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After action review of the COVID-19 surveillance system in Quang Ninh Province, Vietnam, in 2020

Ha-Linh Quach, MPH, MAppEpid, Khanh Cong Nguyen, MD, MSc, Thai Quang Pham, MD, PhD, Ngoc-Anh Hoang, BSc, Hien Hong Thi Do, MD, PhD, Dung Thi Nguyen, MPH, Chu Van Ninh, MD, Emma Field, MAppEpid, DrPH, Anh Duc Dang, MD, PhD, Duong Nhu Tran, MD, PhD, Ha Cam Thi Pham, MSc, Anh Tu Tran, MD, MSc, Hien Tran Nguyen, MD, PhD, Nghia Duy Ngu, MD, PhD, Florian Vogt, MD, PhD


Surveillance is the backbone of any response to an infectious disease outbreak, and comprehensive evaluation of surveillance systems is crucial. However, structured evaluations of surveillance systems during the COVID-19 pandemic are scarce. We conducted a after action review (AAR) of the performance of the COVID-19 surveillance system in Quang Ninh Province, Vietnam, during 2020 using the COVID-19-specific AAR methodology developed by the World Health Organization in combination with guidance from the US Centers for Disease Control and Prevention (CDC). We conducted a stakeholder survey, document reviews, and key informant interviews with staff from Quang Ninh CDC’s COVID-19 surveillance system. The COVID-19 surveillance system was based on the pre-existing surveillance system in the province. The system’s strengths were early preparation for emergency response, strong governance and central coordination, and multidisciplinary collaboration. Stakeholders agreed that the system proved useful and adaptive to the fast-evolving COVID-19 situation but was weakened by overly complex systems, redundant administrative processes, unclear communication channels, and lack of resources. Overall, the surveillance systems in Quang Ninh province proved effective in containing COVID-19 and adaptive in a fast-changing epidemiological context. Several recommendations were made based on identified areas of concern that are of relevance for COVID-19 surveillance systems in Vietnam and similar settings.


COVID-19, Vietnam, surveillance system, evaluation, after action review

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Ministry of Health: COVID-19 updates in Vietnam. Available at Accessed May 1, 2020.

La VP, Pham TH, Ho MT, et al.: Policy response, social media and science journalism for the sustainability of the public health system amid the COVID-19 outbreak: The Vietnam lessons. Sustain. 2020; 12(7): 2931.

World Health Organization: Guidance for after action review (AAR). Geneva. 2009. Available at Accessed May 21, 2021.

ECDC: Conducting in-action and after-action reviews of the public health response to COVID-19. Stockholm. 2020. Available at Accessed July 20, 2021.

World Health Organization: Guidance for conducting a country COVID-19 intra-action review (IAR). Geneva. 2020. Available at Accessed May 21, 2021.

Copper F, Mayigane L, Pei N, et al.: Simulation exercises and after action reviews—Analysis of outputs during 2016-2019 to strengthen global health emergency preparedness and response. Global Health. 2020; 16(1). Available at Accessed July 20, 2021.

WHO: After Action Review (AAR) | Strategic Partnership for Health Security and Emergency Preparedness (SPH) Portal [Internet]. Geneva: World Health Organization. Available at Accessed July 20, 2021.

Riccardo F, Bolici F, Fafangel M, et al.: West Nile virus in Europe: After action reviews of preparedness and response to the 2018 transmission season in Italy, Slovenia, Serbia and Greece. Global Health. 2020; 16(1): 1-13. Available at Accessed March 18, 2022.

Stoto MA, Nelson C, Hidgon MA, et al.: Learning about after action reporting from the 2009 H1N1 pandemic: A workshop summary. J Public Heal Manag Pract. 2013; 19(5): 420-427. Available at Accessed July 20, 2021.

Sorbello S, Bossi E, Zandalasini C, et al.: After action reviews of COVID-19 response: Case study of a large tertiary care hospital in Italy. Int J Health Plann Manag. 2021; 36(5): 1758-1771. Available at Accessed July 20, 2021.

Vermont Healthcare Emergency Preparedness Coalition: COVID-19 pandemic response: After-action report/improvement plan. 2020. Available at Accessed July 20, 2021.

Connecticut Department of Public Health: COVID-19 facility after-action report (FAAR)/improvement plan (IR). 2020. Available at Accessed July 20, 2021.

German RR, Lee LM, Horan JM, et al.: Guidelines Working Group Centers for Disease Control and Prevention (CDC). Updated guidelines for evaluating public health surveillance systems: Recommendations from the Guidelines Working Group. MMWR Recomm Rep. 2001; 50(RR-13): 1-35; quiz CE1-7.

Ministry of Planning and Investment SR of V: Quang Ninh province: Local economic and geography. Available at Accessed July 13, 2021.

Quach H-L, Nguyen KC, Hoang N-A, et al.: Association of public health interventions and COVID-19 incidence in Vietnam. Int J Infect Dis. 2021; 110(Suppl. 1): 24. Available at Accessed August 17, 2021.

Khanh NC, Thai PQ, Quach H-L, et al.: Transmission of SARS-CoV-2 during long-haul flight. Emerg Infect Dis. 2020; 26(11): 2617-2624. Available at Accessed November 9, 2020.

World Health Organization: Communicable disease surveillance and response systems guide to monitoring and evaluating. 2006. Available at Accessed March 15, 2022.

Vietnam Ministry of Health: Decision no 3468/QD-BYT official guidance on surveillance, prevention and control of COVID-19. 2020. Available at Accessed March 15, 2022.

Pollack T, Thwaites G, Rabaa M, et al.: Emerging COVID-19 success story: Vietnam’s commitment to containment—Our world in data. Our World Data. 2020. Available at Accessed February 24, 2021.

Quang Ninh Standing Party Committee: Official directive on the prevention and control of acute pneumonia caused by a new strain of corona virus (nCoV). Official Online Press by Quang Ninh Department of Health. 2020. Available at Accessed July 13, 2021.

Takashima K, Wada K, Tra TT, et al.: A review of Vietnam’s healthcare reform through the direction of healthcare activities (DOHA). Environ Heal Prev Med. 2017; 22(1): 1-7. Available at Accessed July 20, 2021.

Quach HL, Hoang NA: COVID-19 in Vietnam: A lesson of prepreparation. J Clin Virol. 2020; 127: 104379.

Wongsanuphat S, Jitpeera C, Iamsirithaworn S, et al.: An evaluation of the enhanced information system for COVID-19 surveillance in Thailand, 2020: A pre-post intervention comparison. OSIR J. 2020; 13(3): 101-109.

Ibrahim NK: Epidemiologic surveillance for controlling COVID- 19 pandemic: Types, challenges and implications. J Infect Public Health. 2020; 13(11): 1630-1638.

World Health Organization: Early Detection, Assessment and Response to Acute Public Health Events: Implementation of Early Warning and Response with a Focus on Event-Based Surveillance: Interim Version. Geneva: World Health Organization, 2014. Available at Accessed March 15, 2022.

Cheng HY, Li SY, Yang CH: Initial rapid and proactive response for the COVID-19 outbreak—Taiwan’s experience. J Formos Med Assoc. 2020; 119(4): 771-773.

Wongsanuphat S, Sangwanloy S, Sopha P, et al.: Enhancing coronavirus disease (COVID-19) surveillance system through information technology, Thailand, 2020. OSIR J. 2020; 13(3): 90-100.

Vitak J, Zimmer M: More than just privacy: Using contextual integrity to evaluate the long-term risks from COVID-19 surveillance technologies. Soc Media Soc. 2020; 6(3): 205630512094825. DOI: 10.1177/2056305120948250.

Ricoca Peixoto V, Nunes C, Abrantes A: Epidemic surveillance of COVID-19: Considering uncertainty and under-ascertainment. Port J Public Health. 2020; 38(1): 23-29.

Sorbello S, Pleet AR, Ambrosio A, et al.: Using after-action reviews to strengthen hospital preparedness: A lesson learned from COVID-19. Qual Manag Health Care. 2021; 31(3): 196-197.



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