COVID-19 and the Long-Term Care system in Vietnam

Structural characteristics of the LTC system, impacts of the pandemic, measures adopted and new reforms

This country profile contains a section of the LTCcovid International Living Report on COVID-19 Long-Term Care that brings together information on the experience of the long-term care sector (focussing on people who use and provide care) during the COVID-19 pandemic in Vietnam, as well as description of the system and of new reforms. The LTCcovid Living report is updated and expanded over time, as experts on long-term care add new contributions. This profile also provides links to research projects on COVID-19 and long-term care, to key reports, and lists key experts on the impacts of COVID-19 on the long-term care sector in Vietnam.

Living report: COVID-19 and the Long-Term Care system in Vietnam:

PART 1 – Long-Term Care System characteristics and preparedness
  • 1.00. Brief overview of the Long-Term Care system
    The rapidly growing ageing population in Vietnam poses a significant challenge to the social welfare system. There is particular concern about the high prevalence of non-communicable diseases (NCDs), which are the dominant cause of death, in the over-50 population (source: Global Burden of Diseases Project). There is currently no legal policy on long-term care. Some policies relating to older people have been enacted; mostly relating to their healthcare. For example, The Elderly Law (2009), which emphasises the role of primary healthcare and access to quality healthcare services for these members of the population. It also highlights the role and responsibility of families, communities, and broader society in caring for elderly people (Van et al., 2021). Indeed, most senior citizens in Vietnam live with and are cared for by their families; hence the common phrase, tu dai dong duong (four generations under one roof). However, some people have complex needs that require support beyond what family members can provide, or indeed do not have families to provide such long-term care (in part due to children modernising and moving to cities for work). There are some institutions that are run by the government that cater for the elderly, the disabled, and orphans – such as social protection centres. However, these are only available to social assistance beneficiaries; for the elderly, this covers people over age 85 without social insurance or pension, and lonely or poor older people (Dung et al., 2020). According to a recent report by The Vietnam National Committee on Aging (VNCA), only around 10,000 elderly people in Vietnam live in public social protection centres (out of approximately 11 million older persons nationwide). This means that there is great demand for private institutional care. Indeed, there are some long-term care facilities provided by the private sector and by mass organisations, such as The Red Cross (the latter being run by volunteers). Religious groups also provide some nursing homes – which are free of charge to those in need. Privately run nursing homes are mainly aimed at wealthier members of the population who are able to afford the steep $400-$1000/month fee (VNCA). It should also be noted that the supply of private nursing homes in Vietnam is expanding relatively slowly, as loans for construction are difficult to obtain and there are no incentives (tax concessions) provided for setting them up (Dung et al., 2020). There are significant gaps in the provision of care in Vietnam: nursing homes are mainly found in larger cities, there are a limited number of social protection centres (which are inefficient and do not satisfy all needs), and, in light of a limited government budget, high co-payments are mostly out of pocket (Van et al., 2021). Care Preferences In their 2012 study, Van Hoi et al assessed willingness to use and pay for different models of care for community-dwelling elderly in rural Vietnam. They found the most requested service was use of mobile team care, and that using a nursing centre was intended by the fewest respondents, although households were found to be more willing to pay for elderly day care and nursing centres than older participants. Willingness to use services decreased as potential fees rose. References: Dung, V., Thi Mai Lan, N., Thu Trang, V., Xuan Cu, T., Minh Thien, L., Sy Thu, N., Dinh Man, P., Minh Long, D., Trong Ngo, P., & Minh Nguyet, L. (2020). Quality of life of older adults in nursing homes in Vietnam: https://doi.org/10.1177/2055102920954710 Van Hoi, L., Thi Kim Tien, N., Van Tien, N., Van Dung, D., Thi Kim Chuc, N., Goran Sahlen, K., & Lindholm, L. (2012). Willingness to use and pay for options of care for community-dwelling older people in rural Vietnam. BMC Health Services Research, 12(1), 1–12. https://doi.org/10.1186/1472-6963-12-36/TABLES/7 Van, P.H., K.A. Tuan and T.T.M. Oanh (2021), ‘Older Persons and Long-term Care in Viet Nam’, in Komazawa, O. and Y. Saito (eds.), Coping with Rapid Population Ageing in Asia. Jakarta: ERIA, pp.45-56. Link
  • 1.01. Population size and ageing context

    Vietnam is a lower-middle income country in Southeast Asia with a population of just over 97 million people (source: World Bank). Since 1999, the percentage of the population aged 65 and over has been increasing, representing 7.9% of the total population by 2020 (source: World Bank). Meanwhile, the younger population (aged 14 and below) has been decreasing. These trends are predicted to persist (source: Vietnam Population Census); thus Vietnam is undergoing a demographic transition and is predicted to be an aging population by 2040 (source: United Nations). Vietnam is also one of the fastest aging countries globally (source: WHO). The growing elderly population in Vietnam poses a challenge to the social welfare system; the World Bank have therefore stressed the importance of developing relevant and timely health and social care solutions to ensure country capacity.

    People in Vietnam are considered who are 60 years and older are considered “elderly”. The majority (more than 70%) of older people live in rural areas. There are more females than males in the aging population in Vietnam; an imbalance which is also higher in rural than urban areas. A minority (5.8%) of older people live alone (with most of these individuals being women in rural areas), and few (11.5%) live only with a spouse. Most older people in Vietnam are household heads and live with a child. As such, children and grandchildren are the main caregivers (Van Hoi et al., 2012). More recently, however, increasing employment opportunities in urban centres have resulted in temporary migration of the younger generations, leaving the more elderly members of the population on their own and with less emotional and physical support from family (Van Hoi et al., 2012).

    References:

    Van Hoi, L., Thi Kim Tien, N., Van Tien, N., Van Dung, D., Thi Kim Chuc, N., Goran Sahlen, K., & Lindholm, L. (2012). Willingness to use and pay for options of care for community-dwelling older people in rural Vietnam. BMC Health Services Research, 12(1), 1–12. https://doi.org/10.1186/1472-6963-12-36/TABLES/7

  • 1.03. Long-term care financing arrangements and coverage

    Given the large number of people in Vietnam in need of social care – a figure that is increasing rapidly – the provision of services is considered inadequate and underfunded (source: UNDP report). The state has a minimally developed LTC system and is heavily reliant on informal care, which is funded by families as out-of-pocket expenses. However, these are unaffordable by many members of the population, and family carers are not entitled to benefits other than in exceptional circumstances (source: Royal Commission into Aged Care Quality and Safety). Furthermore, according to a UNDP report, the majority of working age people in Vietnam do not have a pension to look forward to (with over half of people over age 65 unable to access one); thus, many face income insecurity at an older age and need to work until they are too frail to continue doing so. They may be entitled to social assistance payments, but total state expenditure on these payments is low compared to other middle-income countries (such as Brazil and South Africa), and even some low-income countries (such as Bangladesh). This makes the possibility of purchasing private LTC unlikely for most.

    Most of the financial support that does exist is to support those who qualify for institutional care, rather than providing people with support to remain in their homes or with their families. State-funded care is based around a nationwide network of social protection centres, which provide residential accommodation for various vulnerable segments of the population, including some elderly people. There are a total of 393 social protection networks around Vietnam; 180 are run by non-state entities and 213 are publicly run. Thirteen of the social protection centres serve the elderly population. The centres are all financed by the government: the public units are financed directly, and the non-state units are financed indirectly via tariffs paid to the provider, based on what services are delivered. Expenditure is approximately $35 per person per month. A range of weaknesses have been highlighted in these public care centres; mostly due to limited financing, which translates into low-quality standards of accommodation, poor services, an absence of various key services (such as counselling) and difficulties recruiting staff due to low salaries. Furthermore, they are only available to a small segment of the elderly population, leaving many without access to LTC outside of their families (source: UNDP report).

    Due to the abovementioned government-funded services failing to meet the increasing demand for LTC in Vietnam, the government provides some incentive payments for volunteer primary caregivers in the community to cover elderly members of the population who are unable to live independently, are poor, and do not family to care for them. In these cases, social assistance payment s are provided to both the recipient of care and caregiver  (source: Royal Commission into Aged Care Quality and Safety).

  • 1.05. Quality and regulation in Long-term care

    Quality in state-run institutional care centres in Vietnam is reputedly poor, which is mostly down to low levels of funding (source: UNDP report). The responsibility for quality assurance in terms of staffing sits at federal level: The Ministry of Labour, Invalids and Social Affairs prescribes professional standards and training care workers. Training is not mandated, but staffing levels are: for low-level care, they are 1:8-10, and for high level care 1:3-4. Nutrition staff (food purchasers and cooks) are mandated at 1:20. All care institutions (private, public, and NGO or religious providers) must submit annual reports to the federal authorities (source: Royal Commission into Aged Care Quality and Safety).

    It is unclear whether quality is higher in private care homes. However, it may be worth noting that according to a recent report, 18% of the private residential care centres in 2016 were unlicensed (this suggests that it is quite possible that they have not been submitting any quality control reports to the authorities).

  • 1.10. Workforce conditions: pay, employment conditions, qualification levels, shortages

    Vietnam faces a shortage of qualified nursing care staff for the elderly population. Most are cared for by family or domestic workers, who usually have no training in care or medical expertise (source: Vietnam Investment Review). They also do not normally receive any financial support from the government for their informal caring duties (source: UNDP report).

    Staff in formal nursing homes do not have to be formally trained. Their salaries are low due to limited funding, which results in difficulty with recruitment and difficulty reaching staffing quota levels (source: UNDP report). Staffing levels in social protection facilities are mandated by The Ministry of Labour, Invalids and Social Affairs. The ratio of care staff to recipients is 1:8-10 for low-level care needs and 1:3-4 for higher level care. The ratio for nutrition staff (preparers and purchasers of food) is 1:20 (source: Royal Commission into Aged Care Quality and Safety).

  • 1.11. User voice, choice and satisfaction

    A 2020 study by Dung et al. investigated the quality of life in care homes in Vietnam; measured as a subjective assessment of mental and social well-being. Participants came from public, religion-run, and private nursing homes. Results from the study showed that nursing home residents in Vietnam generally had a moderate level of quality of life; a finding similar to studies conducted in other Asian settings such as Hong Kong and Korea. Findings from the study suggest that the services provided at private and public nursing homes are of similar quality; no significant differences in quality of life were found between the two.

    References:

    Dung, V., Thi Mai Lan, N., Thu Trang, V., Xuan Cu, T., Minh Thien, L., Sy Thu, N., Dinh Man, P., Minh Long, D., Trong Ngo, P., & Minh Nguyet, L. (2020). Quality of life of older adults in nursing homes in Vietnam: Https://Doi.Org/10.1177/2055102920954710, 7(2).

  • 1.12. Equity

    There is an increasing disparity in health service access between socioeconomic groups, with people in rural areas have notably less access than those in urban areas. Older people are frequently limited by mobility issues and an inability to afford health care services; in particular, long-term care. Given that chronic illness is prevalent in around 40% of older people, support for long-term elderly care has become an issue in rural areas (Hoi et al., 2011). Private nursing homes, which are more available in urban areas, are still relatively expensive for most Vietnamese people and are therefore exclusionary.

    References:

    Hoi, L. V., Thang, P., & Lindholm, L. (2011). Elderly care in daily living in rural Vietnam: Need and its socioeconomic determinants. BMC Geriatrics, 11. https://doi.org/10.1186/1471-2318-11-81

PART 2 – Impacts of the COVID-19 pandemic on people who use and provide Long Term Care
  • 2.00. Overview impacts of the Covid-19 pandemic on people who use and provide Long-Term Care

    There is little information available on the impacts of the COVID-19 pandemic on those who use and provide LTC specifically.  Compared with other countries, and as a result of strong and multidimensional solutions and a compliant population, Vietnam maintained a relatively low number of confirmed infections and older patients throughout most of the pandemic (Tung, 2020).

    Economic Impact

    As most elderly people in Vietnam live with their families, a major source of income for older people is family support. However, because of the pandemic and related lockdowns, more than half the workforce has been negatively affected: the income of roughly 75% of all households has reduced. This has compromised the amount of assistance that households can provide to older family members, including those with older members who need medical care. These households are therefore at increased risk of falling into poverty as a result of the pandemic (source: Aging Asia report).

    References:

    Tung, L. T. (2020). Social Responses for Older People in COVID-19 Pandemic: Experience from Vietnam. Journal of Gerontological Social Work, 63, 682–687. https://doi.org/10.1080/01634372.2020.1773596

  • 2.01. Impact of the COVID-19 pandemic on the country (total population)

    Given high economic openness and a large population, with many people living in crowded areas, Vietnam had high risks of being devastated by COVID-19 (Tung, 2020). However, Vietnam was called a ‘COVID exemplar’ by Our World in Data, who reported that by the end of 2020 Vietnam had reported only 1,465 laboratory confirmed cases of COVID-19 and 35 deaths. By comparison, by this time the United Kingdom had suffered some 72,000 deaths (source: GOV.UK) and the USA roughly 385,000 (source: CDC). Egypt, which has a similar population to Vietnam although lower population density, had suffered around 7,000 COVID-19 deaths by the end of 2020 (source: worldometres).

    This relative success may be attributed to several factors. Key containment decisions were made within a few days of the outbreak; a decision which took some other governments several weeks. It is likely that Vietnam was able to act as quickly as it did due to its experience and existing relevant infrastructure, having experienced a severe acute respiratory syndrome (SARS) epidemic in 2003 and avian influenza between 2004 and 2010.

    Vietnam’s proactive containment strategy was based on comprehensive detecting, contact tracing, and containment. Testing was scaled up in areas with community transmission, and three degrees of contacts was traced each time a positive case was identified. These individuals were placed in government-run quarantine centres. Areas where community transmission had been demonstrated were immediately locked down (source: Our World in Data). Furthermore, the population in Vietnam was relatively compliant, having high reported levels of trust in the authorities (Tung, 2020).

    The second half of 2021 was less of a success story for Vietnam as a fourth, and most complicated and dangerous, wave hit the nation (Minh et al., 2021). From early June, confirmed cases began to grow exponentially and went from around 7,500 to around 1.7 million by the end of the year. This was mainly due to the emergence of the new (delta) variant, which spread quickly within hospitals in Vietnam, and also in large industrialised zones and communities. The sudden spike in community cases put a huge burden on the system; in particular on healthcare services and track and trace (Minh et al., 2021). Cumulative deaths were at 48 on the 1st June 2021, but similarly grew exponentially in the second half of the year and had reached just under 32,000 by the end of 2021. The main spikes in death were in August, early September, and December (source: Our World in Data).

    To date (end of December, 2021), there have been no reported cases of the Omicron variant (source: Reuters).

    References:

    Minh, L. H. N., Khoi Quan, N., Le, T. N., Khanh, P. N. Q., & Huy, N. T. (2021). COVID-19 Timeline of Vietnam: Important Milestones Through Four Waves of the Pandemic and Lesson Learned. Frontiers in Public Health, 9, 1587. https://doi.org/10.3389/FPUBH.2021.709067/BIBTEX

    Tung, L. T. (2020). Social Responses for Older People in COVID-19 Pandemic: Experience from Vietnam. Journal of Gerontological Social Work, 63, 682–687. https://doi.org/10.1080/01634372.2020.1773596

  • 2.02. Deaths attributed to COVID-19 among people using long-term care

    There is no publicly available information that provides a breakdown of COVID-19 deaths by population group. We know that the first cases of COVID-19 deaths in Vietnam were elderly members of the population: the first was a 70-year-old man, and the second was a 63-year-old man.  Although there have been relatively few deaths as a result of the pandemic (although the number spiked in late 2021), it could be assumed that the elderly faced higher risks of fatality as compared to other population age groups (Susilowati et al., 2020).

  • 2.04. Impacts of the pandemic on access to care for people who use Long-Term Care

    There is no information available on the impacts of the pandemic on access to health and social care services for those who use formal LTC. However, there are reports of elderly patients with various health conditions being reluctant to visit hospitals when they needed to due to fear of visiting crowded places. Across Vietnam, rates of inpatient care and hospital visits declined by around 30% during the pandemic (original source: DoH HCMC). This meant that healthcare work has often been done by the individual themselves or family members; neither of whom were likely to have the appropriate training or experience. As a result, there were reports of patients suffering from preventable conditions such as strokes and kidney and respiratory failure as a result of not going into hospital (source: Aging Asia report).

  • 2.05. Impacts of the pandemic on the health and wellbeing of people who use Long-Term Care

    The following section refers to the impact of the pandemic and measures adopted on the health and wellbeing of the elderly population in Vietnam, as there is little information available that is specifically on users of long-term care.

    In the Vietnamese government’s response to COVID-19, there were various general policies which applied to all citizens regardless of age. For example, mass communication health messages, medical declarations in which older people were given priority, and covered costs for any testing, treatment, or quarantining. In addition to benefiting from this, older people received further support for the prevention and treatment of COVID-19 and other medical conditions (source: Aging Asia report). For example, the Ministry of Health issued two documents aimed at elderly people: one with additional guidance for COVID-19 prevention for older people living in the community and the other for older people with additional non-communicable diseases (NCDs). Up to three months’ worth of prescription medication was also made available to individuals with NCDs, and the use of telemedicine was promoted (source: Aging Asia report). At home check-ups and treatment by doctors and nurses were also offered to some, although this was generally limited to those in the bigger cities (Tung, 2020).

    However, there were also reports of elderly patients with various health conditions being reluctant to visit hospitals when they needed to due to fear of visiting crowded places. Across Vietnam, rates of inpatient care and hospital visits declined by around 30% during the pandemic (original source: DoH HCMC). This meant that healthcare work has often been done by the individual themselves or family members; neither of whom were likely to have the appropriate training or experience. As a result, there were reports of patients suffering from preventable conditions such as strokes and kidney and respiratory failure as a result of not going into hospital (source: Aging Asia report).

    Self-reported impact of the pandemic

    A recent report documented the self- reported impact of the pandemic on older people, who were categorised into non-disadvantaged and disadvantaged groups. In both groups, a majority felt that they were negatively impacted by the pandemic. The non-disadvantaged group mainly felt impacted socially due to social distancing. The disadvantaged group reported income as their biggest concern. In both groups, very few reported concerns over health: both had strong faith in the local authorities’ response to the pandemic.

    References:

    Tung, L. T. (2020). Social Responses for Older People in COVID-19 Pandemic: Experience from Vietnam. Journal of Gerontological Social Work, 63, 682–687. https://doi.org/10.1080/01634372.2020.1773596

  • 2.07. Impacts of the pandemic on unpaid carers

    It should be noted here that the majority of care in Vietnam is informal and provided by unpaid carers. In fact, it is written into The Elderly Law that older people in Vietnam may choose to live with their children or grandchildren at their will; and indeed, many do. Thus, while there is no information on the impact of the pandemic on unpaid carers specifically, it is likely that the effects of the pandemic on households has a significant impact on those receiving care at home.

    The economic impact of the pandemic in Vietnam, not unlike in most of the world, has been enormous, and has been felt by individuals through day-to-day consumption. For example, due to an increase in demand, there was an enormous price surge of preventative goods (such as face masks, which are also commonplace in Vietnam outside of pandemic times) in 2020. This resulted in as much as 20% of the household income of an average-income four-person household going towards such preventative items (Tran et al., 2020). As in many countries, a huge number of jobs were lost or severely compromised; particularly in the service industry, which contributes around 40% of the country’s GDP (source: Statista). With schools closed or online during most of 2020, parents struggled to balance work and childcare (and presumably care of their elderly family members), resulting in further income loss (Tran et al., 2020).

    As an attempt by the government to mitigate some of the economic impact of the pandemic, daily food allowances were given to individuals in quarantine. However, these payments were small (between $1.79 and $2.59 per day) and so did not make up for loss of income or inability to work. Farmers in rural areas, where poverty is not uncommon, were particularly hard-hit as a result of border closures and an inability to sell their stock  (Tran et al., 2020).

    These economic difficulties are likely to have impacted availability of food, medical care, and other necessary supplies for the elderly population who require informal, unpaid care in Vietnam.

    References:

    Tran, P. B., Hensing, G., Wingfield, T., Atkins, S., Sidney Annerstedt, K., Kazibwe, J., Tomeny, E., Biermann, O., Thorpe, J., Forse, R., & Lönnroth, K. (2020). Income security during public health emergencies: the COVID-19 poverty trap in Vietnam. BMJ Global Health, 5(6), e002504. https://doi.org/10.1136/BMJGH-2020-002504

  • 2.08. Impacts of the pandemic on people working in the Long-Term Care sector

    There is no information to-date on the formal LTC workforce specifically, but some information on the impact on unpaid carers (who make up the bulk of the LTC workforce) can be found in section 2.07.

PART 3 – Measures adopted to minimise the impact of the COVID-19 pandemic on people who use and provide Long-Term Care
  • 3.00. Overview of the pandemic response in the Long-Term Care system

    As there is no information on people who use or provide LTC specifically, the following information pertains to measures adopted to minimize the impact of the COVID-19 pandemic on elderly people; the group most likely to use LTC (albeit often from their families).

    Aside from additional support provided by the Government / Ministry of Health (see section 2.05), various socio-political organisations have played an important role in caring for and supporting vulnerable people (including elderly people and in particular, lonely elderly people) throughout the pandemic. For example, The Fatherland Fund established charity funds to help with the containment of COVID-19, and Youth Union has provided free food to vulnerable older people. The private sector has also played a role – for example, private donors set up ‘rice ATMs’ to distribute free rice to vulnerable people in some of the rural areas (Tung, 2020)..

    References:

    Tung, L. T. (2020). Social Responses for Older People in COVID-19 Pandemic: Experience from Vietnam. Journal of Gerontological Social Work, 63, 682–687. https://doi.org/10.1080/01634372.2020.1773596

  • 3.01. Brief summary of the overall pandemic response (not specific to Long-Term Care)

    By the end of 2020, Vietnam had emerged as one of the few countries to effectively contain COVID-19, having gained epidemic response experience as one of the first countries in the world to successfully eliminate SARS in 2003. Vietnam had therefore made invaluable investments into its public health infrastructure prior to the current pandemic, including a national public surveillance system, a national public emergency operations centre (PHEOC), and four regional operations centres. These were all used to successfully manage the spread of COVID-19 immediately after the first outbreak (Thi Mai Oanh et al., 2021).

    This experience also meant that the government was able to make quick decisions in response to the outbreak in the first wave. This included an immediate nationwide lockdown, limiting international flights, and shutting its borders. The aggressive contact tracing, testing, and quarantining of anyone who had been within three degrees of separation of any positive case, as outlined in section 2.01, also ensured that no potential cases could go undetected. Communications with the public were consistent and went out through a vast array of sources throughout the pandemic, with timely updates on the details of new cases and details of the actions being taken. A hard stance was also taken against fake news and the spreading of disinformation on social media (Thi Mai Oanh et al., 2021).

    References:

    Thi Mai Oanh, T., Khanh Phuong, N., & Anh Tuan, K. (2021). Sustainability and Resilience in the Vietnamese Health System Sustainability and Resilience in the Vietnamese Health System Sustainability and Resilience in the Vietnamese Health System. https://weforum.org/phssr

  • 3.04. Financial measures to support users and providers of Long-Term Care

    In response to the pandemic, the government introduced various policies to support the population. One of these, Resolution 42 (passed on 09-04-21) applied to people whose income decreased significantly or who could not maintain their minimum living standard due to the pandemic. However, there were reports that significant barriers were faced by many trying to access this support, including people with disabilities and their carers. Resolution 42 also applied to elderly people over the age of 80 (identified as part of the Social Protection beneficiaries). Few barriers were reported in terms of access for this group, mainly because their information is always available and accurate (source: careevaluations.org report).

  • 3.11. Vaccination policies for people using and providing Long-Term Care

    In early 2021, the Vietnamese Ministry of Health set out a target of 150 million doses to vaccinate 75% of the population and achieve herd immunity by early 2022. A rollout plan was issued which included 16 priority groups. These groups included medical workers and those who participate in COVID-19 prevention and control work, people with chronic conditions, people aged 65 and older, poor people, and social policy beneficiaries. No mention is made of people who provide long term care (although notably these are mainly informal carers / family members of older people) (source: CCI France Vietnam).

    For those who were unable to go to health facilities to receive the vaccine (for example, due to old age or disability) in some areas, vaccination medical teams did home visits (source: WHO).

    To date (end of December 2021), almost 80% of the total population have received at least one dose of the vaccine and around 58% are fully vaccinated (source: Our World in Data). On December 24th 2021, the Ministry of Health declared that they aim to complete the administration of booster shots by the end of the first quarter of 2022 (source: Reuters).

    There is no information available (in English) on the number of vaccines different segments of the population (for example, elderly people) have received.

PART 4 – Reforms to address structural weaknesses of Long-Term Care systems and to improve preparedness for future pandemics and other emergencies
Printable version of the report:

https://ltccovid.org/country/vietnam/

Experts on COVID-19 and long-term care in Vietnam that have contributed to this report so far:

Daisy Pharoah

To cite this report (please add the date in which the document was accessed):

Pharoah D., COVID-19 and the Long-Term Care system in England. In: Comas-Herrera A., Marczak J., Byrd W., Lorenz-Dant K., Pharoah D. (editors) LTCcovid International Living report on COVID-19 and Long-Term Care. LTCcovid, Care Policy and Evaluation Centre, London School of Economics and Political Science. https://doi.org/10.21953/lse.mlre15e0u6s6


Acknowledgement and disclaimer:

This report has built on previous LTCcovid country reports and is supported by the Social Care COVID-19 Resilience and Recovery project, which is funded by the National Institute for Health Research (NIHR) Policy Research Programme (NIHR202333) and by the International Long-Term Care Policy Network and the Care Policy and Evaluation Centre at the London School of Economics and Political Science. The views expressed in this publication are those of the author(s) and not necessarily those of the funders.

Copyright: LTCCovid and Care Policy and Evaluation Centre, LSE