Cablegate: Vietnam - Preparations for Possible Return Of

This record is a partial extract of the original cable. The full text of the original cable is not available.





E.O. 12958: N/A



1. (U) Summary. In anticipation of the resurgence of SARS,
Mission plans to encourage vaccinations against the flu and
will continue to promote healthy practices in the work
place. Consular Sections at both posts are in the process of
a systematic updating, appraisal, and testing of our Warden
System. Embassy has re-established a SARS working group, is
in direct contact with the CDC SARS working group, and is in
contact with the EU SARS working group. On October 21 and
22, the MOH will hold a symposium in Hanoi to make public
its "SARS Readiness Plans."

2. (U) Screening procedures at the airports and borders for
possible SARS cases currently are lax. Clear policies on
medical evacuation in the event of suspected SARS remain the
single most critical area of concern in the event of future

End Summary.


3. (U) In anticipation of the resurgence of SARS in
country, Mission will encourage all staff to participate in
vaccinations in early October against the influenza virus in
keeping with M/MED's recommendations. Mission will also
provide information on flu immunization to all American
citizens in country to encourage vaccination.

4. (U) The Embassy and Consulate General have N95 masks and
anti-bacterial hand sanitizer available in all restrooms and
by all sinks. The cleaning crews have been instructed in
proper and frequent disinfection of all public access area
surfaces. Management is in frequent contact with all of the
medical service providers in both cities.

5. The Embassy has reestablished a SARS working group whose
role will be: to obtain information; coordinate with other
embassies, international organizations, and GVN health
authorities; communicate with the Department, the RMOs in
the region, the AmCham, and with the various elements of the
US Mission in Vietnam, including the ConGen HCMC; draft
reporting and other cables to the Department; and draft
notices and messages to USG employees and Americans resident
in Vietnam. Through the CDC Office, Embassy is in direct
contact with the CDC SARS working group and maintains close
connections with WHO. The CDC Office has also been invited
by Vietnam's Ministry of Health (MOH) to participate in
strategic planning for SARS. The EU is also establishing a
SARS working group. It is unclear at this point whether the
US and other non-EU countries will be invited to
participate. Even if the US is not invited to participate,
Mission will remain in close contact with this working

6. (U) Embassy consular section conducted an informal,
feedback survey to gauge Amcit satisfaction with our Warden
Messages during the spring 2003 SARS outbreak. The general
feedback we received indicated that our information
dissemination efforts during SARS were well appreciated and
helpful. The more information we can provide, the better,
many said. One Amcit wrote, "We would like to know what
medevac plans/services are available if American citizens
are affected by any possible SARS outbreak in the futures.
I appreciate the WARDEN system very much."

7. (U) Another Amcit wished for more information regarding
the authorized departure of some U.S. Embassy family
members. She wrote, "I did find the updates helpful as a
citizen, and it was useful to have the embassy host the town
meetings to listen to the community's concerns. What might
have been explained more clearly was the rationale behind
permitting embassy staff and dependents to leave the
country. I realize that was more reflective of the lack of
medical facilities than alarm about the spread of SARS in
Vietnam, but the message wasn't conveyed in that light and
may have caused unintended anxiety. If it should happen
again, the daily updates and prevention hints would again be

8. (U) Consular Sections at both posts are in the process
of a systematic updating, appraisal, and testing of our
Warden System.

9. (U) The EAC will review tripwires established during the
last outbreak to review their effectiveness should another
outbreak occur.

10. (U) Meetings with the Overseas Security Advisory
Councils (OSAC) and the American Chambers of Commerce in
Hanoi and Ho Chi Minh City will be held to review lessons
learned from the last outbreak and elicit feedback.


11. (U) International SOS Vietnam has demonstrated a
portable isolation unit that was used to transfer a SARS
patient from Penghu island (off the coast of Taiwan) to
Taipei. SOS Clinic Manager in HCMC believes that all
nations would receive their own citizens and that Australia
has stated it would accept patients from any nationality
from anywhere in the world. However, SOS states in a press
release of May 15, 2003, "Clearly, any movement of SARS
patients would require the full co-operation and
authorization of all government authorities responsible for
Public Health and Civil Aviation in the countries concerned
and in the countries where the aircraft would refuel or fly
over to reach its destination. Singapore RMO reports there
are still no nations in the region who have stated a
willingness to accept medically transferred SARS patients"
From the Mission perspective, it is uncertain whether this
cooperation could be achieved.

12. Clear policies on medical evacuation in the event of
suspected SARS remain the single most critical area of
concern in the event of future cases. Many details are still
unclear, including (a) whether medical evacuation will be
generally available, particularly in the event of large
scale epidemic; (b) possible evacuation points (e.g., will
case-patients be medevac'ed to neighboring countries or to
their country of origin?); (c) Which, if any, countries have
agreed to accept case-patients?

13. (U) To evacuate an American SARS case to the United
States, refueling privileges must be granted. As yet, we
have not heard of a place that would grant landing rights
for this. Given what Mission has heard about Hawaii's
refusal to accept an AmCit diagnosed with SARS who was being
medevac'ed from China, we would appreciate the Departments'
best estimate of whate states might do when asked to admit
to their jurisdictions AmCit SARS patients or suspected
patients or AmCits returning from countries where SARS has
been detected.

14. (U) A spokesman for the WHO in Hanoi told Embassy they
are working with the (MOH) on developing and implementing
new strategies to apply in various situations and locations,
(e.g., border crossings, hospitals) in the event of a
resurgence of SARS.

15. (U) On October 21 and 22, the MOH will hold a symposium
in Hanoi to make public its "SARS Readiness Plans." The
general feeling in the international medical community is
that the GVN would handle any future outbreaks of SARS in a
similar fashion as they did the last one. Suspected SARS
patients would be required by the government to go to one of
the designated isolation hospitals. The National Institute
of Clinical Research on Tropical Medicine (NICRTM) at the
Bach Mai National Hospital in Hanoi, and the Tropical
Medical Hospital in Cholon District in HCMC, were the
isolation hospitals in the 2003 epidemic earlier this year.
Both hospitals are operating as usual, and currently remain
the MOH-designated hospitals for quarantine and treatment of
probable SARS cases. However, there are reports that Hanoi
is building an isolation facility outside the city limits.
More will be reported on this as details become available.

16. (U) The Hanoi French Hospital (only recently reopened
after closure during the first SARS epidemic), the Franco-
Vietnamese Hospital in HCMC, the International SOS clinics
in both cities, and the Hanoi and HCMC Family Medical
Practice have protocols in place that would prevent
potential SARS patients from infecting other patients at the
clinics (e.g questionnaires, isolation rooms, etc).

17. (U) Border control: The Vietnamese Government purchased
thermal imaging machines for international airports and
instituted a health check questionnaire. However, how
systematically these machines and questionnaires are being
used is erratic. It has been noted that these are not always
in use in Ho Chi Minh City's Tan Son Nhat airport or Hanoi's
Noi Bai airport. The health questionnaire is still issued
to incoming passengers but is not required for entry into
HCMC, while it is usually required for entry into Hanoi.
One must presume that in the case of a new outbreak these
measures would be strictly enforced; however, they would not
stop the initial entry of a SARS carrier into the country.
Vietnam has re-opened borders with China and in late
September, Vietnam Airlines will resume SARS-suspended
flights to Guangzhou. Other SARS-suspended flights were
resumed earlier this summer and most routes are operating at
normal or near normal "pre-SARS" frequency.


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