First Covid-19 Death in Vietnam

July 31: +22 new cases, +1 death
July 30: +50 new cases
July 29: +13 new cases
July 28: +15 new cases
July 27: +11 new cases
July 26: +3 new cases
July 25: +4 new cases

2nd death

I don't want to sound too cold but it sounds like the 1st patient to die (#428) was clearly on his last legs.   Heroic measures were taken which might not have even been undertaken in the west for anyone who left "do not resuscitate" instruction.

Vietnam has performed amazingly in exclusionary measures, with a real quarantine coupled with negative testing to be released from quarantine.  The challenge now is stopping community transmission which is the much more difficult task.  My comment on another thread re: the USS Roosevelt illustrates my opinion that the disease has existed at a low level in Da Nang for a while.  I certainly hope that Vietnam can resolve this.  If any country can, it may be Vietnam, as the country combines modern medicine with somewhat strict although not ironclad population controls.  Regardless of how one feels about governmental control over individuals, hopefully it will prove useful in the case of coronavirus.  They live rather far away from Da Nang but I am very worried for four in-laws who have comorbidities.

FabriceVN wrote:

2nd death

Yes, the second death was Patient 437, a 61 year old resident of Da Nang.  He had a history of chronic renal failure, was treated for that as well as hemodialysis, hypertension, diabetes, atrial fibrillation, and gout at Danang Hospital long before he became infected with COVID-19 on July 27.

He died on the afternoon of July 31.  Cause of death:  Septic shock, multi-organ failure, respiratory arrest due to pneumonia, dialysis regularly with hypertension, gout, and COVID-19.

THIGV wrote:

I don't want to sound too cold but it sounds like the 1st patient to die (#428) was clearly on his last legs.   Heroic measures were taken which might not have even been undertaken in the west for anyone who left "do not resuscitate" instruction.

Vietnam has performed amazingly in exclusionary measures, with a real quarantine coupled with negative testing to be released from quarantine.  The challenge now is stopping community transmission which is the much more difficult task.  My comment on another thread re: the USS Roosevelt illustrates my opinion that the disease has existed at a low level in Da Nang for a while.  I certainly hope that Vietnam can resolve this.  If any country can, it may be Vietnam, as the country combines modern medicine with somewhat strict although not ironclad population controls.  Regardless of how one feels about governmental control over individuals, hopefully it will prove useful in the case of coronavirus.

The second patient who died on the same day (yesterday Vietnam time) as the first also had the same multiple end stage diseases, was also treated in the same department.  Even without being infected by Covid, both patients would've not lasted long.

Agree with everything you said above.

I might add that the death of these patients is not a negative indication on the quality of medicine in Vietnam.  These patients lives would probably have been lost in any hospital in the US or Europe.  In fact in some locations in the US where beds are limited, they might have even been triaged and sent home to die.

Yes but vietnam can't longer boast of having better medicine than other countries: the true reason why he had 0 death so far was the age of infected people. Vietnam has a young population, and most of infected people of the 1st wave were 20-30 years old.
This disease only kills the old persons, in poor health. It is the same in all countries of the world.

FabriceVN wrote:

This disease only kills the old persons, in poor health. It is the same in all countries of the world.

This seems more a political position than a scientific one.  "Only" is an absolute adjective, as is "all".  For perhaps the most extreme manifestation of COVID-19 in children: MIS-C

Also I know that I never said that Vietnam's medicine was better than others but that it was the equal.  My example of patients being triaged and refused treatment, in particular in Texas, was not an indictment of quality but of policy.

The panic and deaths will soon follow. You can’t escape the inevitable. No place is safe.

I had typed this yesterday but didn't send it so as to not sound callous.  I really have a tough time calling these COVID deaths.  Both were at end of cycle with their chronic diseases.  The first one especially.

In the US they have had traffic fatalities where injuries from the car accident caused death at the scene.  For some reason they feel they must test post-mortem to see if they have COVID in the system.  If it is present then a traffic accident is counted as a COVID death.  One reason in the US is that Medicaid pays a hospital $13,000 for every admitted COVID patient, $30,000 if they are put on a ventilator.  Most hospitals are for-profit hospitals.  Follow the money.

Another case was a woman that was in hospice for inoperable cancer and had been for a couple of months.  The doctors could do nothing to save her.  She contracted COVID at some point and died.  Yep, COVID death, even though she was only marking time until she passed from the cancer.

SteinNebraska wrote:

I had typed this yesterday but didn't send it so as to not sound callous.  I really have a tough time calling these COVID deaths.  Both were at end of cycle with their chronic diseases.  The first one especially.

In the US they have had traffic fatalities where injuries from the car accident caused death at the scene.  For some reason they feel they must test post-mortem to see if they have COVID in the system.  If it is present then a traffic accident is counted as a COVID death.  One reason in the US is that Medicaid pays a hospital $13,000 for every admitted COVID patient, $30,000 if they are put on a ventilator.  Most hospitals are for-profit hospitals.  Follow the money.

Another case was a woman that was in hospice for inoperable cancer and had been for a couple of months.  The doctors could do nothing to save her.  She contracted COVID at some point and died.  Yep, COVID death, even though she was only marking time until she passed from the cancer.

UK is same even although the NHS is non profit, but nursing homes for old people are not free. 50% of covid deaths noted in UK are from nursing homes. There are countless posts in social media & in the TV news from families who are mystified saying their parent or grand parent was terminal & did not die from covid!........you know why? same like you say, they get paid more from the state if the death is noted as covid. WTF is that about then??

Reading on the news in the UK 78, out if 100 propel that recover from covid show signs of heart damage months after recovering... Despite being in good health before.

Maybe if people realised how serious it can be they wouldn't runs the risk of escaping quarantine and endangering others

SteinNebraska wrote:

I had typed this yesterday but didn't send it so as to not sound callous.  I really have a tough time calling these COVID deaths.  Both were at end of cycle with their chronic diseases.  The first one especially.

In the US they have had traffic fatalities where injuries from the car accident caused death at the scene.  For some reason they feel they must test post-mortem to see if they have COVID in the system.  If it is present then a traffic accident is counted as a COVID death.  One reason in the US is that Medicaid pays a hospital $13,000 for every admitted COVID patient, $30,000 if they are put on a ventilator.  Most hospitals are for-profit hospitals.  Follow the money.

Another case was a woman that was in hospice for inoperable cancer and had been for a couple of months.  The doctors could do nothing to save her.  She contracted COVID at some point and died.  Yep, COVID death, even though she was only marking time until she passed from the cancer.

It will be interesting to see the statistics for death from disease and medical issues in the coming year. Im sure there will be a drop in numerous things like cancer, as Covid seems to be what everyone is dying from.

Unlike most of you fellows, I tend to give the medical profession the benefit of the doubt in things like this.  In one example, if someone has a heart attack and drives his motorbike off the bridge into the water, what was the cause of death?  In fact, doctors can tell by examining the lungs if he was still alive when he hit the water.  I know this is a simplistic example but I still trust the doctors.  In a few cases, COVID=19 death attributions have been reversed in Hawaii.  Patient privacy laws in the US mean they can't give out much detail, but it does happen.  The same could be true in Vietnam if the case was right.

SteinNebraska wrote:

I had typed this yesterday but didn't send it so as to not sound callous.  I really have a tough time calling these COVID deaths.  Both were at end of cycle with their chronic diseases.  The first one especially.

In the US they have had traffic fatalities where injuries from the car accident caused death at the scene.  For some reason they feel they must test post-mortem to see if they have COVID in the system.  If it is present then a traffic accident is counted as a COVID death.  One reason in the US is that Medicaid pays a hospital $13,000 for every admitted COVID patient, $30,000 if they are put on a ventilator.  Most hospitals are for-profit hospitals.  Follow the money.

Another case was a woman that was in hospice for inoperable cancer and had been for a couple of months.  The doctors could do nothing to save her.  She contracted COVID at some point and died.  Yep, COVID death, even though she was only marking time until she passed from the cancer.

I (retired Regular Nurse) totally agree.

Also, it's very likely, based on the official reports (which someone said were too much unnecessary information) that some of the serious cases may have been the result of NOSOCOMIAL (hospital-acquired) infections.

Also, I think when we look back on this time period, it's statistically likely that the vast majority of these new "Active cases" will have very mild or no symptoms at all.

Based on news media reporting and social media speculation, it would be very easy for people to believe that there are people dying of COVID-19 all over Danang.

It's just not true

FabriceVN wrote:

Yes but vietnam can't longer boast of having better medicine than other countries: the true reason why he had 0 death so far was the age of infected people. Vietnam has a young population, and most of infected people of the 1st wave were 20-30 years old.

1- Where did you read that VN boasted of having better medicine than other country?  From everything I've read and listened (in the language of the original statements and from the official sources so there's no misunderstanding whatsoever), the PM, the Vice PM, and the Minister of Health have repeatedly said that VN either doesn't have or has very limited access to the best of medical supplies, that's why their citizens need to be extremely careful not to be overconfident, because any size of outbreak can be detrimental to all.

2- The median age in VN is 35.  The median age in the US is 38.  The largest group of people who were infected in VN was between the age of 29 - 49.  In the US, it's between the age of 50 - 59 and getting younger by the week according to USA Today.  Your statement about the previous zero death in VN was due to the young population holds no water.

Do you know why there were few elderlies in VN who fell victims to Covid?  It's not because of the young population, but because the elderlies here do not live in nursing homes where they can infect one another.  Here, grandparents and great-grandparents live under the same roof with their grandchildren and great-grandchildren.  Here, the older generation is cared for and watched out for by the younger one, thus the chance for them to be exposed to this pandemic is the same as their offsprings, or even lower because they have fewer contact with outsiders/strangers than their younger offsprings do.

Ciambella wrote:

FabriceVN wrote:

Yes but vietnam can't longer boast of having better medicine than other countries: the true reason why he had 0 death so far was the age of infected people. Vietnam has a young population, and most of infected people of the 1st wave were 20-30 years old.

1- Where did you read that VN boasted of having better medicine than other country?  From everything I've read and listened (in the language of the original statements and from the official sources so there's no misunderstanding whatsoever), the PM, the Vice PM, and the Minister of Health have repeatedly said that VN either doesn't have or has very limited access to the best of medical supplies, that's why their citizens need to be extremely careful not to be overconfident, because any size of outbreak can be detrimental to all.

2- The median age in VN is 35.  The median age in the US is 38.  The largest group of people who were infected in VN was between the age of 29 - 49.  In the US, it's between the age of 50 - 59 and getting younger by the week according to USA Today.  Your statement about the previous zero death in VN was due to the young population holds no water.

Do you why there were few elderlies in VN who fell victims to Covid?  It's not because of the young population, but because the elderlies here do not live in nursing homes where they can infect one another.  Here, grandparents and great-grandparents live under the same roof with their grandchildren and great-grandchildren where they're being cared for and the chance to expose themselves to the peril of this pandemic is much lower than most countries in the world.

That's all, folks.

Well they might not have access or limited access to the best meds, but Vietnam certainly did a great job with the UK Vietnam Airlines pilot, my opinion for what its worth back in UK he was probably a goner!

Not sure if I get the last bit about extended families all living together was why the elderly had limited chance of exposure though.

SteinNebraska wrote:

I had typed this yesterday but didn't send it so as to not sound callous.  I really have a tough time calling these COVID deaths.  Both were at end of cycle with their chronic diseases.  The first one especially.

The second one had the same multiple end-stage illnesses as the first one.  In fact, they shared the same treatments in the same hospital ward before being infected by Covid.

I also do not feel comfortable calling them Covid deaths, but I only translated the announcement from the Ministry of Health without giving my opinion.

I don't think you sound callous at all.  You only spoke out loud what we all think.

goodolboy wrote:

Well they might not have access or limited access to the best meds, but Vietnam certainly did a great job with the UK Vietnam Airlines pilot, my opinion for what its worth back in UK he was probably a goner!

Not sure if I get the last bit about extended families all living together was why the elderly had limited chance of exposure though.

I'm 100% in agreement with your first paragraph. 

My reply was to Fabrice VN who said the reason for the (erstwhile) zero death was due to VN's young population with most of infected people were in 20-30 years old. 

I pointed out that the US also has a young population, with a slightly older group than VN being infected, but 80% of their deaths were older than 60s so the population or the age of the infected have nothing to do with the number of deaths. 

I said Vietnamese elderlies didn't die of Covid because they live at home and their offsprings did not allow them to have contacts with the potential danger from the outside, unlike the elderlies in other countries who live alone or in nursing homes.

Ciambella wrote:

goodolboy wrote:

Well they might not have access or limited access to the best meds, but Vietnam certainly did a great job with the UK Vietnam Airlines pilot, my opinion for what its worth back in UK he was probably a goner!

Not sure if I get the last bit about extended families all living together was why the elderly had limited chance of exposure though.

I'm 100% in agreement with your first paragraph. 

My reply was to Fabrice VN who said the reason for the (erstwhile) zero death was due to VN's young population with most of infected people were in 20-30 years old. 

I pointed out that the US also has a young population, with a slightly older group than VN being infected, but 80% of their deaths were older than 60s so the population or the age of the infected have nothing to do with the number of deaths. 

I said Vietnamese elderlies didn't die of Covid because they live at home and their offsprings did not allow them to have contacts with the potential danger from the outside, unlike the elderlies in other countries who live alone or in nursing homes.

I can see the culture of looking after the elderly at home will change in the next few decades. Sad, but Viet Nam is changing year by year.

Nursing homes

colinoscapee wrote:

I can see the culture of looking after the elderly at home will change in the next few decades. Sad, but Viet Nam is changing year by year.

Nursing homes

At 20M for two people, that's more money than most people can afford, even if it's inclusive.

Ciambella wrote:

colinoscapee wrote:

I can see the culture of looking after the elderly at home will change in the next few decades. Sad, but Viet Nam is changing year by year.

Nursing homes

At 20M for two people, that's more money than most people can afford, even if it's inclusive.

Near my wifes family farm in Binh Chau they are building a nursing home for 100 people. Its being built by the government. At present there are over 400 nursing homes, I can see this increasing in years to come.

colinoscapee wrote:

Near my wifes family farm in Binh Chau they are building a nursing home for 100 people. Its being built by the government. At present there are over 400 nursing homes, I can see this increasing in years to come.

Sad.   

Ciambella wrote:

colinoscapee wrote:

Near my wifes family farm in Binh Chau they are building a nursing home for 100 people. Its being built by the government. At present there are over 400 nursing homes, I can see this increasing in years to come.

Sad.   

Yes, it's a tradition that should be kept.

But in this age of want and materialism, old people don't fit into the mix.

colinoscapee wrote:

I can see the culture of looking after the elderly at home will change in the next few decades. Sad, but Viet Nam is changing year by year.

Nursing homes

I wonder if this is available to foriegners?  With the average cost of nursing home care in the US being more in line with 100-200M per month could we start seeing "nursing home tourists"?  If one ponied up for the most luxurious facility it would be a fraction of the cost of a standard facility back home.

I could see a business case for nursing home tourists.  Build a facility that caters to foriegners with English speaking staff in a resort-type setting and you could increase that 20M to 50M per month fairly easily.  Heck, buy one of the really nice Da Nang hotels that are for sale and convert it.  It's already set up for individual rooms with baths.  Obviously ths last thought is after this COVID thing is done.  I'm not sure how to deal with the VISA issue, though.  Would be tough for border runs.  Maybe it would be better suited to a location between HCMC and Moc Bai where land isn't super expensive.  Could have facility owned buses with wheelchair lifts that could transport patients to the border and orderlies that accompany them and take them through the border.  It wouldn't be a huge expense in the grand scheme of things.

I am game if there is an opportunity for such business model.   

Yoda0807 wrote:

I am game if there is an opportunity for such business model.   

Taking care of the elderly is 24/7/365.  In that respect, maybe the only occupation worse is milking dairy cows.

SteinNebraska wrote:

colinoscapee wrote:

I can see the culture of looking after the elderly at home will change in the next few decades. Sad, but Viet Nam is changing year by year.

Nursing homes

I wonder if this is available to foriegners?  With the average cost of nursing home care in the US being more in line with 100-200M per month could we start seeing "nursing home tourists"?  If one ponied up for the most luxurious facility it would be a fraction of the cost of a standard facility back home.

I could see a business case for nursing home tourists.  Build a facility that caters to foriegners with English speaking staff in a resort-type setting and you could increase that 20M to 50M per month fairly easily.  Heck, buy one of the really nice Da Nang hotels that are for sale and convert it.  It's already set up for individual rooms with baths.  Obviously ths last thought is after this COVID thing is done.  I'm not sure how to deal with the VISA issue, though.  Would be tough for border runs.  Maybe it would be better suited to a location between HCMC and Moc Bai where land isn't super expensive.  Could have facility owned buses with wheelchair lifts that could transport patients to the border and orderlies that accompany them and take them through the border.  It wouldn't be a huge expense in the grand scheme of things.

I think you are dreaming out loud there. Until or if there is a change to the Visa rules I can just see in my minds eye this bus load of foreign geriatrics some half dead, some senile, some in wheelchairs, some with zimmers & some still in wheelie beds with drips attached to their arms, crossing the border at Moc Bai every 3 months or possibly every month if the new rules apply.

Not saying its a bad idea if a new eventide home person visa came into play though.
Can you imagine the paperwork when someone snuffs it in one of these homes??

THIGV wrote:

Yoda0807 wrote:

I am game if there is an opportunity for such business model.   

Taking care of the elderly is 24/7/365.  In that respect, maybe the only occupation worse is milking dairy cows.

They got new robots to do that now, saw a documentary on BBC about it. The cows can even decide when they come in to get milked. After they even get a full body massage if they want to. Very impressive I thought.
So I suppose the future of eventide homes could be the same. As a 69 year coming up 70 year old might have that to look forward too. Mind you, the thought of a young Vietnamese nurse giving you a bed bath sounds better!!

THIGV wrote:

Yoda0807 wrote:

I am game if there is an opportunity for such business model.   

Taking care of the elderly is 24/7/365.  In that respect, maybe the only occupation worse is milking dairy cows.

I think being a prostate doctor or in fimo is up there.

SteinNebraska wrote:

Heck, buy one of the really nice Da Nang hotels that are for sale and convert it.  It's already set up for individual rooms with baths. 

... Would be tough for border runs.  Maybe it would be better suited to a location between HCMC and Moc Bai where land isn't super expensive.  Could have facility owned buses with wheelchair lifts that could transport patients to the border and orderlies that accompany them and take them through the border.  It wouldn't be a huge expense in the grand scheme of things.

... and not difficult to manage.  It's an excellent idea. 

Make the border run a field trip day with a bit of entertainment thrown in, then it wouldn't be a chore in the mind of the tenants.

THIGV wrote:

Taking care of the elderly is 24/7/365.  In that respect, maybe the only occupation worse is milking dairy cows.

Three shifts overlapping.  I know a number of men and women in this country who have experience in elderly care and wouldn't mind a stable job, indoors, with free time in between scheduled duties.

THIGV wrote:

Taking care of the elderly is 24/7/365.  In that respect, maybe the only occupation worse is milking dairy cows.

That would be one of the benefits to doing it here.  A huge amount of the cost in the US is obviously labor to cover that 24/7/365.  Much lower cost to do that here with no reduction - and I suspect an increase in - the standard of care.  And with the generally more positive view of elders here compared to the US it could work.

Ciambella wrote:

THIGV wrote:

Taking care of the elderly is 24/7/365.  In that respect, maybe the only occupation worse is milking dairy cows.

Three shifts overlapping.  I know a number of men and women in this country who have experience in elderly care and wouldn't mind a stable job, indoors, with free time in between scheduled duties.

Put me down provisionally for a bed then but with the proviso only lady nurses get to do the bed baths & any "extras" that are in with the deal.

goodolboy wrote:

Ciambella wrote:

THIGV wrote:

Taking care of the elderly is 24/7/365.  In that respect, maybe the only occupation worse is milking dairy cows.

Three shifts overlapping.  I know a number of men and women in this country who have experience in elderly care and wouldn't mind a stable job, indoors, with free time in between scheduled duties.

Put me down provisionally for a bed then but with the proviso only lady nurses get to do the bed baths & any "extras" that are in with the deal.

You forgot the daily rectal examinations in that deal.

SteinNebraska wrote:

colinoscapee wrote:

I can see the culture of looking after the elderly at home will change in the next few decades. Sad, but Viet Nam is changing year by year.

Nursing homes

Would be tough for border runs.  Maybe it would be better suited to a location between HCMC and Moc Bai where land isn't super expensive.

You would lose your clientele once they see how horribly corrupt Moc Bai is ... the officials would see them only as Gold in a wheelchair ... they would keep at least one back until 'extra' payments were made.

Try land nearer to Lao Boa. Maybe Hue.

5 Dead now. Nuts.

I'm not going to quote any one particular person here, but the idea of starting a business in "nursing homes" for foreigners in Vietnam has got to be one of the craziest ideas I've ever heard.

Nursing homes are developing in Vietnam for citizens of Vietnam out of NECESSITY for Vietnamese CITIZENS.

Now picture the entrepreneurial person who approaches the government and says that businesses should be allowed to bring the  infirm elderly from other nations into Vietnam.

We are already seeing neighboring countries drastically increase the requirement for insurance deposits when new travellers arrive who are not even elderly or infirm.

Now you were talking about importing a whole new section of the population that has nowhere to go but down when it comes to the quality of their health.

Remember that most nursing homes in the world are medical facilities to some degree, often designated as "skilled nursing facilities" or SNFs.

They are custodial facilities where people are given basic assistance with activities of daily living including hygeine and medications and meals and housekeeping and help with their wheelchairs, PLUS healthcare for chronic and stable conditions such as long-term postoperative wound care, physical and occupational therapy, MEMORY care, urinary catheter care and toilet functions.

But people only stay in those facilities as long as their health remains "stable".

There are leaders in this government who understand actuarial numbers as well as any insurance executive.

They know that the odds are that these elderly and infirm people are going to become HOSPITAL patients very quickly, and need to at least temporarily be moved out of their status as custodial residents for ACUTE CARE when they develop heart and lung and gastrointestinal and neurological and circulatory and endocrine and EENT and Integumentary and genitourinary and musculoskeletal problems that can no longer be managed in a Skilled Nursing Facility... because that's what happens to people in skilled nursing facilities on a far-too regular basis.

And the owner operators of skilled nursing facilities are responsible for the transportation of their residents to and from acute care facilities (sometimes clinics, usually hospitals).

If you are living in a hotel or an apartment by yourself now, congratulations you are now in an INDEPENDENT living facility, especially if it provides an option for breakfast in the morning and laundry service and the other options usually available in a "serviced apartment".

If you are hiring a housekeeper and a cook and a regular massage therapist then you are now in effect living in an ASSISTED living facility, especially if you're getting some help with hygiene or dressing or managing other simple tasks, or if your "girlfriend" helps you.

Do not fool yourself.

If you could construct a true Nursing Home in Vietnam to the standards of Western care, the cost would be prohibitive for foreigners,  especially when considering how the government would become involved in such an enterprise.

Better to keep your mouth shut, don't tell a lot of people about your personal health problems, and find one or two trustworthy Vietnamese people to provide domestic help for you.

Don't worry, OB, we are just talking for the sake of talking here.  I don't think any of us are serious aout going out and building a facility.