Quyết định 3646/QĐ-BYT năm 2021 về Tiêu chí phân loại nguy cơ người nhiễm SARS-CoV-2 do Bộ trưởng Bộ Y tế ban hành

DECISION

CRITERIA FOR CLASSIFYING SARS-COV-2 INFECTION RISK

MINISTER OF HEALTH

Pursuant to the Law on Medical Examination and Treatment dated November 23, 2009;

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

Pursuant to Decision No. 447/QD-TTg dated April 1, 2020 on declaring COVID-19 Epidemic;

At request of Director of Vietnam Administration of Medical Services, Ministry of Health.

HEREBY DECIDES:

Article 1. “Criteria for classifying SARS-CoV-2 infection risk” is attached hereto.

Article 2. “Criteria for classifying SARS-CoV-2 infection risk” applies on a nationwide scale to medical personnel and other individuals assigned by medical personnel to assess the risk.

Article 3. Vietnam Administration of Medical Services shall act as contact point and cooperate with Department of Preventive Medicine and Health Environment Management Agency in directing, guiding, inspecting, monitoring, and supervising implementation of Risk classification criteria.

Article 4. This Decision comes into effect from the day of signing.

Article 5. Director of Department of Medical Examination and Treatment, Director of Department of Preventive Medicine, Director of Health Environment Management Agency, Chief of the Ministry Office, Chief Ministry Inspector, directors of departments and agencies affiliated to Ministry of Health; directors of hospitals and facilities providing hospital beds affiliated to Ministry of Health; Directors of Departments of Health of provinces and central-affiliated cities, heads of relevant entities; heads of medical sector of ministries are responsible for implementation of this Decision. /.

CRITERIA FOR CLASSIFYING SARS-COV-2 INFECTION RISK AND GUIDELINES FOR INTIAL RESPONSE

(Attached to Decision No. 3646/QD-BYT dated July 31, 2021 of Minister of Health)

1. PREFACE

The COVID-19 epidemic outbreak is going on in many countries around the world and in Vietnam. Every single medical sector braces themselves for the rise in number of SARS-CoV-2 cases. Effective risk classification will allow medical system to avoid overload and confusion in treatment. In addition, correct classification will allow identification of SARS-CoV-2 infected individuals with different risks thereby identifying demand for treatment, care and support for each individual, improving treatment effectiveness, and saving resources of medical sector and society. Thus, the development of criteria for classifying risks and guidelines for initial response are vital in this stage.

2. OBJECTIVES AND PRINCIPLES OF ADOPTING THE CRITERIA

2.1. General objectives

Assess risks of individuals infected with SARS-CoV-2 in order to accurately identify treatment demand thereby assigning said individuals to appropriate treatment establishments in order to achieve satisfaction of the individuals infected with SARS-CoV-2, minimize resources and maintain effective epidemic management.

2.2. Purpose of classification

1. Assess specific risks for each patient.

2. Classify patients based on risks appropriately and rapidly in order to provide a response suitable to specific risk.

3. Detect cases with severe development for timely interventions.

2.3. Response principles after classification:

1. Select treatment establishments appropriately for individuals infected with SARS-CoV-2 in different risk categories;

2. Guarantee adoption of safe and thorough isolation in order to prevent infection to other individuals;

3. Comply with guidelines for response to and treatment stringently, minimize severe development of patients in inappropriate treatment establishments.

3. CRITERIA FOR RISK CLASSIFICATION AND RESPONSE

NOTE:

Based on epidemic development, reception and treatment results, medical sector of each local administrative division may promptly adjust and add more to risk classification if necessary in order to respond to patients rapidly, safely, and effectively.

Medical personnel must rapidly classify individuals infected with SARS-CoV-2 and prioritize transferring individuals who fall under the category of “very high risk” to the nearest appropriate medical facilities. In case the patients experience state of emergency and require immediate intervention during classification, disregard all responses under guidelines above and instead transferring and arranging hospitals beds in appropriate hospitals for patients in a timely manner.

ANNEX 1 – HIGH RISK UNDERLYING MEDICAL ILLNESSES

1. Diabetes mellitus

2. Chronic obstructive pulmonary disease and other pulmonary diseases.

3. Cancer (especially malignant tumors regarding hematology, lung cancer, and other metastasis cancers).

4. Chronic kidney illness

5. Organ transplant or stem cell transplant

6. Overweight

7. Cardiovascular diseases (heart failure, coronary artery disease, or heart muscle disease)

8. Cerebrovascular conditions

9. Down syndrome

10. HIV/AIDS

11. Neurological conditions, including dementia

12. Sickle cell disease

13. Asthma

14. Hypertension

15. Immunodeficiency

16. Liver diseases

17. Substance use disorder

18. Use of corticosteroid or other immunosuppressive drugs

19. Systemic illness

ANNEX 2 – SIGNS AND SYMPTOMS OF SARS-COV-2 INFECTION

1. Coughing

2. Fever (above 37.5 oC)

3. Headache

4. Sore throat

5. Rhinorrhea, nasal congestion

6. Dyspnea

7. Chest pain, chest tightness

8. Body aches, muscle pain

9. Loss of taste

10. Loss of smell

11. Stomachache, nausea

12. Diarrhea

ANNEX 3 – STATE OF EMERGENCY

1. Disorders of consciousness

2. Dyspnea, rapid ventilation (> 25 times/minute) or SpO2 < 94%

3. Rapid heart rate > 120 beats/minute

4. Hypotension, maximum blood pressure < 90 mmHg, minimum blood pressure < 60 mmHg

5. Any other irregularity advised for treatment by medical personnel.

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