.

d) Test to dispose infected hotspots: depending on risk factors, epidemic situations, and severity of the hotspots, local governments shall decide on test subjects and test locations accordingly.

dd) Conduct group testing in case of screening test, survey test, or periodic test.

3. Medical quarantine

a) For individuals arriving from infected areas (areas under level 4 epidemic or areas under regional medical quarantine), individuals who make close contact (F1): comply with applicable guidelines of Ministry of Health[6] [7].

b) For the elderly, individuals with underlying medical conditions, pregnant women, individuals under 18 years of age (children)⁷, quarantine at home together with a caretaker.

4. COVID-19 vaccination

Promote COVID-19 vaccination progress, prioritize individuals at 50 years of age or older, individuals with underlying medical conditions, pregnant women, and workers working in industrial parks, industrial complexes.

5. F0 treatment: comply with applicable guidelines of Ministry of Health.

6. For COVID-19 epidemic management in manufacturing facilities, business facilities, commercial centers, supermarkets, markets, restaurants, diners, education institutions, and vehicle operators: comply with applicable guidelines of Ministry of Health, Ministry of Education and Training, Ministry of Transport, and Ministry of Industry and Trade.

For organization of indoor and outdoor gathering activities in areas with level 2, 3, or 4 epidemic: local governments shall increase maximum number of participants or working capacity in case of 100% of participants have received adequate doses of COVID-19 vaccine or have relieved of COVID-19 or have negative SARS-CoV-2 test result.

III. ORGANIZATION FOR IMPLEMENTATION

1. People’s Committees of provinces or central-affiliated cities

a) Direct implementation of these Guidelines to effectively implement Resolution No. 128/NQ-CP dated October 11, 2021 of the Government; submit reports on classification criteria and adjustment of epidemic level of provinces/cities to Ministry of Health (General Department of Preventive Medicine).

b) Expedite and examine local facilities for preparation of requirements for rapid response in case of changing epidemic situations.

c) Direct Departments of Health to publicize and update epidemic level in local administrative divisions and areas under medical quarantine of provinces and cities, and respective measures in effect on website of local government; update epidemic level and areas under medical quarantine on website of Ministry of Health.

d) Direct Departments of Health to advise to adjust classification criteria and adjust epidemic level depending on epidemic situations, vaccine coverage, practical situations, and implementation facts.

dd) Direct execution of reports on implementation results when requested.

2. Ministries and agencies of central government

a) Direct relevant agencies and entities to cooperate with local governments in implementing these Guidelines in order to effectively implement Resolution No. 128/NQ-CP dated October 11, 2021 of the Government.

b) Cooperate with Ministry of Health and local administrative divisions in expediting and examining compliance with these Guidelines.

3. Entities affiliated to Ministry of Health

a) Actively organize implementation of these Guidelines within their tasks and functions for COVID-19 epidemic management.

b) Health Environment Management Agency shall act as contact point and cooperate with General Department of Preventive Medicine and relevant entities in guiding, publicizing, directing, examining implementation, and submitting reports on implementation hereof when requested.

c) General Department of Preventive Medicine shall provide guidelines on organizing, directing, and inspecting implementation of COVID-19 vaccination campaign on a national scale in a manner that guarantees safety, science, and effectiveness; develop roadmaps for vaccinating children and vaccinating remaining individuals.

d) Department of Medical Service Administration shall instruct local governments to develop plans, train personnel, and organize implementation to guarantee capacity for accepting and providing treatment of all levels; organize management of F0 at home.

dd) Vietnam Administration for HIV/AIDS Control shall instruct local governments to develop plans and implement mobile medical stations; teams for taking care of COVID-19 patients in community.

e) Department of Information Technology shall cooperate with General Department of Preventive Medicine in updating and publicizing infected areas and epidemic level of all administrative divisions on website of Ministry of Health.

g) Department of Planning – Finance shall act as contact point to cooperate with relevant entities in proposing and guiding implementation of measures and policies on enhancing investment capacity and improving medical system capacity, especially preventive healthcare and local medical care.

h) Organization and Personnel Department shall act as contact point and cooperate with Ministry Office and relevant entities of Ministry of National Defense and Ministry of Public Security in preparing mobile forces to promptly reinforce local administrative divisions in case the epidemic exceeds control capacity of local governments.

Difficulties that arise during the implementation should be reported to the Ministry of Health (via Health Environment Management Agency) for consideration. These Guidelines shall continue to be updated and amended to match practical situations./.

[1] Number of new infected cases in community/100,000 people/week = [(Number of new infected cases in a week + number of new infected cases of the previous week)/(2 x Local population)] x 100,000. New infected cases in community do not include infected cases entering Vietnam and infected cases in concentrated medical quarantine;

[2] https://www.who.int/publications/i/item/considerations-in-adjusting-public-health-and-social-measures-in-the-context-of-covid-19-interim-guidance

[3] Determined as total number of individuals who have been vaccinated over total population in the area by group age x 100 (%).

[4] This criterion applies on a provincial level and is mandatory for all provinces and central-affiliated cities regardless of epidemic level. Provincial-level People’s Committees shall approve plans for establishing facilities for accepting and providing treatment for COVID-19 and plans for guaranteeing number of ICU beds in medical examination and treatment establishments affiliated to provinces and cities (including private medical establishments) according to Decision No. 4111/QD-BYT dated August 26, 2021 of Ministry of Health and Decision No. 2626/QD-BYT dated May 28, 2021 of Ministry of Health; the plans must identify current and future capacity for accepting and providing treatment.

[5] District-level People’s Committees shall approve plans for providing medical oxygen in medical stations of communes to fulfill demands in case of epidemic outbreak; plans for establishing mobile medical stations according to Decision No. 4042/QD-BYT dated August 21, 2021 of Ministry of Health and teams for taking care of COVID-19 patients in community according to Decision No. 4349/QD-BYT dated September 10, 2021 of Ministry of Health; develop plans for establishing mobile medical stations in industrial parks, industrial complexes (in combination with medical department of manufacturing facilities); may rehearse and stand-by for actions when necessary.

[6] Apply according to Official Dispatch No. 8399/BYT-MT dated October 6, 2021 of Ministry of Health; For individuals participating in work teams according to decision of competent authority, comply with Official Dispatch No. 6386/BYT-MT dated August 6, 2021 of Ministry of Health; For forces participating in COVID-19 epidemic management, comply with Official Dispatch No. 7316/BYT-MT dated September 3, 2021 of Ministry of Health;

[7] Apply according to Official Dispatch No. 5599/BYT-MT dated July 14, 2021 of Ministry of Health; Official Dispatch No. 7020/BYT-MT dated August 25, 2021 of Ministry of Health.