MANILA — The Cambodian government has taken additional measures to curb the country’s latest outbreak of COVID-19, including giving power to provincial and municipal authorities to close shops not adhering to public health protocols, imposing a mandatory 14-day quarantine for travelers entering the country, and controversial moves such as publishing the names of people infected with the coronavirus.
These measures come on the heels of the first cases of a community transmission, dubbed the “Nov. 28 incident,” after Cambodian General Director of Prisons Chhem Savuth, his wife, and several family members tested positive for COVID-19.
The incident led the government to again close schools in the capital of Phnom Penh and limit gatherings to no more than 20 people.
In countries such as Laos and Cambodia, there is concern that health systems could become overwhelmed — or collapse — if there were to be a widespread COVID-19 outbreak.
Preventing a larger-scale community transmission is critical. While Cambodia has reported only a small volume of cases — 348 as of Monday — compared with its neighboring countries and zero deaths from COVID-19, large-scale community transmission could put pressure on its health system.
Prior to this latest outbreak, the country had a COVID-19 scare in which government officials — including the prime minister — went into quarantine after Hungarian Foreign Minister Péter Szijjártó, who visited the country on Nov. 3, tested positive for COVID-19.
The World Health Organization congratulated Cambodia for managing that crisis, but now the head of the United Nations health agency in the country is once again emphasizing the need for mass individual action and a speedy response.
Speaking to Devex on Friday, WHO Cambodia country representative Dr. Li Ailan voiced concerns about the latest outbreak, saying the country is not fully prepared for large-scale community transmission.
She underscored the importance of the public to avoid the “three Cs” — crowded places, close-contact settings, and confined spaces — and said ongoing investigation into the latest cluster is focused on these high-risk areas where the conditions are ripe for virus transmission.
As of Monday, the government had tested over 11,000 people linked to the latest outbreak, with 32 positive results. While the government has identified two people believed to be the source of the transmission, it is still unclear where and from whom they got COVID-19. Contact tracing to identify and quarantine others is ongoing, as is a retrospective investigation to identify the source of infection.
“[The] virus is cleverer than us; [the] virus is running faster than us. … This is the nature of [the] virus itself,” Li said.
“Cambodia is much better prepared for responding to larger-scale community-level transmission compared to 10 months ago. … However, they are not fully ready for responding to larger-scale community-level transmission. Capacity development takes time,” she added.
Cambodia now has four laboratories with reverse transcription polymerase chain reaction testing, and testing capacity has now improved from around 600 samples to 3,000-4,000 samples per day. The country also now has over 3,000 members of a rapid response team that the government is able to utilize in current contact-tracing efforts.
But even if coronavirus-designated hospitals in the country now have more beds in intensive care units and personnel trained on COVID-19 treatment, they will face challenges if large-scale community transmission results in large volumes of patients in need of hospitalization and where there are more critically ill patients suffering from multiple organ failure.
“That's why I urge the government and partners in Cambodia [that] while we are doing [the] response, please do not stop … effort[s] to prepare for larger-scale transmission,” Li said.
In the early months after Cambodia reported its first COVID-19 case near the end of January, there was high public compliance with health measures such as social distancing, Li said. This has helped keep the number of COVID-19 cases low in the country. However, pandemic fatigue eventually kicked in, and some people became complacent, adopting a more lenient approach to public health measures.
“Cambodia is much better prepared for responding to larger-scale community-level transmission compared to 10 months ago. … However, they are not fully ready for responding to larger-scale community-level transmission.”— Dr. Li Ailan, Cambodia country representative, WHO
But there are also socioeconomic factors at play. Tim Vora, executive director at the Health Action Coordinating Committee, a network of NGOs working on health in the country, told Devex that if the current outbreak continues and quarantine measures are imposed, the situation of people living in poverty would be a cause for concern.
“How [will] they get support? How will they feed their [families]?” he said.
Meanwhile, Chak Sopheap, executive director at the Cambodian Center for Human Rights, told Devex in a written statement that the government’s decision to publicly identify COVID-19 patients puts those individuals at risk of discrimination and harm from members of the public. She said that the sharing of personal data or personally identifiable information is a violation of the right to privacy and that alternative, less restrictive measures of contact tracing should be explored.
“A public health crisis does not warrant the total abandonment of the right to privacy and data rights. The [government of Cambodia] must practice data minimization and limit its processing of personal information of COVID-19 patients, only recording what is strictly necessary,” she said.
Over the weekend, Cambodian Prime Minister Hun Sen said he had already prepared a royal decree and message for the king to declare a state of national emergency, as well as letters for the presidents of the Senate and the National Assembly. However, he said everyone should work together to prevent the current COVID-19 situation from escalating to a national emergency, appealing to the public to adhere to health measures.
“I do not want to get there [the declaration of a state of emergency] because it will stall the Cambodian economy. Closing the whole country or in part/s, such as Phnom Penh or anyone province … will stall the economy, especially affecting the business of our people,” he said.
“From the beginning, I said that we must start from each and every individual. If the individual cannot do this, the pandemic will get to the family, and then to our community, which will cause serious damage to the nation,” he added.