NCOVI and Bluezone in Vietnam: Government Launches Digital Apps to Contain COVID-19
|The Exemplars in Global Health program would like to thank Do Lap Hien from Vietnam’s Ministry of Information and Communications, Vu Hoang Duong and Roger Mathisen from Alive & Thrive FHI Solutions, and Trung Nguyen The from the DTT Technology Group for their contributions to and review of this report.|
In this case study, we describe the implementation story of NCOVI and Bluezone in Vietnam in the context of COVID-19. At end, there is an assessment of performance against the MAPS framework.
Vietnam’s performance in managing the COVID-19 pandemic has been among the best in the world. Between January 2020 and March 2021, Vietnam reported fewer than 2,600 cases of COVID-19—and just 35 deaths from the disease—out of a population of 97 million. The country’s success at containing the outbreak can be attributed to several key factors, including a well-developed public health system, a decisive central government, and a proactive, comprehensive strategy for testing, tracing, and quarantining.1
Many of Vietnam’s public health responses have been enabled and accelerated by digital health apps. Even before the COVID-19 pandemic, the country had a robust information and technology sector and high mobile penetration and social media use.2 The pandemic has further catalyzed digital transformation across Vietnam, with many new innovations led by the government.3, 4
Within a week of Vietnam’s first reported cases of COVID-19, the head of Vietnam’s official Steering Committee for COVID-19 Prevention and Control called on the Ministry of Health (MOH) and the Ministry of Information and Communications (MIC) to build apps to assist with surveillance, contact tracing, and the dissemination of information. NCOVI is a mobile app designed to encourage voluntary symptom logging, share health care providers’ advice on whether to self-quarantine or go to the hospital, and help officials identify hotspots by reporting suspected infections in their communities.5 NCOVI also serves as the official channel for state agencies to distribute rapid updates and public health recommendations to everyone who uses it.
Shortly after NCOVI launched, the MOH released another mobile app called Bluezone, which leverages Bluetooth Low Energy to alert users if they were in close contact with someone who tested positive for COVID-19.6
Other apps include Hanoi SmartCity, which helps authorities track and monitor people who have been infected and quarantined, sending a notification to the heads of districts if the patient moves more than 98 feet (30 meters) from the designated quarantine area, and the Vietnam Health Declaration, a mandatory multilingual tracking and tracing app designed for domestic and international travelers entering Vietnam. Together, these innovative digital surveillance apps have played a critical role in Vietnam’s ability to contain COVID-19. 6,7
Digital Transformation in Vietnam
Vietnam has a strong foundation for digital innovation—45 percent of the population owned smartphones in 2020, making Vietnam among the top 15 countries with the highest number of smartphone users.2 The country also had 68 million Facebook users in 2020, more than almost any other country in the world and a study found that Vietnamese people spend more time on the internet and social media compared with neighboring countries in Asia.2,3,8 It also has a thriving startup ecosystem and government commitment to the digital transformation agenda.4
In June 2020, Prime Minister Nguyen Xuan Phuc approved the National Digital Transformation Roadmap 2025, which sets targets and guidelines to help Vietnam reach its digital transformation goals for e-government, e-economy, and e-society by 2030.5 The Roadmap sets out to (1) overhaul the entire government infrastructure to digitalize public services and administrative procedures, (2) build a digital economy that will represent up to 30 percent of Vietnam’s gross domestic product by 2030, and (3) address Vietnam’s digital divide to ensure equal access to the internet and use of online services. The government has also leveraged the Roadmap to galvanize support from the private sector and their “Make in Vietnam” campaign focuses on reenergizing the private sector to help revive Vietnam’s post-COVID-19 economy.
Additionally, many of the legal structures and systems that enabled a rapid response to COVID-19 were already in place in Vietnam because of the country’s experience with SARS. In 2007, policies were developed to encourage inter-ministry collaboration and a law was passed on the prevention and control of infectious diseases (which laid the foundation for preparedness, rapid coordination, and quarantine policies).9,10
Adapting to a New Challenge
The Vietnamese government had long been committed to the digital transformation agenda, and the COVID-19 pandemic served as a catalyst for accelerating innovation in digital health. Developers, engineers, and health professionals worked in collaboration with government agencies to build tools for disseminating up-to-date health information to the public, correcting misinformation and “fake news,” and helping health care workers and the MOH detect and contain COVID-19 cases before the disease spread out of control.11
Five days after the first cases of COVID-19 were detected in Vietnam, the prime minister established a national steering committee—headed by Deputy Prime Minister Vu Duc Dam—including the minister of information and communication, two deputy ministers of health, and 16 other deputy ministers.12,13 Two days later, the MIC established a subcommittee on communication that included the CEOs of the three largest state-owned telecommunications groups: Viettel, MobiFone, and Vietnam Posts and Telecommunications Group (VNPT). One of this committee’s priorities was to mobilize companies to develop software to monitor the spread of COVID-19 and assist with contact tracing.
The initial platforms were very simple, and the team of developers met every two days to publish the latest announcements from the deputy prime minister. The team soon developed a second, linked website to map reported cases and provide spatial visualizations of the virus’s spread.
By March 2020, contact tracing efforts had begun in earnest in Vietnam, and the demand for mobile versions of the apps had increased. By March 9, the MIC and MOH had launched two mobile-phone apps—NCOVI and the Vietnam Health Declaration—to help health care providers and officials trace suspected cases of COVID-19. While both apps were designed to encourage symptom logging, the NCOVI app was intended for voluntary use by the Vietnamese public, and the Vietnam Health Declaration app was mandated for all travelers entering Vietnam.
Timeline of key events
Developed by the state-owned VNPT,14 the NCOVI app asks users to voluntarily provide personal and family information and contact details; users can then complete a disease survey and self-assessment of their health status. The survey, which the government suggests users complete daily, typically takes less than one minute to complete, and users can complete health declarations for their family members as well (of particular importance for older populations and multigenerational households).15 In April 2020, the NCOVI app began generating QR codes for registered quarantine checkpoints at airports and international borders, enabling people to scan the code by using the app on their phones to report their health status.16,17
In addition to using voluntarily reported data to map hotspots of new cases, NCOVI also serves as an official channel for authorities to disseminate urgent health recommendations, best practices, and COVID-19 updates to all users (e.g., number of new cases, nearby outbreaks and neighborhood hotspots, and health recommendations such as mask wearing).14,18,19
The NCOVI app has drawn criticism from some privacy advocates, however. While accurate and real-time data collected through the NCOVI app has proven to be very helpful for the government, the app (and others like SmartCity) have generated concerns about data privacy and mass surveillance. After the identities of infected patients were leaked on social media, the government clarified in statements that use of the app was voluntary and that information collected would be used only for epidemic control.5 The minister of information and communications had a meeting with leading technology firms to discuss developing a contact tracing app using Bluetooth rather than relying on location data. The authority of information technology application of the MIC then mobilized experts from different technology groups—Memozone, VNPT, Bkav, and MobiFone—to develop this new contact tracing app independently from one another while sharing technological challenges and discussing strategic solutions in a joint effort for COVID-19 prevention and control.
In just three weeks, the technology firm Bkav had developed and received an official endorsement from the government to launch Bluezone,20 a low-energy Bluetooth app that alerts users if they have been in close contact with people who tested positive for COVID-19, but it does not collect, use, or share location data for its users.7
Screen examples from the NCOVI (left) and Bluezone (right) apps.
Smartphones with the Bluezone app installed communicate with each other within a distance of 6.6 feet (2 meters), recording the time and duration of close contacts. For Bluezone to work, the phone must have Bluetooth activated, but the app uses Bluetooth Low Energy to preserve battery life. If it runs all day, it only consumes about 10 percent of the phone’s battery.7
When a new case of COVID-19 is confirmed, health authorities enter this data into the system, which then sends a notification to other smartphone users with Bluezone installed. The app analyzes and compares users’ history of exposure to a positive case in the previous 14 days; if it finds a match, Bluezone will alert users at risk of infection and instruct them to contact health authorities to get help.21 If the distance between two smartphones with Bluezone installed is less than 2 meters, the users’ interaction will be categorized as a “close” contact, whereas others will be classified as a contact.22
How does the Bluezone system work?
To ensure data security and preserve user anonymity, each phone running the Bluezone app generates a random alphanumeric ID, shuffled regularly, that it broadcasts to nearby phones in a protocol known as Bluetooth “handshakes.” This protocol keeps users anonymous to one another.20 Only health authorities learn the identities of infected people and those who are suspected of infection due to close contact with COVID-19 cases. To avoid the risk of fake declarations, only health authorities can update data on positive cases. Like NCOVI, Bluezone also provides regular status updates and notifications to users on cases, deaths, recoveries, and vaccinations to benefit the user.
The Path to Scale
The apps initiated by the MOH and MIC share the aims of disseminating up-to-date information with the public, correcting misinformation, and supporting health care workers and the MOH to detect COVID-19 cases and contain the spread.13 Early on, Deputy Prime Minister Vu Duc Dam called on every member of the public to use NCOVI, calling it a “positive contribution” to the country’s epidemic control efforts and “a practical and meaningful action.” He noted that using NCOVI is encouraged for all citizens but not mandatory.
The MOH has also leveraged existing platforms for creative public health communications and to encourage voluntary use of the apps throughout the pandemic, including Zalo. Zalo is the most popular messaging app in Vietnam and includes options for video calls, group chats, news feeds, and sharing media.23 The MOH’s official Zalo account began sending messages about COVID-19 on January 28, 2020, six days after the first case was reported in Vietnam, and the app is still being used to communicate key information and warnings to over 50 million users.24 The app is similar to WhatsApp or WeChat and has been used to send daily alerts to users about hotspots and new cases, and encourage the use of NCOVI and Bluezone to help contain COVID-19.
Installing NCOVI and Bluezone has not been mandatory for the general population, but the government has strongly encouraged people to use them, particularly Bluezone. The MIC promoted a campaign to encourage people to install the Bluezone app for themselves and for three other people, with the goal of protecting all of Vietnam within a month. The message “Let’s install Bluezone” also appeared on people’s smartphones next to the phone carrier’s logo.25 Public health messaging has focused on the idea that voluntary use is a step toward protecting one’s community.
During the Da Nang outbreak in July and August 2020, several provinces required individuals returning from the city to use NCOVI and Bluezone to update their health status regularly so that local governments could closely monitor the evolving outbreak and respond in a timely manner.26 The heads of companies and other organizations were responsible for ensuring that the health status of their staff was being logged. In February 2021, proof of Bluezone installation became mandatory to enter certain restaurants and public spaces, although the decision to enforce this was up to the individual owner.
As of March 2021, Bluezone has been downloaded by 24.18 percent of the population and NCOVI has been downloaded by 19.81 percent of the population. Although the MOH initially declared that at least 50 million active Bluezone users were required for the app to have a meaningful impact, this did not realistically account for the number of smartphone users (43.4 million) and the app has provided value beyond the original use case for many users with the dissemination of critical information notifications.22 Furthermore, as the rollout of vaccines for SARS-CoV-2 continues in Vietnam, Bluezone may also be leveraged to monitor vaccination—using QR codes to track multiple doses, for instance.
While the long-term, post-COVID-19 plans for these apps remains uncertain, the underlying infrastructure is likely to serve Vietnam well with respect to future pandemic preparedness, just as the country’s previous experience with SARS enabled a swift response for the novel coronavirus.
The launch and maintenance of these digital apps are the result of collaborations between the MOH, MIC, telecommunication groups, software developers, and medical experts. The three largest state-owned telecommunications groups, Viettel, MobiFone, and VNPT, supported advertising for these apps, and VinaPhone provided free data for its subscribers when accessing the NCOVI app.27 Additionally, these telecommunications groups subsidized 20 billion SMS messages (sent by the government to the general public) and 1.2 million calls on the toll-free COVID-19 hotline for Q&A about the pandemic, and made more than 1.6 million calls to encourage people to download Bluezone during the outbreak in Hai Duong Province. These telecommunications groups also enabled the Vietnamese population to donate 152 billion VND (US$6.6 million) via SMS to the government for pandemic control activities. Because these companies are owned and operated by the government (the Ministry of Defense and the Ministry of Information and Communications), they are quick to cooperate with these efforts.
The number of downloads and usage of Bluezone and NCOVI are tracked and reported by the Authority of Information Technology Application of the MIC. While the number of users has not met the expected amount of 60 percent of the population, Bluezone has proven to be useful in information dissemination and contact tracing. During the second wave in Da Nang, 21 first- and second-degree contacts of those infected were detected using Bluezone.26
The uptake of both apps has increased throughout the pandemic, with accelerated downloads during periods of local transmission. During the Da Nang outbreak at the end of July 2020, the number of Bluezone users increased from 260,000 to 5.7 million in just over a week. The areas with the highest numbers of Bluezone users correspond to access to smartphones.28
Transparency and knowledge sharing have been core tenets to the development of Bluezone. The project is open source under GPL 3.0 license and users of countries around the world are encouraged to learn about system activities at the source code level and use, research, modify, and share it.20
The information collected by these apps has given the MOH nearly real-time access to data for decision making and monitoring. Data from NCOVI, Bluezone, and other apps synchronize to one large database managed by the MOH. The MOH manages all COVID-19 prevention and control data according to its regulations, and the MIC ensures operation and informational security.
Data Flow of Digital Tools for Decision-Making in Vietnam
What Were the Key Drivers of Scale?
The adoption and scale of the suite of digital tools used for surveillance and information dissemination in Vietnam can be attributed to:
- Partnerships – Proactive government leadership and multisectoral collaboration: As the head of the National Steering Committee for COVID-19 Prevention and Control, Deputy Prime Minister Vu Duc Dam encouraged the development of digital tools for surveillance, contact tracing, and disseminating information before many cases of COVID-19 had been reported in Vietnam. In less than a week, a subcommittee on communication had been established that included the CEOs of the three largest state-owned telecommunications groups: Viettel, MobiFone, and Vietnam Posts and Telecommunications Group (VNPT).The launch and maintenance of Bluezone and NCOVI are the result of collaborations between the MOH, MIC, telecommunication groups, software developers, and medical experts.
- Groundwork – Leveraging previous experiences and foundation for digital innovation: The government leveraged Vietnam’s digital transformation agenda, thriving startup ecosystem and experience with SARS to launch NCOVI, Bluezone, and other innovative digital apps early. These apps were developed with remarkable speed. The initial web version took three days, NCOVI took less than two weeks, and Bluezone took less than a month from design to launch. High digital literacy and social media use, particularly among the younger population, also contributed to the rapid expansion of the digital tools.
- Operations – Outreach and promotion with a strong sense of community: The more people who download the NCOVI and Bluezone apps, the more effective they are. Promotional messaging has been about “challenging the virus with the strength of our community,” and the MOH and MIC encouraged all smartphone users to install Bluezone for themselves and three others: “Protect yourself, protect the community.”7 The message “Let’s install Bluezone” also appeared on people’s smartphones next to the phone carrier’s logo.25
What Implementation and Scaling Challenges Remain?
Although Bluezone was designed, in part, to address the privacy issues faced by NCOVI after data leaks on social media platforms, like many surveillance applications it too has dealt with skepticism.29 Other challenges include:
- Monitoring & Evaluation – Reliance on voluntary downloads and self-reporting: The NCOVI app relies on voluntary symptom logging, which has limited impact in the context of asymptomatic transmission and also does not account for the stigma that surrounds COVID-19. Although Bluezone is now required to enter certain public places, and the use of these apps has become mandatory during epidemic peaks, installation is largely voluntary. There have been no formal impact evaluations to date, and the effect of these tools compared to traditional contact tracing methods has been difficult to assess.
- Groundwork – Digital divide persists and influences parameters of scale: NCOVI, Bluezone, the Health Declaration App, and Hanoi SmartCity are all designed for smartphone users. Only 45 percent of the population has access to smartphones, necessarily limiting the scale of these apps. Fortunately, with NCOVI, making voluntary health declarations on behalf of other household members is encouraged and many young users are able to use the app for their families.
- Technology & Architecture – Lack of interoperability: NCOVI and Bluezone were launched sequentially, along with the other range of tools initiated by the MOH and MIC and the lack of interoperability between these apps may be a barrier to scale. Though recent efforts have been made to ensure that the data are synchronized into the same database run by the government, some people are using older, pre-synchronization versions of the apps, this process does not always work seamlessly.
- Operations – Sustainability of voluntary contributions: These efforts have relied heavily on contributions from state-owned telecommunication groups, press agencies, and TV stations for infrastructure, advertising, and funding. Medical professionals, freelance engineers, and private companies have contributed on a voluntary basis. The initial sense of responsibility and collective enthusiasm to collaborate may wane as the pandemic continues and the long-term vision for these apps remains uncertain.
Vietnam’s success in containing the spread of COVID-19 has been attributed to several key factors, including a well-developed public health system, a decisive central government, and a proactive containment strategy on comprehensive testing, tracing, and quarantining. These apps have enabled and accelerated specific aspects of Vietnam’s response and have played an important role in bolstering the offline components of Vietnam’s pandemic management including strict enforcement of public health guidelines such as lockdowns and quarantines. The rapid development and uptake of apps like NCOVI and Bluezone can be attributed to Vietnam’s strong digital foundation, a thriving startup ecosystem, a highly connected and digitally literate population, and the government’s commitment to the digital transformation agenda.
Assessment of the suite of tools implementation in Vietnam across the MAPS framework
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