Quyết định 4800/QĐ-BYT 2021 Hướng dẫn tạm thời về chuyên môn y tế thực hiện Nghị quyết 128/NQ-CP

DECISION

Issuing the Interim Guidance for implementation of the Government’s Resolution No. 128/NQ-CP dated October 11, 2021 promulgating the Interim Regulation on “safe and flexible adaptation and effective control over the COVID-19 pandemic”

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THE MINISTER OF HEALTH

Pursuant to the 2007 Law on Prevention and Control of Infectious Diseases;

Pursuant to the 2009 Law on Medical Examination and Treatment;

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

Pursuant to the Resolution No. 128/NQ-CP dated October 11, 2021 of the Government promulgating the Interim Regulation on “safe and flexible adaptation and effective control over the COVID-19 pandemic”;

At the proposal of the Director of Health Environment Management Agency.

DECIDES

Article 1. Issuing together with this Decision the Interim Guidance for implementation of the Government’s Resolution No. 128/NQ-CP dated October 11, 2021 promulgating the Interim Regulation on “safe and flexible adaptation and effective control over the COVID-19 pandemic”.

Article 2. This Decision takes effect on the signing date.

Article 3. The Chief of Ministry office; Chief of Inspectorate of Ministry; Directors and General Directors of Departments and Directorates of the Ministry of Health; Directors of Institutes of preventive medicine; Directors of hospitals of the Ministry of Health; Directors of Health Departments, Centers for Disease Control of provinces and centrally-run cities; Heads of medical units of ministries and sectors, Heads of units, relevant agencies, organizations and individuals shall be responsible for the implementation of this Decision./.

INTERIM GUIDANCE

For implementation of the Government’s Resolution No. 128/NQ-CP dated October 11, 2021 promulgating the Interim Regulation on “safe and flexible adaptation and effective control over the COVID-19 pandemic”

(Attached to the Ministry of Health’s Decision No. 4800/QD-BYT dated October 12, 2021)

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I. CRITERIA FOR ASSESSMENT OF PANDEMIC RISK LEVELS

1. Criteria

a) Criterion 1: New confirmed cases in the community/population/duration.

b) Criterion 2: Vaccination coverage.

c) Criterion 3: Ensuring the receipt and treatment capacity of medical examination and treatment establishments at all levels.

2. Requirements for criteria

2.1. Criterion 1: New confirmed cases in the community/100,000 population/week1.

New confirmed cases in the community/100,000 population/week (new confirmed cases) are classified into 04 levels in accordance with the guidance of the World Health Organization2 (level 1: 0 -< 20; level 2: 20 - <50; level 3: 50 - <150; level 4: ≥150). Localities may reduce or increase the number of new confirmed cases specified for each level in accordance with the actual situation.

2.2. Criterion 2: Percentage of people aged 18 years and older who have got at least 01 shot of COVID-19 vaccine3.

a) Percentage of people aged 18 years and older who have got at least one shot of COVID-19 vaccine is divided by 2 levels (≥70% of people aged 18 years and older received at least 1 shot of vaccine; <70% of people aged 18 years and older received at least 1 shot of vaccine). Localities may reduce or increase the percentage of vaccination coverage prescribed in accordance with the actual situation.

b) In October 2021, it is required that at least 80% of people aged 65 years and older have fully vaccinated against COVID-19. From November 2021, it is required that at least 80% of people aged 50 years and older have fully vaccinated against COVID-19.

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1 New confirmed cases in the community/100,000 population/week* = [New confirmed cases of the week + New confirmed cases of the previous week)/(2 x population in the locality)] x 100,000. New confirmed cases in the community do not include confirmed cases on entry and confirmed cases being in concentrated quarantine establishments;

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 Being the number of vaccinated people per the total population residing in the locality by age x 100 (%).

2.3. Criterion 3: Ensuring the receipt and treatment capacity of medical examination and treatment establishments at all levels

a) The province or city has a plan to set up receipt and treatment establishments and a plan to ensure adequate ICU beds at medical examination and treatment establishments under the province or city (including private establishments) to be ready to respond to the level-4 pandemic risk4.

b) Districts, towns and cities (districts) have plans to set up mobile health stations, teams taking care of COVID-19 cases in the community and have plans to provide medical oxygen for health stations of communes, wards, townships (communes)5 to respond to the pandemic, in cases of outbreak of the pandemic.

3. Pandemic risk classification in accordance with the Government’s Resolution No. 128/NQ-CP dated October 11, 2021 shall be in accordance with the following table:

* For criteria 1 and 2, the number of new confirmed cases and the percentage of vaccinated people as specified in each level may be adjusted in accordance with the actual situation in localities.

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4 This criterion is applied at provincial level and obligatory for all provinces and centrally-run cities, regardless of their pandemic risk levels. Provincial-level People's Committees approve plans to set up COVID-19 treatment and receipt establishments and plans to ensure adequate ICU beds at medical examination and treatment establishments under the province or city (including private establishments) as prescribed in the Ministry of Health’s Decision No. 4111/QD-BYT dated August 26, 2021 and the Decision No. 2626/QD-BYT dated May 28, 2021; in which, their current receipt and treatment capacity and plans for the addition are required.

5 District-level People's Committees approve plans to provide medical oxygen for health stations of communes to respond to the pandemic, in cases of outbreak of the pandemic; plans to set up mobile health stations according to the Ministry of Health’s Decision No. 4042/QD-BYT dated August 21, 2021 and teams taking care of COVID-19 cases in the community according to the Ministry of Health’s Decision No. 4349/QD-BYT dated September 10, 2021; have plans to set up mobile health stations at industrial zones and clusters (in combination with health departments at production and business establishments); participating in drills to be ready to respond the pandemic when necessary.

4. Change of pandemic risk levels:

- In case the locality fails to satisfy Criterion 3, the pandemic risk level shall remain the same.

- The pandemic risk level shall be increased by one level, if the locality fails to satisfy requirements specified at Point b, Clause 2.2, Section 2, Part I (unless the locality is suffering level-4 pandemic risk or records no confirmed case).

5. Provinces, centrally-run cities shall, based on the pandemic development, vaccination coverage and actual conditions (population density, socio-economic circumstances, etc.), and response ability, adjust the corresponding criteria and pandemic risk levels in accordance with the Government’s Resolution No. 128/NQ-CP dated October 11, 2021.

II. SPECIALIZED MEASURES

1. Capacity preparation for response to COVID-19 pandemic

In order to ensure the safe and flexible adaptation and effective control over the COVID-19 pandemic, provinces and centrally-run cities shall prepare the following contents:

a) Develop scenarios and plans to ensure healthcare for COVID-19 prevention and control at each risk level; organize the implementation when recording confirmed cases in localities.

b) Strengthen the training and education to improve the capacity of tracing, testing, quarantine and treatment in localities.

c) Improve the capacity of receiving, treating and taking care of COVID-19 cases:

- Develop plans on receiving, caring and treating COVID-19 cases (F0 cases), especially plans to ensure adequate ICU beds. Update data and manage the software on establishments receiving and treating F0 cases.

- Prepare plans when there is an outbreak: Medical examination and treatment establishments at district level or higher must have liquid oxygen and compressed air; health stations of communes, wards or townships must ensure to provide adequate medical oxygen; prepare plans on organization among mobile health stations, groups taking care of F0 cases in the community and organizations managing F0 cases at home.

- Organize medical examination and treatment establishments that provide treatment for patients suffering normal diseases and COVID-19 patients. Organize to separate and screen suspected cases visiting medical examination and treatment establishments to detect infected cases, closely manage to avoid cross-infection in establishments.

2. Testing

a) The testing shall be implemented according to at-risk areas and at-risk groups.

- Tests shall be conducted for those who show any of the following symptoms, including fever, cough, fatigue, sore throat, loss of taste and smell, dyspnoea, etc.

- Random and screening tests and periodic tests shall be conducted by health agencies in high-risk areas with crowded people such as medical examination and treatment establishments, wholesale markets, bus stations and supermarkets, etc.; at-risk groups (people who travel to many places, or contact many people, etc.) such as drivers, motorbike taxi drivers, goods deliverers (shipper), etc.

- Production and business establishments, service providers, trade centers, supermarkets, agencies and offices: self-organize random tests for SARS-CoV-2 for people at high risk of infection.

b) Not indicate testing for the citizens’ movements; only require testing for those who come from level-4 pandemic risk areas or areas subject to lockdown and suspected cases or those who come from level-3 pandemic risk areas and are subject to epidemiological investigation requirement.

c) Fully vaccinated people and those who have recovered from COVID-19: Testing is only required at epidemiological investigation requirement; people subject to quarantine measure or medical monitoring and people who come from level-4 pandemic risk areas or areas subject to lockdown.

d) Carrying out testing to handle outbreaks: Depend on risk factors, pandemic development and risk levels of the outbreaks, localities shall decide on subjects and areas for testing.

dd) Group testing in case of periodic testing or screening.

3. Quarantine

a) People who come from pandemic-hit areas (level-4 pandemic risk areas or areas subject to lockdown), and close contacts (F1 cases): Comply with current instructions provided by the Ministry of Health 6,7.

b) The elderly, people suffering underlying diseases, pregnant women and people aged under 18 (children)7: Subject to home-quarantine with their caregivers.

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6 Follow the Ministry of Health's Official Dispatch No. 8399/BYT-MT dated October 06, 2021; those who participating in working teams under the competent agencies’ decisions shall comply with the Ministry of Health’s Official Dispatch No. 6386/BYT-MT dated August 06, 2021; those who participate in supporting the COVID-19 prevention and control shall comply with the Ministry of Health’s Official Dispatch No. 7316/BYT-MT dated September 03, 2021;

7 Follow the Ministry of Health's Official Dispatch No. 5599/BYT-MT dated July 14, 2021; the Ministry of Health's Official Dispatch No. 7020/BYT-MT dated August 25, 2021.

4. Vaccination against COVID-19

Speed up the vaccination against COVID-19, prioritize to give vaccines for people aged 50 or older, people suffering underlying diseases, pregnant women, employees working at industrial parks/clusters.

5. Treatment for F0 cases: Comply with current instructions provided by the Ministry of Health.

6. The assurance of COVID-19 prevention and control at production and business establishments, trade centers, supermarkets, restaurants, education and training institutions, drivers of transporting vehicles shall comply with current instructions provided by the Ministry of Health, the Ministry of Education and Training, the Ministry of Transport and the Ministry of Industry and Trade.

With regard to the organization of in-door and out-door activities in level-2, level-3 and level-4 pandemic risk areas: Localities shall decide on increasing the number of participants or the capacity in case 100% of participants have been fully vaccinated or recovered from COVID-19 or have a negative test result for SARS-COV-2.

III. ORGANIZATION OF IMPLEMENTATION

1. People's Committees of provinces and centrally-run cities shall

a) Direct the implementation of this Guidance to effectively implement the Government’s Resolution No. 128/NQ-CP dated October 11, 2021; report on criteria for classification and adjustment of pandemic risk levels of the provinces and cities to the Ministry of Health (the General Department of Preventive Medicine).

b) Strengthen the urging and inspection work to the grassroots level, prepare necessary conditions to be ready to quickly respond to the pandemic development.

c) Direct the Departments of Health to announce and update the pandemic risk levels of localities and areas subject to lockdown of the provinces and cities; and applied corresponding measures on their portals; update the pandemic risk levels, areas subject to lockdown on the Ministry of Health Portal.

d) Direct the Departments of Health to advise to adjust the classification criteria and adjust the pandemic risk levels in accordance with the pandemic development, vaccination coverage, actual conditions and actual implementation.

dd) Direct the work of reporting the implementation results upon request.

2. Ministries, sectors and central agencies shall

a) Direct relevant units and agencies to coordinate with localities in organizing the implementation of this Guidance to effectively implement the Government’s Resolution No. 128/NQ-CP dated October 11, 2021.

b) Coordinate with the Ministry of Health and localities to strengthen urging and inspecting the implementation of this Guidance.

3. Units under the Ministry of Health

a) Proactively organize the implementation of this Guidance within their functions and tasks as assigned in COVID-19 pandemic prevention and control.

b) The Health Environment Management Agency shall act as the focal point, coordinate with the General Department of Preventive Medicine and relevant units in guiding, disseminating, directing and inspecting the implementation and reporting the implementation results of this Guidance upon request.

c) The General Department of Preventive Medicine shall guide the organization, direction and inspection of the implementation of nationwide COVID-19 vaccination campaign, ensuring safety, effectiveness; formulate the roadmap of vaccination for children and vaccine booster shots.

d) The Medical Services Administration shall guide localities in planning, training human resources and organizing the implementation to ensure the receipt and treatment capacity of all levels; organizing management of F0 cases at home.

dd) The Vietnam Administration of HIV/AIDS Control shall guide localities to formulate plans and organize mobile health stations; teams taking care of COVID-19 cases in the community.

e) The Information Technology Department shall coordinate with the General Department of Preventive Medicine in updating and publicizing pandemic areas and pandemic risk levels in all localities across the country on the Ministry of Health Portal.

g) The Planning and Finance Department shall act as the focal point, coordinate with relevant units in continuing to propose and guide the implementation of solutions and policies to strengthen investment capacity, improve the capacity of the health system, especially preventive medicine and health agencies at grassroots.

h) The Organization and Personnel Department shall act as the focal point, coordinate with the Ministry’s Office and relevant units of the Ministry of National Defence and the Ministry of Public Security in preparing mobile forces to promptly support localities in case the pandemic development is beyond the localities’ pandemic control capacity.

Any difficulty and problem arising in the course of implementation should be reported to the Ministry of Finance (the Health Environment Management Agency) for prompt settlement. This Guidance shall continue to be updated and adjusted in accordance with the actual situation./.