Cambodia braces for the worst as arrivals rise on easing restrictions
After a comparatively low number of Covid-19 cases, a slow uptick is noticed as more travellers land on Cambodian shores. But does the Kingdom have it all under control?
THE country is bracing for the second phase of Covid19 as the numbers creep up after a nearly 40-day hiatus. Beginning May 20, new cases made up of air travel arrivals from overseas pushed the toll up to 129 with no fatalities. Only three were hospitalised.
US Centres for Disease Control and Prevention Cambodia’s (US CDC) global health protection programme director Dr Michael Kinzer said: “It is a very small fraction so far, but we think this is typical of a second phase.
“It is what we were expecting from the second phase of the epidemic which is testing arriving passengers who are infected, controlling them, quarantining them, following their contacts, and making sure we stop transmissions.”
Unlike neighbouring countries, Cambodia’s borders were not closed per se, as air passengers trickled in mostly into Phnom Penh and via water transportations.
With travel restrictions easing around the world, Cambodian health authorities are on alert as thousands are expected in the coming months.
The government has imposed compulsory Covid-19 prerequisites on foreigners arriving in the country, including the possession of a minimum $50,000 health insurance, Covid-19-free health certificate and a $3,000 deposit for health checks.
Apart from that, an initial health system has been designed to screen and test arriving passengers in Phnom Penh, although this needs some adjusting to fit the current scenario.
“I think there are still a lot of questions that the government is trying to answer, including where the samples are tested, how the results are recorded, what tests are used, what percentage of passengers get tested, and how it is paid for,” Kinzer said.
He notes that every country in the world is going to be faced with these questions and no one is going to have the right answer.
“Therefore, Cambodia is now in the process of coming up with answers to those questions and I am sure they will have something. They will try, decide it does not work well enough, and they will try something else. Again, every country on earth is going to be faced with the same problems,” he said.
In the meantime, close cooperation with Cambodia Airports, and other agencies in the government stay on track so that they know what is coming.
“Because, if every passenger is going to be tested, whatever lab that is being used to test needs to know that suddenly they are going to get 500 samples.
“They would need to assign staff and prepare reagents. So there is a whole system that needs to be prepared to follow up on any kind of decision as to how we are going to screen arriving airline passengers,” he said.
An uptrend is already visible based on State Secretariat of Civil Aviation’s record where a 30 per cent increase was seen in aircraft movement and passenger arrivals within two weeks of June compared to the previous month.
Last month alone, 20,818 passenger arrivals were charted in all three airports in the Kingdom, with the capital’s airport receiving the highest number of 17,796 travellers.
In Preah Sihanouk, some 1,066 Chinese nationals comprising of workers and investors made their way there between May 23 and June 13, said provincial hall spokesman Kheang Phearum.
“Quarantine is quarantine”
Up to April 12, there were 122 cases in the Kingdom, most of them traced to someone who brought it in.
“Basically, you have a case that comes back and they have contacts or people who they were around with at that time. Those contacts who ended up being infected were mostly high-risk household contacts such as spouses and children,” said Kinzer.
Business partners or regular interlocutors fell into the medium-risk category while the low-risk group consists of anyone who was indoors with an infected person.
“The vast majority, even if highrisk contact, did not get infected. We can say that because we carried out contact tracing with every single case and we tracked over 2,200 contacts in total,” he said.
Still, the authorities are aware of the challenges as the system to screen and test passengers is only present at the Phnom Penh International Airport.
There are no laboratories to conduct testing outside the city. There are also few resources in Sihanoukville, even though arrivals are rising there.
For now, airline passengers are tested for Covid-19 upon arrival and ordered to self-quarantine for 14 days in their lodgings if they test negative before being re-tested on Day 13.
What if they breach the order by going out? Are their activities monitored?
“No. Quarantine means quarantine. They [must] stay home. Cambodia currently does not have the capacity to police self-quarantines,” Kinzer said, adding that the absence of monitoring might not necessarily cause problems but it is not ideal.
“A lot of what we do in Cambodia – because of resources and insufficient feasibility – is not ideal. There is no perfect system. Cambodia is a lower-middle-income country. It has to make choices as to how it uses its resources,” he said.
It is understood that earlier plans to put up travellers in additional hotels and other facilities to assist in quarantines were shelved, apart from 3,000 rooms presently available, as Cambodia did not have the resources to keep people in one place for two weeks due to the high pace in arrivals.
This makes the testing on Day 13 essential, including for those who are asymptomatic.
An asymptomatic infection acquired overseas or on a plane would most likely be picked up on arrival or during quarantine if symptoms develop or on the Day 13 test.
“We have had people who tested negative on arrival, and then positive on Day 13. [However] it is true that there have been asymptomatic transmissions, but we think it is in the minority of cases.
“The current system can detect cases and react quickly to track contacts and isolate them for testing,” he said.
“No surveillance is perfect”
To date, Cambodia has been somewhat fortunate, having recorded a negligible number of cases – a phenomenon that has elicited scepticism on the people’s susceptibility level.
In contrast, Thailand charted 3,135 cases as of June 17, Indonesia (41,431 cases) and Malaysia (8,515 cases).