DECISION

PROMULGATION OF “CONTACT TRACING FOR COVID-19 HANDBOOK”

THE MINISTER OF HEALTH

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

At the request of the Director of General Department of Preventive Medicine, the Ministry of Health,

DECIDES:

Article 1. “Contact Tracing for Covid-19 Handbook” is promulgated together with this Decision

Article 2. “Contact Tracing for Covid-19 Handbook” shall be applied nationwide.

Article 3. This Circular comes into force from the day on which it s signed.

Article 4. The Chief of the Ministry Office; the Ministerial Chief Inspector, Directors of Departments of the Ministry of Health; Directors of hospitals affiliated to the Ministry of Health; Directors of Epidemiology Institutes, Pasteur Institutes, National Institute for Malariology - Parasitology – Entomology, Institute of Hygiene and Public Health of Ho Chi Minh City, Provincial Departments of Health; heads of health units of other Ministries and central authorities, heads of relevant units are responsible for the implementation of this Decision./.

CONTACT TRACING FOR COVID-19 HANDBOOK

PREFACE

COVID-19 is a group A infectious disease caused by the SARS-CoV-2 virus; the disease is transmitted from person to person. The incubation period is approximately 14 days. Patients may have diverse clinical symptoms: fever, cough, sore throat, fatigue, aches, decrease in or loss of taste and smell, shortness of breath, possibly severe pneumonia, acute respiratory failure and death, especially in people with underlying medical conditions, chronic diseases and the elderly. There is a high rate of people infected with SARS-CoV-2 virus without clinical symptoms (about 40%) and can be a source of transmission in the community, making epidemic management more difficult.

The first person to test positive for SARS-CoV-2 test (hereinafter referred to as “case”) was identified in Wuhan city, Hubei province, China on December 03, 2019. On March 11, 2020, WHO announced COVID-19 as a pandemic. As of October 27, 2020, Covid-19-19 cases have been reported in 217 countries/territories. The number of cases still tends to increase despite the efforts of countries/territories to implement multiple epidemic management measures. Imported cases and community cases have been reported in Vietnam.

To date, there is no specific treatment for COVID-19 and no vaccine is widely used in the community. Surveillance, early detection, contact tracing and isolating sources of infection are still currently the main measures in preventing the spread of the disease in clusters.

This Handbook is developed by the Ministry of Health on the basis of Pursuant to experience from Covid-19 control efforts in Vinh Phuc, Hanoi, Hai Duong, Da Nang and other areas in order to provide instructions for health workers to carry out contact tracing and organize quarantine, prevent outbreak of the disease in the community.

CONTACT TRACING FOR COVID-19

I. Purposes:

Find and quarantine people who have contact with a case to prevent spreading of the disease.

II. Requirements:

1 – Contact tracing must be rapid and thorough to avoid missing contacts.

2 - Steering Committees for Covid-19 Control of provinces, districts, communes, agencies and units shall mobilize all resources to ensure rapid and effective contact tracing.

III. Principle:

1 – Contact tracing must be carried out as soon as possible after having information about a confirmed case.

2 – Identify exposure sites, then people who have contact with the confirmed case.

3 - Utilize multiple forces to find contacts at the exposure sites.

4 – Implement multiple contact tracing measures; Information collected may be overlapping but also complementary. This will help finding contacts thoroughly and systematically.

5 – Invest resources and time to find F1 cases as quickly as possible; Identify F2 cases after tracing of F1 cases is relatively finished.

6 – The exposure sites and close contacts of F1 must be identified in a period of 3 days before the onset date of until the patient is isolated.

7 – Contact tracers shall implement measures to prevent infection in performance of their duties.

IV. Definitions

1 - F1: A person who has contact within 2 meters with a confirmed case (hereinafter referred to as “patient”) in 03 days before the onset date until the patient is isolated. Onset date is the day the patient has the first symptoms which can be: fever, fatigue; body aches, chills; decrease or loss of taste or smell; fever; cough; sore throat ... If the patient is a carrier (infected without symptoms), the onset date shall be the day on which the specimen is collected and tests positive for SARS-CoV-2.

2 - F2: A person has contact within 2 meters with an F1 case in the period from the first day the F1 case has contact with the patient (3 days before onset date) until the F1 case is quarantined.

3 - Exposure site: A location or event where the patient visited or participated in during the period of 03 days before the onset date until the patient is isolated.

Note: The investigation into the source of the patient in 14 days before onset date is part of baseline epidemiological investigation and not covered by this Handbook.

V. F1 tracing method

1. Step 1: Identification of exposure sites

- Investigators: Investigators of the Center for Disease Control (CDC) of the province or the medical center of the district, local authorities and local health authorities.

- Product: A list of exposure sites according to Form 1.

- Tracing method:

+ Question the patient in person or by phone

+ Question the patient’s relatives/friends/neighbors

+ Check the patient’s medical record/profile

- Contents:

Ask about the exposure sites where the patient visited or participated in during the period of 3 days before onset date until the patient is isolated according to Table 1. Specify the names/locations/times of the exposure sites according to Form 1.

Table 1: Common exposure sites

2 – Step 2: Notify the coordination unit of the exposure sites

The coordination unit should be located within the infectious disease control department of CDC of the province or medical center of the district.

- After the exposure sites are identified, the contact tracer shall immediately notify the coordination unit by any fastest means (phone, messaging, taking photo of Form 1 and send via Zalo or Viber, etc.)

- The coordination unit shall immediate notify the local authority, surveillance system and medical center of the exposure sites, deploy contact tracers to these exposure sites to cooperate with local forces in finding F1 cases. For exposure sites located outside of their areas, the coordination unit shall contact relevant units for cooperation.

3 – Step 3: Initiate F1 tracing

Combine multiple methods: questioning the patient; tracing at the patient’s community; tracing at exposure sites; tracing through mass media, Bluezone, Viet Nam Health Declaration applications.

3.1. F1 tracing by questioning the patient:

- Investigators: After exposure sites are identified and reported,  local authorities and local health authorities, investigators of the CDC of the province or the medical center of the district in Step 1 shall cooperate with local authorities and health facilities in F1 tracing by questioning the patient’s, his/her family and related persons.

- Product: A list of F1 cases according to Form 2

- Tracing method:

+ Question the patient about activities of each day in reverse chronological order to identify F1 cases accordingly

+ Make a list of F1 cases according to Form 2.

+ Question the patient one more time about the common close contacts according to Table 2, keep adding F1 cases to Form 2.

Table 2:  Common close contacts:

+ Keep finding information and add more exposure sites to Form 1 (if any).

+ Provide Form 2, a pen and phone number for the patient to add close contacts in the next days. Instruct the patient to send messages via Zalo, Viber, etc. or call the investigator when additional F1 cases are identified.

+ Question the patient on the next days if necessary.

3.2. F1 tracing in the patient’s community

- Investigators: Contract tracers of the province/district/commune or additional contact tracing forces (medical students, other force), local authorities, police forces, neighborhood authority, community Covid-19 team, local association officers and other relevant forces.

- Product: A list of F1 cases according to Form No. 3

- Tracing method:

+ Check every house, question everyone. To be specific: start with the patient house, then the adjacent houses in the patient’s community to make a list of F1 cases according to Form 3.

+ Make announcement on the public address speakers about the confirmed case, definition of F1 cases; request people who identify themselves as F1 cases to report to the local authorities and medical center of the commune.

3.3. F1 tracing at exposure sites

- Investigators: Contract tracers of the province/district/commune or additional contact tracing forces (medical students, other force), local authorities, police forces, neighborhood authority, community Covid-19 team, local association officers and other relevant forces.

- Product: A list of F1 cases according to Form No. 3

- Tracing method:

+ Contact the responsible persons of the exposure sites.

+ Choose a convenient place to work (convention hall, meeting room, large and airy place).

+ Request the responsible persons to announce the confirmed case, purposes and requirements of contact tracing at the exposure site; the location where the investigation team works in order for relevant people to report. Avoid gathering of crowds and maintain safety distance at the investigation location.

+ Directly question relevant people about their contacts.

+ Extract cameras at exposure sites (if any).

+ Examine work log at exposure sites (if any)

+ Examine the list of relevant people at exposure sites: list of guests of wedding, parties, etc. (if any).

- + Make announcement on the mass media about the confirmed case and the exposure sites; request relevant people to report to the local authorities and health authorities.

- Provide email addresses and phone numbers for relevant people to provide information if necessary.

- Make a detailed list of F1 cases at each exposure site according to Form 3.

Note: A person may have contact with the patient at multiple exposure sites and included in multiple lists. All of them must be recorded and overlapping events will be handled later.

3.4. F1 tracing through mass media

- Make announcement on mass media about the confirmed case and the exposure sites; specify the time and location of each exposure site.

Instruct the people to provide additional information about F1 cases for local authorities and health authorities.

- The local authorities, CDC of the province or medical center of the district shall provide their phone numbers or hotline numbers, receive information provided by the people after making announcements on the mass media.

- Contact tracing teams shall keep adding new F1 cases if found.

- Make a supplementary list of F1 cases according to Form No. 3.

3.5. Contact tracing via Bluezone, Viet Nam Health Declaration.

Bluezone application is installed on smart phones to detect Bluezone users who have close contact with a Covid-19 patient who also uses Bluezone. Contact tracing units shall register with the Ministry of Health to receive instructions on how to carry out contact tracing at https://cdc.bluezone.gov.vn/. Viet Nam Health Declaration may also be used to determine travel, quarantine, lodging history of inbound passengers and domestic travelers.

4 - Step 4: Review and complete the list of F1 cases

- All contact tracing teams shall send F1 lists to the coordination unit as soon as they are completed; keep updating the lists until contact tracing is completed (take photos of F1 lists and send them to the coordination unit by Zalo, Viber, etc.).

- The coordination unit shall enter the F1 lists sent by contact tracing teams into Microsoft Excel or other applications. Use Microsoft Excel or other applications to eliminate overlapping information and make a consolidated list of all F1 cases.

- Immediate send the consolidated list of F1 cases to the local authorities and Steering Committee for Covid-19 Control of all levels for organization of quarantine and perform the next steps as per regulations.

5 – Step 5: Organization of isolation and specimen collection

- The Steering Committee for Covid-19 Control and local authorities shall prepare vehicles to take F1 cases to quarantine centers in accordance with regulations of the Ministry of Health. While taking F1 cases to quarantine centers, local health authorities, local authorities and other local forces shall carry on contact tracing to make sure all F1 cases are quarantined correctly.

- F1 cases shall have their specimens collected for the first time at the quarantine center as soon as possible. Specimens shall be transported to a capable laboratory for testing as per regulations of the Ministry of Health. It is not recommended to collect specimens of F1 cases at their communities to avoid disorder and untimely quarantine of F1 cases.

VI. F2 tracing method

After F1 tracing is relatively completed, F2 cases shall be traced as follows:

1 - Hand out Form 4 (List of F2 cases declared by F1 case) to F1 cases. F1 cases shall complete this form themselves.

2 – The quarantine center, local authorities and health authorities shall carry on F2 tracing at the community and questioning of F1 cases at the quarantine center.

3 – Transfer the list of F2 cases to the local authorities for home quarantine as per regulations.

FORM 1. LIST OF EXPOSURE SITES

Patient’s full name:........................................................... Gender: ................... Year of birth ...................

Patient's code:................... Workplace: ........................... Tel: ................................

Residence: ...................... Commune/Ward: .................. District: ...................... Province/City: ................

Asymptomatic patient   Symptomatic patient
Onset date (in case of symptomatic patient):  ......../........./...........

Date of positive test result: ......./......../......... – Date of isolation: ........../.........../........

Contact tracing period:  From ........../.........../............ to........../.........../............

List of exposure sites where the patient visited or participated in during the period of 03 days before onset date until the patient is isolated (Table 1):

FORM 2: LIST OF F1 CASES BY DATE

Investigation unit:............................................. Investigation team:................................................. Investigator’s name: ......................................................

Patient’s name:.......................................................... Patient’s code......................... Patient’s phone number: ...............................

Onset date: ........../.........../..............  Date of collection of SARS-CoV-2 positive specimen: ........../.........../.............

Contact tracing period:  From ........../.........../............ to ........../.........../............

*Example: Relationship: husband/wife/father/mother/friend/co-worker, etc. Contact: living in the same house/sharing a table/working together etc.

FORM 3. LIST OF F1 CASES AT EXPOSURE SITES

Investigation unit:............................................. Investigation team:................................................. Investigator’s name: ......................................................

Patient’s name:.......................................................... Patient’s code......................... Patient’s phone number: ...............................

Onset date: ........../.........../..............  Date of collection of SARS-CoV-2 positive specimen: ........../.........../.............

Name of exposure site: ..................................................................................................................

Contact tracing period:  From ........../.........../............ to ........../.........../............

*Example: Relationship: husband/wife/father/mother/friend/co-worker, etc. Contact situation: living in the same house/sharing a table/working together etc.

Note: a person may have contact with the patient at multiple events/locations/exposure sites. All of them must be recorded.

- The house and residence of the patient are consider an exposure site

FORM 4: LIST OF F2 CASES DECLARED BY F1 CASES

(completed by F1 cases)

F1 case’s name :.......................................................... Phone number: ...............................

Name of the patient having contact with F1 case:.......................................................... Patient’s code.........................

Contact tracing period from the first day of contact with the patient (3 days before onset date) until the day on which the F1 case is isolated: from ..................... to ...................................

*Example: Relationship: husband/wife/father/mother/friend/co-worker, etc. Contact: living in the same house/sharing a table/working together etc.

TABLE 1: COMMON EXPOSURE SITES

TABLE 2: COMMON CLOSE CONTACTS (F1)

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