The Latest Chapter in Vietnam’s Valiant Battle Against the Delta Variant

Hoan Kiem Lake in the heart of Hanoi during the lockdown. Photo: Mark Ashwill.

The hectic, sun-drenched streets of the capital have fallen silent
In the middle of the day
The empty parks surrounded by yellow ribbons that exclaim,
Keep out!

Shuttered stores and barricaded neighborhoods
Livelihoods diminished; plans put on hold; dreams deferred
Masked people shuffling around like otherworldly figures
Waiting patiently, resolutely, and with steely determination

Hà Nội in the Fourth Wave: A Heartfelt Wish & a Hopeful Prediction (MAA)

Known the world over as a bustling country filled with optimistic and hard-working people, Vietnam suddenly became an eerily quiet and serene place after the fourth wave of COVID-19 crashed on its shores. The country and its people were confronted with the most acute public health crisis since the end of the US war in 1975. Ho Chi Minh City (HCMC) and neighboring provinces remain the epicenter of the fourth wave with the lion’s share of infections and deaths to date, most of which have occurred since last spring.

The good news is that most Vietnamese and expats are beginning to bask in the light at the end of tunnel. To the collective relief of a combined total of 15 million souls in HCMC and Hanoi, most of the lockdown restrictions were lifted on October 1st in the former and the third week of September in the latter.

A comparison of the number of new cases in August vs. October 2021 illustrates the dramatic progress that is being made on a daily basis. On August 27th, Vietnam confirmed a single-day record of 17,409 new cases and a one-week average of 12,431. By contrast, the one-day increase for October 26th was 3,592 new cases and a one-week average of 3,690.

As of October 27th, there was a cumulative nationwide total of 896,174 confirmed cases, of whom 810,290 (90%) patients have recovered, and 21,802 deaths, according to the Vietnam Ministry of Health.

While these numbers pale in comparison to countries like Brazil, Canada, India, Italy, the US, and Russia, the concern from the outset was to contain the virus, a goal that Vietnam achieved, and now to create immunity through mass vaccinations, because of population density and the nation’s fragile healthcare system.

Life Under Lockdown 

HCMC was under lockdown for three months. In the North, which has had far fewer infections, Hanoi’s lockdown, the government’s attempt to err on the side of caution, lasted for two months. People were only supposed to leave their homes to purchase necessities in their neighborhoods. (The only businesses open were grocery stores, convenience stores, rice shops, and pharmacies.) Others were only permitted to travel beyond their community with special permission.

Streets and neighborhoods in which COVID-infected people resided were cordoned off. Since they were isolated, food and other supplies were delivered to them. The Vietnamese mobilized its military to assist with enforcing the curfew in HCMC and delivering supplies to people in affected areas. In addition, medical personnel from the North were assigned to the South to meet the steadily rising demand for patient care.

I live on the outskirts of Hanoi in a neighboring province and was only able to enter the city if I had a valid reason, e.g., doctor’s appointment. Many people were requested to have a quick COVID-19 test performed at one of the checkpoints set up between my community and the city. A negative result would allow that person to travel back and forth for three days before having to take another test.

While most people couldn’t venture far from home, they were out in the late afternoon and early evening exercising as the sun sinks lower on the horizon and cooler temperatures prevail, walking, jogging, and riding their bikes, all wearing masks without complaint.

As I wrote over the summer after an authorized drive through my adopted hometown in Hà Nội in the Fourth Wave,

Hà Nội, City of Peace, you have faced far worse in your millennia-long history – famine, war, poverty.

Lead the way!

To the life we knew and fervently dream of in the stifling time of COVID

Noisy, bustling, communal, productive
Imperfect yet satisfyingly normal.

My hopeful prediction came true just six weeks later.

A COVID-19 Retrospective

Last year’s short-lived lockdown, the result of the first wave of COVID-19, seems quaint by comparison. Here are some thoughts and reflections I shared with a local media outlet in December 2020.

One of the traits of the Vietnamese people that inspires me is their optimism during challenging times and their ability to tap into the collectivism that lurks beneath the cultural surface to defeat a common enemy, in this case, an invisible one.

Although the lockdown only lasted only a short time, my memories of the Covid-19 time are already shrouded in nostalgia. One day blended into the next, as we all checked the latest information about infection rates and went about our daily routine. Life was simple and predictable. Leave home only when necessary and always take the usual precautions. Working at home was not a hardship but rather a welcome respite. No need to brave the heavy traffic; more time to think, focus, and be productive in a variety of ways.

Like everyone else, I looked forward to the day when some semblance of normality would return so that we could all enjoy life’s simple pleasures again such as having a drink in a café or enjoying a meal in a favorite restaurant. On my infrequent trips to Hanoi to run some essential errands, I witnessed a once-in-a-lifetime spectacle. This normally vibrant and bustling city of many millions was like a ghost town. Virtually no traffic and few people on the streets was reassuring because it meant that the coronavirus had no opportunity to spread.

As March edged ever closer to April (2020), I knew that the economic shutdown would soon end. That was our reward for limiting our freedom of movement for the common good. That was the price that we – as a collective – paid to protect ourselves and others from this highly contagious and potentially fatal virus.

Those of us who live here, Vietnamese and foreigners alike, can be grateful we live in a country whose leadership took decisive action that showed concern for the health and welfare of the people. Vietnam has rightfully been showered with international praise for the way in which it has handled the coronavirus pandemic – in stark contrast to other much wealthier countries.

Looking back, it wasn’t rocket science just basic science and smart policy implementation that included adherence to preventive measures, contact tracing, quarantine, and restriction on international travel. The result was relatively few confirmed cases of the coronavirus and no cases of community transmission since April 16 (2020).

It is said that nothing reveals character, or a lack thereof, like a crisis. Vietnam’s performance during this global pandemic and the results, so far, speak for themselves.

The difference between then and now is two-fold: 1) the source is the Delta variant, which means the danger is more imminent; and 2) the number of infections is now exponentially higher.

While this is starting to change as the country opens up, virtually all news coverage has been dedicated to COVID-19 and its multifaceted implications, including heartrending tales of desperation and heartwarming stories of charity and kindness. As with any crisis that causes dire economic implications, it is the poor, including migrant workers in and around HCMC, who have suffered the most.

One particularly hard-hit sector is tourism and hospitality, which contributed about 9% to Vietnam’s GDP in the pre-COVID era in 2019. Only a select group of foreigners, e.g., diplomats and those with special permission, has entered the country since the government stopped issuing visas in March 2020.

Delta Variant as a Game Changer

As it did with the initial arrival of COVID-19 on January 23, 2020, Vietnam reacted quickly to the spike in new cases in late spring 2021 that heralded the fourth and most dangerous wave of the virus. Following the path taken by other countries, the game changer in the latest battle against the coronavirus was the Delta variant.

This mutation of the original COVID-19 virus is twice as contagious as previous variants and may cause more severe illness than previous strains. In two studies in Canada and Scotland, patients infected with the Delta variant were more likely to be hospitalized than those with Alpha or the original virus strain.

According to one study in China, the virus was first detectable in a small sample of patients four days after exposure, compared with an average of six days among people who had the original strain. The conclusion is that Delta replicates much faster, which makes it more infectious. More ominously, Delta had viral loads up to 1,260 times higher than those infected with the original strain. Nearly 75% of infections occurred during the presymptomatic phase, according to another study.

This excerpt from a July 3, 2021 article The 3 Simple Rules That Underscore the Danger of Delta that appeared in The Atlantic articulates what many of us already knew and zeroes in on the dilemma in which Vietnam finds itself:

Many nations that excelled at protecting their citizens are now facing a triple threat: They controlled COVID-19 so well that they have little natural immunity; they don’t have access to vaccines; and they’re besieged by Delta. At the start of this year, Vietnam had recorded just 1,500 COVID-19 cases—fewer than many individual American prisons. But it is now facing a huge Delta-induced surge when just 0.19 percent of its people have been fully vaccinated. If even Vietnam, which so steadfastly held the line against COVID-19, is now buckling under the weight of Delta, ‘it’s a sign that the world may not have that much time,’ Dylan Morris, an evolutionary biologist at UCLA, told me.

In other words, while the government and most citizens and expats did a yeoman’s job of containing COVID-19 since Day One (January 23, 2020), which enabled life to go on as usual, the clock was always ticking. Vietnam had to obtain enough vaccine to begin inoculating people en masse, which proved to be a tall order. The lack of supply, one of many vexing North-South issues, combined with the highly contagious nature of the Delta variant, are two of the factors that have resulted in a record number of infections with a linear scale that pointed straight up for a time.

Contributing Factors

I recall the exact moment when the fourth wave began to build. It was two days after a series of public events that my company organized in April ending on the 16th. I remember thinking how lucky we were that the outbreaks didn’t start during the events, which probably would have resulted in cancellations in the affected cities.

Colleagues often ask me how to explain the latest round of COVID-19. Vietnam had been a poster country for COVID containment and control. In the absence of a robust nationwide vaccination program, the fourth wave was inevitable. Such is the nature of a virus-fueled pandemic.

In a spring 2021 meeting held in Hanoi, Tran Van Son, Minister-Chairman of the Government Office, cited a number of reasons for the fourth wave. He noted that the main reason is quarantine violations among legal entrants. In two cases, the individuals had completed the mandatory quarantine period but, instead of another two weeks of self-isolation at home, according to the rules, they traveled to various locations and came into contact with a large number of people, thereby transmitting the virus nationwide. The rule that local agencies are supposed to continue monitoring their health status has not been strictly enforced.

Another likely reason is illegal immigration, including Vietnamese and Chinese citizens illegally crossing the border into Vietnam, some of whom infected with COVID. This is a situation over which Vietnam has limited control. It has long and porous borders with China (806 miles), Cambodia (720 miles) and Laos (1342 miles) that people can illegally cross for work, visits, and smuggling.

That may explain why HCMC, which is 83 miles from the Cambodian border, was ground zero for the fourth wave. Equally important are the previously mentioned factors of size and population density, and the fact that the Delta variant is the main culprit. Vietnam has a population of nearly 100 million living in an area slightly larger than the US state of New Mexico.

This alarming statistic puts the public health dangers of illegal immigration in stark perspective. In 2020, the Vietnam Border Guard detailed more than 31,000 illegal entrants, including 25,000 from China. Just imagine how many entered Vietnam undetected and how many of those imported COVID-19 into the country. If that figure is 10%, and 5% of those are COVID-positive; that amounts to 155 infected people blending into the population undetected. On average, someone infected with Delta infects five to eight others, meaning that an initial group of 155 could conceivably spread the virus to as many as 1,240 people, and so on.

Information Flow

Information about the status of COVID-19 has come from a variety of official and unofficial channels. The Ministry of Health provides frequent updates via electronic and social media, including Vietnam’s very own super app, Zalo. It has also overcome problems with multiple contact tracing apps by consolidating them into one called PC-COVID, a COVID Digital Pass that has a QR code scanning function, medical declarations, and the account holder’s updated vaccination information.

Another requirement is to register at every business you enter by scanning its QR code with your PC-COVID app. This is a way of tracking people who are later identified as F0, i.e., infected with COVID-19. In spite of the threat of fines for not following this procedure, implementation is spotty, at best.

Vaccinations Fueled by Public Health and Economic Considerations

Vietnam’s vaccination program got off to a late start on March 8, 2021. The following vaccines have been approved for use: Janssen, Moderna, Pfizer-BioNTech, Oxford-AstraZeneca, Sinopharm (for emergency use), and Sputnik V. The latest vaccine to be approved is Abdala, developed by Vietnam’s Center for Genetic Engineering and Biotechnology. The goal is to vaccinate 80% of the population of nearly 100 million by June 2022.

By mid-August, nearly 18 million vaccine doses had arrived, including over 11 million AstraZeneca doses donated by Japan, Australia, the UK, 5 million doses of Moderna donated by the US, and 1.5 million doses of Sinopharm from China. Vietnam is also well on its way to becoming a vaccine producer of Russia’s Sputnik V vaccine.

The government also launched a $1.1 billion Vietnam Fund for Vaccination and Prevention of Coronavirus Disease to obtain 120 million vaccine doses by the end of 2021. After issuing an urgent request for public donations, the had received $180 million by early June 2021 from more than 230,000 organizations, including Samsung and Toyota, and private citizens.

As of July 24, 2021, 4.5 million vaccine doses had been administered. By October 20th, that number had skyrocketed to 69 million, the result of large batches of vaccine being purchase on the world market and donations from various governments, including Australia, China, Cuba, US, France, Italy, South Korea, and the US, among many other countries. By October 24th, 52.5 million people, including expats, had received at least one dose while nearly 21.5 million are fully vaccinated.

The Vietnam Fund, which now standards at $382 million, is in addition to state-earmarked funds of $791 million, meaning that Vietnam now has enough money to purchase vaccines needed to inoculate 75 million people, or 77% of its population.

Hanoi has already vaccinated around 98% of all adults, accounting for 70% of the total city with at least one Covid-19 vaccine shot. Nearly 50% have been fully vaccinated. The government expects to have a total of 124 million doses available by the end of this year. Earlier this month, the Ministry of Health has authorized the use of COVID-19 vaccines for children aged 12 to 17.

Aside from humanitarian reasons, foreign governments and companies have donated hundreds of thousands or millions of doses of vaccine for pragmatic reasons. For example, after US Vice President Kamala Harris’s August trip from Singapore to Vietnam was delayed, China hastily sent a diplomat to meet with Vietnam’s prime minister to offer 2 million vaccines, twice as many as Harris and the US had promised.

Another self-interested reason for the donations is that Vietnam’s economy plays a key role in the global supply chain ranging from several components for Apple’s new iPhone 13 to Nike shoes. The only way factories and other businesses will open is if more people are vaccinated.

Labor-intensive industries such as garment, footwear and leather, and commercial services are facing a labor shortage. Before COVID-19, HCMC had nearly four million laborers at more than 286,000 businesses, including 320,000 in export processing zones, industrial parks and one high-tech park.

According to a survey conducted in early September involving 300 companies, only about 40% of their employees wanted to return to work after October 1st, the day the city reopened. Many returned to their hometowns and don’t plan to return to work until after the 2022 Lunar New Year in early February. (One silver lining for garment industry workers is that their wages may rise because of a labor shortage.)

In spite of the economic damage inflicted by the fourth wave of COVID-19, Vietnam’s GDP as an aggregate measure of economic activity is predicted to grow by 3.8% this year, the highest rate among the five major Southeast Asian economies that comprise ASEAN, which also includes Indonesia, Malaysia, the Philippines, and Thailand. Last year, Vietnam recorded a 2.9% growth rate while the other four countries experienced negative growth. This is a credit to Vietnam’s ability to contain the coronavirus during the first three waves.

Vietnam Rises to the Challenge – Again

During the summer lockdown in Hanoi, I was inspired, in manner of speaking, to write a ditty about the fourth wave entitled Got the COVID Blues. In its own way it tells the story of Vietnam’s experience with this pandemic from containment to a new and hopeful reality of living with COVID until the vaccination program has run its course.

I’m workin’ from home in my gilded cage
Dreamin’ of travel in the post-COVID age
Coronavirus on the hunt again
Lookin’ for victims wherever it can
I’ve got the COVID blues, don’t you know what I mean
I’ve got the COVID blues, Lord, have mercy on me
Viet Nam, it did a bang-up job
Of kicking COVID’s ass from Hanoi to Saigon
But Delta Vari is back for more
Don’t give up ‘cause we’re still in a war
I’ve got the COVID blues, don’t you know what I mean
I’ve got the COVID blues, Lord, have mercy on me
The city’s locked down, we’re doing all we can
To stop the spread of this goddamn plague
Dreamin’ of the jab and the freedom it brings
Hope for better days when we’re back again
I’ve got the COVID blues, don’t you know what I mean
I’ve got the COVID blues, Lord, have mercy on me
The vaccination is our only hope
Moderna, Astra, Pfizer get us off the ropes
We’re countin’ on you to make us safe again
‘Cause we know in our hearts that it’s the only way
I’ve got the COVID blues, don’t you know what I mean
I’ve got the COVID blues, Lord, have mercy on me
The night is dark, but the dawn is bright
We’ve gotta stay strong and do what’s right
It’s almost over, just around the bend
COVID-19’s about to meet its end
We’ve got the COVID blues, don’t you know what I mean
We’ve got the Cô Vy* blues, Lord, have mercy on me
You know what we need…

(*“Cô Vy” is a play on words in Vietnamese. “Cô” means “Miss” and “Vy” is a female name.)

The only way out, the golden bridge between a highly contagious virus that is infecting thousands every day and a return to normality, is a mass vaccination program in which a high percentage of the nation’s citizens is vaccinated. This future success story will resolve three important issues in one fell swoop: personal safety, economic recovery, and continued political stability.

One delightful result of the return to relative normality is an explosion of wedding parties. The owner of a wedding planning company in Hanoi exclaimed, “It feels like the whole of Hanoi is getting married on October 15th and 24th.” It’s a release of pent-up demand but also an illustration of the idiom, “Strike while the iron is hot,” not knowing if further restrictions will be necessary.

Since the August 2021 take-off phase of vaccinations, the Vietnamese people and the relatively few expats who call Vietnam home are getting exactly what they need. While the fat lady has yet to sing, Vietnam has so far risen to the challenge of the fourth wave with its usual perseverance and determination.


Mark A. Ashwill is an international educator who has lived in Vietnam since 2005. He is an associate member of Veterans for Peace Chapter 160. Ashwill blogs at An International Educator in Viet Nam and can be reached at