To 23-year-old Nhi Tran, a Pennsylvania resident in the U.S. on a working visa, the recent coronavirus pandemic has triggered fearful memories of another respiratory illness that still haunts her from her youth near Hanoi:  SARS, Severe Acute Respiratory Syndrome.

“I was 5 or 6 years old,” Nhi said. “My sister was just born at that time and I can remember it was really scary … A lot of things stalled and a lot of people died. It was on the news constantly.”

SARS is caused by a type of coronavirus, believed to have started in China and possibly transmitted from infected bats to humans. The similarities to the novel coronavirus, late in 2019, were enough to make Nhi fearful for her family still living near Vietnam’s border with China.

“We are right under China so the risk is really high, and usually the border is very open and it’s where a lot of trade happens everyday,” Nhi said.

These days, however, Nhi worries less about her homeland and more about the toll the virus is taking on her adopted community in the Philadelphia area. Nhi is employed by the Accountable Care Organization or ACO, a group of health care providers who work to eliminate duplicative testing, medical errors, and other problems in the industry that drive up costs and lower the quality of healthcare.

Her ACO work has given Nhi a front row seat to the challenges U.S. hospitals confronted in the early stages of the COVID-19 pandemic. As of late April, the Pennsylvania Department of Health has recorded 43,000 cases of COVID-19. Vietnam has had far fewer cases, a fact that triggers another memory for Nhi.

In 2003, the World Health Organization said that Vietnam was the first country to successfully contain the outbreak of SARS. It did this by aggressively identifying and isolating those who were infected. The measures Vietnam took this time drew upon that earlier experience.

“Four or five weeks ago we started quarantining everyone coming back from China, Italy, or South Korea,” Nhi said. Those three countries were among the first cluster of nations that suffered heavily from coronavirus.

“One or two weeks after that it became all people in those countries plus Europe,” Nhi said.

Beginning in February heat sensors were used to take temperatures at airports and border crossings, and anyone with a fever was immediately taken to a medical facility for testing. The borders were also closed to all foreigners on March 22. Vietnamese who returned from abroad went through a 14-day quarantine in camps or military-run centers where they were monitored closely for any symptoms.

Nhi credits the draconian but effective containment measures to the media which is considered effectively an arm of the government in Vietnam.

“We watch the news every day and there is only one national television news channel. So, everybody watches that. It kind of controls how everybody sees and perceives events in the country,” Nhi said.

She said she favors the tough approach from the government because it has limited the spread of the disease to 268 cases and no reported deaths.

“I’m not a fan of one-party government because there is a lot of corruption in the Vietnamese government, but I think that in this type of situation a one-party government functions better,” Nhi said.

She said she believes these strict actions were the only option for a country like Vietnam that doesn’t have an abundance of medical resources.

“The Vietnamese doctors are educated and well-skilled but we don’t have the physical infrastructure to support a huge influx of patients coming in with that kind of condition,” she said. “We don’t have the ventilators or PPE [Personal Protective Equipment]. If we had 500 patients then it already would have been a disaster.”

Unlike in the U.S. where protesters have demanded a reopening to reopen businesses, Nhi said there is little resistance to harsh controls.

“In Vietnam the citizens are compliant. Vietnamese people have a very special way of showing patriotism. Most people are trying to show that they have a responsibility to the country,” Nhi said.

Although she is happy about her country’s progress in battling COVID-19, she is still anxious about her family.

“Right now the government is doing really well controlling the cases that they have control over, but with the cases transmitted in the hospital or within the community that’s what I’m worried about,” she said.

Nhi especially fears for her mother whose chronic respiratory problem is exacerbated by some of the poorest air quality in the world. Hanoi and Ho Chi Minh City rank in the top ten cities for air pollution, a result of the rapid industrialization of Vietnam.

As in other parts of the world, the pandemic-induced economic shutdown in Vietnam has temporarily cleared the air. The smog will most likely return once Vietnam reopens its businesses and factories. But Nhi says other changes brought about by the pandemic, such as social distancing, may be longer lasting.

“In Vietnam the way the people live is very communal. You have a close relationship with your neighbors. You go out a lot,” she said. “It will be a dramatic change in lifestyle for people in Vietnam.”

One potential lifestyle change? Food shopping.

“The way that people in Vietnam go to markets, like the concepts of wet markets, they are very packed and they sit on the street and sell stuff in an alley,” she said.

A wet market is a public market that sells meats, fish, and other foods-sometimes including wild or exotic animals- that vendors often butcher upon purchase. The coronavirus is thought to have emerged from a farmer’s market in Wuhan, China. Public health officials around the world, including Dr. Anthony Fauci, have called for these types of markets to be shut down, because they are seen as prime opportunities for viruses to jump from animals to humans.

In Vietnam the government has encouraged citizens to patronize supermarkets and restaurants further, instead of wet markets and informal sidewalk stands run by street vendors. Until now it has been a losing battle, as both locals and tourists consider the markets and food stalls to be integral parts of Vietnamese culture and cuisine.

The pandemic may give the government the pretext needed to enforce a ban. Given the danger of pandemic Nhi said she can understand the need for occasional strong arm actions by the government.

“In Vietnam sometimes you have to control people.”