Development and implementation of a triage station at one of the largest hospitals during the peak of the third wave of COVID-19 in Vietnam

https://doi.org/10.52322/jocmbmh.11.en.03

ABSTRACT
The Coronavirus disease 2019 (COVID-19) pandemic has greatly impacted healthcare systems and healthcare workers worldwide. Vietnam responded quickly to the epidemic with effective strategies, yet hospital-based transmission remained a major concern. Bach Mai Hospital (BMH) in Hanoi is the largest hospital in northern Vietnam. During the third wave beginning January 2021, BMH implemented an aggressive triage strategy to prevent nosocomial spread. All patients/caregivers were screened and tested for SARS-CoV-2 regardless of symptoms, a major change from testing only symptomatic individuals. This aimed to detect asymptomatic infections which may transmit the B.1.1.7 variant driving this wave. The triage clinic stratified people into risk groups, quarantined higher risk individuals in separate rooms, and restricted hospital entry. Capacity was expanded to handle increased volume. Within one month, over 3,500 people were screened with nearly 3,000 tests performed. Two positive cases were detected, and no nosocomial transmissions occurred despite the more transmissible variant. Challenges included overflow from at-risk individuals not isolating locally, resource waste from prolonged restrictive measures, and lack of effective vaccination. A cost-effectiveness evaluation could inform strategies for resource-limited settings. In conclusion, the triage clinic with expanded testing criteria helped prevent nosocomial spread and protect hospital patients and staff. This model may guide other resource-limited countries to control pandemic spread in healthcare settings. The findings support aggressive testing and monitoring to contain more transmissible variants. Continued evaluation is needed to balance infection control with service maintenance and cost.
Keywords: COVID-19, triage, nosocomial transmission, Vietnam

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