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COVID-19 Report: Cambodia
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The Trend, Impacts, and Post-COVID19 Challenges:

Kingdom of Cambodia

Graduate School of Public Administration

Asia Regional Information Center, Asia Center

Seoul National University

Contributor:

Kilkon Ko (kilkon@gmail.com), Professor, GSPA, SNU

Roth Sopheak Boros (sopheak2019@snu.ac.kr), Office of the Council Of Ministers, Kingdom of Cambodia

 

This work is sponsored by the Asia Regional Information Center, SNU Asia Center

 Introduction

As the new strain of coronavirus spreads throughout the world, countries are reporting cases of it reaching their borders, stoking fears of a global pandemic. It is likely more cases will be diagnosed within the coming days and weeks, and as such, we must remain proactive in prevention, mitigation, and treatment. With origins from Wuhan, Hubei, the number of deaths from the virus has amounted to more than 100, with more than 4,500 individuals contracting the virus, according to the Wall Street Journal. Identifying the virus can be difficult. Symptoms of the virus are similar to those of the flu, which include fever, cough, or shortness of breath. Furthermore, the incubation of the coronavirus ranges between 10 to 14 days, making it difficult to diagnose those with the virus. The World Health Organisation (WHO) emphasised that “not enough is known about the epidemiology of 2019-nCoV to draw definitive conclusions about the full clinical features of the disease, the intensity of the human-to-human transmission, and the original source of the outbreak.

COVID-19 has in fact impacted rapidly and substantially, and increasingly spread from one sector to another. Actually, the spread of COVID-19 has deterred the development of ASEAN, not only in the health sector but also in other sectors such as tourism, trade, finance, industry, and particularly, and the livelihood of the people. The growing number of coronavirus cases have led governments to adopt severe measures to respond to the current outbreak. Without any vaccine or treatment for the 2019-nCoV, complacency isn’t an option. Both governments and citizens have a role to play to prevent the spread of the coronavirus.

As of January 27, the Ministry of Health of Cambodia announced the first case of the virus in Cambodia from a Chinese tourist from Wuhan city visiting Sihanoukville. As far as Cambodia is concerned, and assessed that the COVID19 is at the small cluster stage, in which the majority is imported cases. In an effort to fight against COVID-19, as applied in other ASEAN Member States, Cambodia has imposed strict, firm and rigorous measures in three different fronts: (a) preventing imported cases into Cambodia, (b) preventing local transmission within Cambodia, and (c) treating COVID19 infected patients. To achieve the highest efficiency, Cambodia has established a National Committee to Combat COVID-19, a joint command in leading, introducing and implementing measures to fight against COVID-19. Furthermore, Cambodia has decided to postpone the celebration of the Khmer New Year, and imposed a ban on inter-provincial movements of people.

This report describes an analysis of the  progression of confirmed  new and recovered cases, including the policies and responses of the Cambodia government in responding in containing the pandemic and mitigating its impact to health, economic, finance, social welfare, labor and employment, tourism, transportation, education, and foreign affairs. In the report, it also discussed the topic “WHY ARE CAMBODIAN COVID19 NUMBERS LOW WHEN SO MANY COUNTRIES IN THE REGION ARE ELEVATED?”  Finally, it described the challenges that emerging that the government has to confront in post-covid time.

The Trend of Covid19

Trends of Confirmed Cases

Figure 1: Trends of Confirmed Cases in the Kingdom of Cambodia 

On 27 January 2020 the Ministry of Health (MoH) of the Kingdom of Cambodia, in accordance with the International Health Regulations (IHR 2005), confirmed with WHO that the first case of 2019 novel coronavirus (2019-nCoV) had been detected. The case is a 60-year-old male in Preah Sihanouk province who returned to Cambodia on a direct flight from Wuhan, China on 23 January. He was travelling with three family members. The case-patient developed a fever and runny nose on 25 January and went to Preah Sihanouk Provincial Hospital on January 26 where samples were collected. He was confirmed positive on January 27 for novel coronavirus (2019-nCoV) by sequencing at Institute Pasteur Cambodia. The case-patient was under isolation, receiving treatment and is in stable condition. His three family members initially tested negative and everyone in contact with him including airport officials, a taxi driver and receptionist at hotels where he stayed, were being closely monitored by the Ministry of Health.

On February 10, After two weeks of being treated and kept under observation, he had fully recovered, the Health Ministry stated on account of testing negative for the third time by Pasteur Institute of Cambodia. The family were finally discharged and flew back to their home country on the next day as of the 80 Chinese nationals who arrived in Sihanoukville on the same flight as him, most have since returned to China, although the city of Wuhan remains under quarantine.

On February 13, The cruise ship MS Westerdam was reportedly taking 1,455 passengers and 802 crew around Asia, 651 of whom were U.S citizens. It was previously docked in Hong Kong, around the time it was badly hit by the virus. The Westerdam arrived in Sihanoukville on 13 February after it had been turned away by five countries due to virus concerns. About 20 passengers on board, who were unwell, took a thorough check up but the vast majority had their temperature taken and filled out a form. Most of these passengers then disembarked. Out of 145 Westerdam passengers who stopped in Malaysia by plane on 15 February, an 83-year-old American woman tested positive for the virus, leading to concern that other passengers may also have been infected. By only then, the remaining 781 passengers were isolated and taken clinical tests, and still, the Westerdam was criticized as it was not designed for quarantine and the passengers were able to socialize.

On March 7, The second case of the coronavirus was a 38-year-old man, a Cambodian in Siem Reap. He was among four people (three of the man's relatives and a Japanese woman) placed under quarantine at Siem Reap Provincial Referral Hospital, all of whom had direct contact with a Japanese man in his 40s who left Cambodia on 3 February and tested positive upon arrival in his country at Chubu Centrair International Airport in Tokoname, Aichi. Meanwhile, some 40 other people in the same city had been isolated under medical supervision since indirect contacts with the same Japanese man. The government prompted its decision to close all schools and cancelled the upcoming Songkran (Khmer New Year) in the city.

On March 10, the Ministry of Health confirmed the country's third case. At 4:30 p.m, a 65-year-old British woman had tested positive for the virus in Kampong Cham. She was a passenger of a cruise ship named Viking Cruise Journey, which travelled from Ho Chi Minh City to Kampong Cham City. On March 11, following the event, the boat had been docked to provide samples to be tested from all 29 other passengers and 34 crew and were placed under quarantine in a hotel somewhere in the city. The British patient was transferred to Royal Phnom Penh Hospital in Phnom Penh at her own request, adding that she had been conducted with coordination from WHO.

On March 12, another case of two passengers of Viking Cruise Journey were publicly confirmed at noon to have tested positive in a British man, 73 and his wife, 69, bringing up to five confirmed cases at the time. Due to their ages, the married couple were transferred to Khmer-Soviet Friendship Hospital in Phnom Penh. On March 13, the health officials confirmed two cases in Phnom Penh at 8 p.m sharp, tallying to seven in total. A 49-year-old Canadian and a 33-year-old Belgian were in quarantine in Khmer-Soviet Friendship Hospital. The authorities were trying to locate those who had contacts with the patients. For the time being, another two visitors to Tuol Sleng Genocide Museum (A British and his friend, a Canadian woman who worked in China) were suspected to have the symptoms and admitted to the said hospital. A British man, however, made an escape but was found later in Kampot and hospitalized there. They were tested negative, assuming it was just a fever they had. Nevertheless, their self-monitoring was needed for any changes.  On March 15, the Islamic Republic of Iran was added to the list of countries whose nationals were suspended from entry to Cambodia, making a total of six. This would take effect on March 18.

An additional case of COVID-19 was confirmed in Phnom Penh at 5 p.m sharp on a French man, 35. With his wife and his four-month-old baby, the family flew from Paris to Singapore on 13 March. Showing signs of fever, the authorities there took his samples for examination. To wait for the results, he wasn't allowed to go any further, however as a follow-up health checkup was presented, he was informed that he could carry on and the results would be available accordingly. The family landed at Phnom Penh International Airport on the morning of 14 March. The same day, the test came back positive. As of 15 March, the man was admitted to Khmer-Soviet Friendship Hospital while his wife and child were staying at the home of a relative under medical supervision. Contacts with the man were found in the plane he boarded, in total of 24 passengers (including him and his family), and another two transporters who drove them home, to be examined. At 9 p.m, a report of 4 more cases were publicized, tallied up to twelve at the end of the day. It included a 4-month-old child of the French patient, a Cambodian from France, and two Khmer Muslims, 35 and 39, who attended a mosque event near Kuala Lumpur, Malaysia on 29 February. The ten mosque event attendees arrived at Preah Vihear (except one, who arrived at Stung Treng) on 3 March and up to 14 March, Malaysia informed that it had found the infected from that gathering. Another 8 people were continually in testing.

On March 17, within the span of two days, the total confirmed cases leapt to 33. At half past 9 a.m, 12 cases were publicly stated. 11 Khmer Muslims were found to be infected in various provinces. They were among 79 people returning from attending a mosque event in Malaysia. One case further referred to a Cambodian man who crossed the border from Thailand in Banteay Meanchey.  At 9:00 p.m, nine more cases were included, six more attendees in Malaysia and three Malaysians out of a group of five. Two of the group were put under quarantine at a mosque in Kep. On March 18, four more cases were detected: two Malaysians in Kampot and two more tabligh attendees in Tboung Khmum.

On March 19, ten more cases were detected: two wives of the infected men, two more tabligh attendees, and six Malaysians. On March 20, the Ministry of Health announced an additional 4 confirmed cases: a Malaysian, and three Cambodians, one of whom was infected by an attendee from Malaysia and had no recent travel record overseas. On March 21, two more cases were confirmed at 9 p.m, a 67-year-old and an 80-year-old Frenchmen who arrived in Sihanoukville as tourists on 18 March. 37 people suspected to have contacts were put under quarantine. On March 22, Having tested negative for a few times, a 65-year-old patient, a British woman was reported to have fully recovered. She was discharged later that day. At 10 p.m, more than 29 people linked in the same tourist group of the cases confirmed the previous night, plus two Cambodian guides were detected of the virus. The tourist group arrived in Cambodia on March 11, visiting four provinces. As the tour ended in Sihanoukville on 18 March, the group had stayed in Independence Hotel and was scheduled to depart from Phnom Penh on 21 March.

On March 23, at 19:30, three new cases were recorded to include a mother of a 4-month-old child whom she and her infant had been placed under treatment at the Kantha Bopha Children's Hospital and two other Cambodians. On March 24, The Health Ministry registered four new cases, rising up to 91. A British couple and an American couple were passengers of Viking Cruise Journey where the rest of them, 24 people were cleared and would depart for home from Phnom Penh via charter flights the next day. It also added that four patients, two from Tboung Khmum and another two from Battambang, were all tested negative twice and ready to be discharged. On March 25, Cambodia recorded five new cases, two from the French tourist group and 3 Cambodians with no recent foreign travels. Four more patients, three from Phnom Penh and one from Tboung Khmum, had made complete recovery for that day. 174 Chinese nationals had been quarantined in Svay Rieng upon their arrival from Phnom Penh by bus after two of them exhibited high temperatures. On 26–28 March, two Indonesians taking off from Thailand and a Cambodian family of four who went on a trip to France were added to confirmed cases. On 29–31 March, six cases were added to the total of 109 at the month's end.

Figure The Trend of New Cases

Eleven patients from Koh Kong, Banteay Meanchey, Phnom Penh, Kampong Chhnang, Battambang and Siem Reap were reported to have recovered from the disease. In a span of nine days, Cambodia counted 9 new cases, most notably on April 9, a discharged patient was found to be relapsing two days after. Moreover, 48 patients reportedly had recovered, mostly in Sihanoukville, adding up to 68 in total.

Till May,28th, according to the Ministry of Health's Communicable Disease Control Department (CDC), no new case of the novel coronavirus (COVID-19) has been identified in Cambodia. The count thus remains at 124, comprising 53 Cambodians, 40 French, 13 Malaysians, 5 British, 3 Chinese, 3 Vietnamese, 2 Americans, 2 Indonesians, 2 Canadians and 1 Belgian. Of these 122 were completely healed. The two remaining active cases are a Cambodian man of 26 who lives in Kampong Tralach district, Kampot province, and a Cambodian woman of 39 who lives in Phnom Penh. Through the Philippines and the U.S. they returned to Cambodia from the Republic of Korea, respectively.

Since the first case detected in Preah Sihanouk province in late January, the COVID-19 pandemic has so far hit 13 provinces and the capital of Cambodia.

Figure The Trend of Active Cases

After the first  wave of Covid-19 hit the Kingdom and lasted several months. The new cases of Covid-19 emerged. On 20 May, a 26 years old man who traveled from the Philippines and transited in South Korea was tested positive at Phnom Penh International Airport. It registered as a new imported case of Covid-19 after 122 patients were fully recovered. This triggers a health warning for the outbound passengers.

By 6 October 2020, Cambodia reported 280 confirmed cases of COVID-19, of which 276 recovered. In addition to Cambodia, 242 cases were acquired abroad, representing 12 nationalities, with the remainder locally acquired. Actively, there are five patients hospitalized; two in SieReap, two in PhnomPenh and one in Battambang. 112 connections are quarantined at the quarantine center in Phnom Penh or in their respective provinces and are checked regularly for any symptoms.  (Ministry of health of Cambodia)      

Confirmed cases by provinces

Province

Cases

Re⁠coveries

Banteay Meanchey

5

5

Battambang

9

8

Kampong Cham

16

16

Kampong Chhnang

3

3

Kampot

2

2

Kandal

2

2

Kep

4

4

Koh Kong

2

2

Phnom Penh

175

174

Preah Vihear

2

2

Siem Reap

9

7

Sihanoukville

40

40

Tboung Khmum

8

4

Source: https://covid19-map.cdcmoh.gov.kh/

Classification

Cases

 All

280

Controlling COVID-19 by Different Actors

Cambodia maintains an impressively low level of infection. The number of infections is less than 300 in September and more than 70% of the infection cases are because of overseas infections.And until 5 October 2020,242 (86%) of the 280 patients were imported and the remaining cases were locally diagnosed and were all epidemiologically related to confirmed cases. As shown Figure below, the Cambodian government reacts to COVID-19 very decisively but does not impose the strict border closing policy.

The Royal Government of Cambodia with the support of all relevant stakeholders, has been taking some possible process to control the COVID-19 outbreak in the country such as:

Process law on state of emergency

The draft law aiming to place the Kingdom in a state of emergency amid the Covid-19 pandemic is likely to be approved soon, there is a slim chance of enforcement given the current situation. The draft law was approved by the Council of Ministers’ Standing Committee and the bill has to be passed by the two legislative bodies and reviewed by the Constitutional Council before being promulgated by the King. Consisting of five chapters and 12 articles, the draft law sets out formalities, procedures and terms to declare a state of emergency if the country runs into danger and stipulates a maximum 10-year imprisonment for anyone caught breaking it or hindering its enforcement.

https://pressocm.gov.kh/

Postpone for the celebration of Khmer New Year (Public Holiday)

In order to reduce the risk of COVID-19 infection in the country, all workers and civil servants in all sectors have to work as normal on the Khmer New Year celebrations. The Prime minister appealed to his compatriots to reduce the travelling from Phnom Penh to the countryside, to their homeland and tourist attractions; and enhance the personal, family, and community hygiene, especially keep social distancing to prevent the contamination of COVID-19 pandemic.

The government has ordered a lockdown of all district and provincial borders within the Kingdom from midnight on Thursday to midnight on April 16. (during Khmer New Year). The public is not allowed to travel out of their districts or provinces to halt the spread of Covid-19 in light of the impending Khmer New Year. The only exception is Phnom Penh where no travel restriction is applied.

https://www.phnompenhpost.com/

Budget for supported

The Ministry of Economy and Finance announced on Thursday that it was working with the Health Ministry to allocate $30 million to finance. the allocation would be used for preventive and monitoring measures, as well as to treat potential patients testing positive for COVID-19

The announcement comes a day after Prime Minister Hun Sen called for all relevant ministries to prepare for a fight against the viral outbreak. He even asked ministries to cut expenditure, excluding salaries, by half to prepare for the virus spread in Cambodia.

https://www.mef.gov.kh/

https://www.voacambodia.com/

Donation Policies

The government has begun to accept donations for the fight against the Covid-19 (coronavirus) pandemic. Donors can contact designated health officials or visit the Ministry of Health for donations, adding that the acceptance of donations came after the country established a national committee to combat the virus. The committee comprises key officials from various ministries, the army, the national police, the national military police, and governors of all cities and provinces across the kingdom

As the government prepares stricter measures to try to contain the virus’s spread, several government officials, including the Prime Minister have pledged to donate several months of their nominal salaries, of around $1,250 to $2,500 a month.

(https://english.cambodiadaily.com/author/xinhuanet/)

https://vodenglish.news/

Foreign policies response

The Ministry of Foreign Affairs and International Cooperation on behalf of Royal Government of Cambodia has inform the mission to all diplomatic and consular mission accredited to prevent the spread of the COVID-19 as follows:

https://www.mfaic.gov.kh/

As many infection cases are due to the overseas infection, the Cambodian government introduces requirements for prevention, containment, and response to the spread of COVID-19 for all international travelers. Some of them are:[1] 

 

 

Trade policies response

The government almost sealed off after Thailand, Laos, and Vietnam closed their borders amid coronavirus fears. But the government has been negotiating with the neighboring countries to set up the district only for people movement but the exchange of goods at the international border checkpoints will be allowed after truck drivers are thoroughly screened for coronavirus. The Prime Minister of Cambodia has mentioned that he has been discussing with Vietnam’s leader that the two countries continue to ship goods across the border.

“At the same time, we will collect the revenue from Customs taxes at the border gates with Vietnam and Laos because we’re still exchanging goods,” said Cambodian Prime Minister.

All cross-border activities, including people movement, are affected but the exchange of goods at the international border checkpoints will be allowed after truck drivers are thoroughly screened for coronavirus

Economic response (Restructure loans policies response)

In early March, the National Bank of Cambodia (NBC) said the requirement for financial institutions to reserve at least 50 per cent of their capital will be delayed until late 2021. The Central Bank also reduced the interest rate on the liquidity-providing collateralized operation (LPCO), a financial tool that allows NBC to lend to financial institutions in the local currency. LPCO’s interest rate has been cut to 2.5 per cent a year (from three percent), 2.3 per cent for six months (from 2.8 per cent), and 2.1 per cent for three months (from 2.6 per cent). The last measure announced by NBC this month is the deduction of the interest rate on the negotiated certificate deposit (NCD), a tool that allows the financial sector to deposit with NBC to earn interest. The purpose of these policies is to support economic growth as the country faces the Covid-19 threat. NBC continues to closely monitor the development of the situation inside and outside Cambodia.

On March 27, 2020, the National Bank of Cambodia (NBC) issued a directive to all banks and financial institutions to restructure loans in order to maintain financial stability, support economic activity, and ease the burden of debtors facing major revenue declines who may find it difficult to repay loans during the ongoing COVID-19 outbreak.  

This directive requires banks and financial institutions to establish a policy and procedure on loan restructurings amid the COVID-19 outbreak, and have it approved by the board of directors.

The banks and financial institutions must also pay close attention to clients, with particular attention given to clients engaged in the following sectors:

The directive recommends that banks and financial institutions verify that:

In restructuring a loan, banks and financial institutions may:

Banks and financial institutions are also required to closely monitor restructured loans and provide monthly reports to the NBC

The directive further requires that loan restructurings be carried out by a separate team from the department in charge of processing the loan. The team must regularly review clients’ loan portfolios and how they are impacting clients' financial positions.

https://www.nbc.org.kh/

https://www.tilleke.com/

Education policies response

Schools have been closed nationwide since mid-March following the Covid-19 outbreak. According to the Ministry of Education’s announcement, students are now required to take home-based and online courses organized by the ministry and its partners.

The Ministry of Education has extended the suspension of public and private schools. It will fill the educational gap with distance learning programs accessible via television. The Ministry also produced teaching videos to upload on the official facebook page and boost the page to increase viewers. The ministry announced that it has instructed public schools to collaborate with parents, guardians and local authorities to promote the Distance Learning and E-Learning programs to students. The Ministry advised public schools and private schools to set up a schedule for guardians to be present to ensure the safety and security of schools by regularly cleaning the campus and encouraging students to borrow textbooks to improve their autonomy and distance learning.  The most rural students did not have a laptop but at least one smartphone. Hence they could receive the same education as urban students using television, facebook, and other materials. Government Diploma and Baccalaureate examinations have been postponed. But the ministry has allowed private schools to administer both examinations via distance learning or e-learning

http://www.moeys.gov.kh/

Labor response policies

The Ministry of Labour and Vocational Training has instructed enterprises, business owners and travel agencies in five provinces to prepare the proper forms for the suspension of employment contracts. The government announced changes in the allowances for temporarily laid-off garment workers from receiving 60 percent of the minimum wage to a flat $70. Of the figure, $40 will come from the government and $30 from factory employers. the government to provide the $40, employers or owners of factories, enterprises and establishments in the textile, garment and footwear sectors have to follow the procedure mandated by it. Employees in the tourism sector who are in Phnom Penh, Siem Reap, Preah Sihanouk, Kep and Kampot provinces and out of work because hotels, guesthouses, restaurants and travel agencies were affected by the Covid-19 pandemic were subject to the same conditions.

There was the repatriation of Cambodian workers from Thailand due to the numbers of infected cases has increased dramatically in Thailand. Thai government decided to send all the Cambodian workers back until this epidemic ends. The Cambodian government always encourages its citizens who are living abroad to remain in those countries even in difficult situations.

http://mlvt.gov.kh/

https://www.phnompenhpost.com/

Public health response

The Ministry of Health on behalf of Royal Government of Cambodia has been preparing for this response over the novel coronavirus (2019-CoV) event by collaborating with the WHO to strengthen managerial and technical response on the following measures:

Policies after accepted the Westerdam Cruise Ship

After several days at sea, the Royal Government of Cambodia agreed to accept the Westerdam cruise ship and the 2,257 persons on board, taking into consideration a number of factors including the needs of passengers and humanitarian considerations. Following docking at Sihanoukville Port on 14 February 2020, a decision was made by the Royal Government of Cambodia to allow passengers to disembark based on the following measures taken:

www.cdcmoh.gov.kh

www.who.int/emergencies/diseases/novel-coronavirus-2019

WHO assesses the success factors of Cambodia as follows.[2] 

First, the strong leadership and coordination led by the Prime Minister, Minister of Health, and other government agencies are notable.

Second, there was a functional public health system due to the past investment. Around 3000 Rapid Response Team members (RRTs) across the country conduct case investigation and contact tracing. Moever, there are successful strong multi-source surveillances such as indicator-based surveillance for acute respiratory infection, influenza-like illness (ILI) and severe acute respiratory infection (SARI); event-based surveillance (MoH Hotline 115); and screening media on clusters of fever, ILI, SARI and animal deaths.Third, effective risk communication and community engagement is also found. The Cambodian government timely delivers messages through TV, radio and social media, regular press releases, press conferences and media briefings.

Finally, the Cambodian government engages in international cooperation. The government work closely with UN agencies and development partners and actively participate in international meetings including regular coordination between WHO’s National IHR Focal Points.

Recommendations and Reinforced Quarantine Measures

All foreigners who wish to enter Cambodia must apply for a visa in their country at the Cambodian Embassy and request COVID-19 negative certification issued within 72 hours (based on flight departure) and an insurance card covering a total of USD 50.000. (Covid Novice) All foreigners who wish to enter Cambodia must apply for a visa at the camboccan Embassy. Anyway, Captains and crews of airlines (as from Mar.31) Diplomatic and formal visa holders (COVID 19 negative confirmation needed and no condition is imposed.), Travelers will bear costs for examination, quarantine and care COVID19 and they are expected, as soon as they arrive in Phnom Penh (as at June 15), to deposit US$ 2 000 in the bank counter at the airport.

All passengers will be under 14 days self-quarantine if all passengers are found to be negative and if one has been found to be positive, then all passersby will be put on a quarantine basis under the 14-day term at a facility established by the Government of Cambodia. (As early as 20 May).

https://www.aseankorea.org/eng/New_Media/notice_view.asp?BOA_NUM=15444&BOA_GUBUN=12

Impacts of Covid19

Economic

The Asian Development Bank (ADB) recently forecasted that the economic impact of COVID-19 in Cambodia will lead to a 1.2-2.9% drop in GDP—a loss of US$283-711 million. Cambodia’s economy is extremely vulnerable to both demand-side shocks from the decline in tourism and supply-side shocks from heavy dependence on upstream linkages with China.

Source: Asian Development Bank

On the demand side, Cambodia’s economy is heavily dependent on tourism. In 2018, tourism contributed 32.8% of GDP. In the same year, 33% of total tourist arrivals come from the People’s Republic of China.

Government figures from March show the number of tourists arriving from abroad has already dropped by more than 60%. In addition, Cambodia has put in place strong travel restrictions to curb the spread of the virus. As a result, the ADB estimates tourism revenues will decline by 1.4-3.5% of GDP—a loss of US$345.7-856.5 million.

On the supply side, Cambodia is seeing supply-chain disruption from China’s COVID-19 response. Cambodia’s garment sector is tightly dependent on China for raw materials, with more than 60% of raw material for the apparel industry sourced from China. As Cambodia’s factories start running out of raw materials, authorities estimate that 200 of Cambodia’s factories will suspend up to 160,000 workers in the coming weeks.

Source: World Bank

Cambodia urgently needs economic stimulus to jumpstart recovery in key sectors

The government has already announced a COVID-19 stimulus amounting to 3% of GDP ($2 billion). The package provides suspended workers with income, co-funded by their employers, and offers tax relief to the tourist industry. The government is also extending low-interest loans to small and medium-sized enterprises (SMEs).

While these are proactive steps in the right direction, the most vulnerable groups may be left unprotected. Cambodia has a large informal sector—an estimated 95% of SMEs are not officially registered and will not be eligible for the stimulus. The government will need to thread a fine line between encouraging small businesses to register, so they can gain access to support, while not forcing them to pay the increased costs that come with formalizing their companies.

The crisis offers an opportunity for long-term reforms to increase resilience and transform the economy.

The pandemic has exposed the cracks in our global supply chains but offers an opportunity for ASEAN countries like Cambodia to position themselves as a supply chain alternative to China.

Retailers are learning lessons about the necessity of diversifying their manufacturing hubs to make them more resilient in the face of shocks. Several textile companies, such as Levi Strauss and Adidas, have recently increased their US imports from Cambodia. In the last 3 months, Levi Strauss had a 81.7% increase in shipments while Adidas had a 28.9% increase in imports from Cambodia. Now is the time for Cambodia to capitalize on this pivot and accelerate their manufacturing sector.

The pandemic has also led to widespread displacement of workers, creating an opportunity for the government to invest in the human capital of workers. The government is providing retraining and upskilling programs for displaced workers to support their reintegration. The move is timely and falls into the broader narrative of preparing the ASEAN labor market for job losses, already anticipated pre-COVID-19, due to existing threats such as automation.

The COVID-19 pandemic is an unprecedented crisis and Cambodia, a country dependent on tourism and supply chain links to China, is faced with heavy economic losses and an urgent need to strengthen public health capabilities. The government needs to respond quickly and decisively to stem the short term economic losses while ensuring that the most vulnerable groups are protected.

But the crisis also creates an opportunity for Cambodia to re-examine its long term priorities. By placing strategic bets on supply chain diversification and investment in human capital, Cambodia can emerge stronger in the post-pandemic world.

Health

Since mid-February, 2020, coronavirus disease-2019 (COVID-19) has been spreading in Cambodia and, as of April 9, 2020, the Ministry of Health has identified 119 polymerase chain reaction (PCR)-positive cases. However, the PCR test is available in only two specialized institutes in the capital city Phnom Penh; therefore, exact and adequate identification of the cases remains still limited. Many vulnerable newborn infants have been admitted to the neonatal care unit (NCU) at the National Maternal and Child Health Center in Phnom Penh. Although the staff have implemented strict infection prevention and control measures, formidable gaps in neonatal care between Cambodia and Japan exist. Due to the shortages in the professional workforce, one family member of sick newborn(s) should stay for 24 hours in the NCU to care for the baby. This situation, however, may lead to several errors, including hospital-acquired infection. It is crucial not only to make all efforts to prevent infections but also to strengthen the professional healthcare workforce instead of relying on task sharing with family members

Covid-19 cases continue to rise globally, the disease is set to strain public health systems in developed and developing countries alike. Soaring death tolls in countries like Spain, Italy, and Iran reveal that the systems that are currently in place around the world are not ready for this challenge. In that regard, Cambodia may have a daunting road ahead.As the timeline for the crisis stretches on, the cost to Cambodia will also rise. But, we must not lose sight of an equally pressing problem – the capacity of Cambodia’s healthcare system to effectively deal with this disease. This will be a defining moment for the country’s health institutions, which are at the moment, scrambling to gather experts and supplies.The reality is, Cambodia will not have enough Intensive Care Unit beds for critically ill patients if the number of cases soars. Countries like Japan and China have made donations to try to address the scarcity of key materials in Cambodia. On February 16, the Japanese government donated 9,360 protective suits, 480 hand sanitisers, 540 protection glasses and 24,400 pairs of gloves.

According to a Ministry of Health press release, its Chinese counterpart donated materials including 7,000 pairs of disposable latex gloves, over 100,000 medical masks, 5,000 N95 protective masks, 5,000 disposable work hats, and more. And then there’s the high profile donation from Jack Ma, the Chinese billionaire and founder of Alibaba, which included 1.8 million face masks and 210,000 coronavirus test kits as a gift to several countries, including Cambodia, to fight against the pandemic. Cambodians are thankful for these donations, but the bigger problem is that this country’s hospitals are starting out at a disadvantage. They are coming at the problem with a lack of necessary knowledge, specialists and equipment to handle a Covid-19 outbreak. Therefore these donations may be far from enough if the pandemic continues to spread quickly in the Kingdom, especially given Cambodia’s insufficient health facilities in rural provinces.

Perhaps one of the most serious challenges facing this country is its shortage of health professionals, doctors and nurses. Cambodia has only 1.4 health workers per 1,000 people, a level of shortage the WHO classifies as a ‘critical’ ,And there are no official statistics that tell us exactly how many of these health workers are lung specialists skilled in treating respiratory illnesses.Even with the team of seven experienced Chinese doctors who came to Cambodia to share their expertise, the country is far behind in terms of the personnel needed to fight a disease like this one.

Secretary of State at the Ministry of Health, Dr Heng Taikry, has admitted that although some hospitals, such as Phnom Penh’s Calmette, are equipped with the kind of advanced facilities like those found in Singapore, for the most part, Cambodia’s health institutions lack qualified and skilled staff to ensure a high level of treatment. It is simply not possible for the government to transform this country’s health care system overnight. 

Social Welfare and Development

The impacts of COVID19 are being felt by all, but especially the rural and urban poor and elderly. Hardship is spreading, what happens if another disaster strikes? UNDP Cambodia's Muhibuddin Usamah and Kelsea Clingeleffer with Kate Jean Smith, on why climate action remains as important as ever. It’s the word of the month, and quite likely the decade  COVID-19. It’s a health crisis on a scale never before seen by our generation, a crisis with far-reaching and profound consequences for the economy, society and the poor. Economic strain as a result is inevitable. A UN article recently stated that over US$220 billion of income losses are expected in developing countries as a direct result of the virus outbreak. Government funding and energy is being channelled towards COVID-19 response. Of course, the economic response has social ramifications. Such challenges can lead to severe social dislocation as livelihoods fall, poverty rises and, if left unchecked, civil unrest can flare.

In  Cambodia, there are also concerns about the health system’s ability to cope if a steep rise in cases was to occur, particularly due to the unpredictability of the situation. The impacts of COVID-19 are being felt by all, but in particular, the most vulnerable in our societies: among them the poor, the elderly, those without literacy skills, and people with disabilities. These communities are suddenly dealing with a double burden, as they attempt to feed their families and make a living (made even harder as industry restrictions bite and and tourism ceases), while navigating daily life and trying to avoid getting sick.

On 2 April, the Ministry of Commerce issued a notification to warn all fuel station and depot owners who sell fuel for unreasonably high prices or misrepresent the quality or quantity of fuel, that the Ministry will take action by enforcing transitional fines, suspending business operations or submitting a complaint to the court.

On 03 April, the Ministry of Economy and Finance issued decision No. 024 on the establishment of a task force to control supply and prices of strategic goods during the fight against Covid-19. This will determine the types of strategic goods that are deemed essential for daily consumption during the Covid-19 situation for instance: rice, salt, vegetable, fish, meat, mask, cleaning alcohol, pharmaceutical and medical equipment. This task force will monitor the daily demand and supply of such strategic goods and guarantee sustainability without any interruptions. This task force will also check quality and ensure appropriate pricing and avoid dramatic price increases. 

Labor and Employment

COVID-19 has so far had devastating effects on individuals, states and businesses alike. For Cambodia, a country which relies on foreign direct investments (FDIs) as much as it depends on its four economic pillars, i.e. hospitality and tourism; agriculture; manufacturing; and construction – has been tremendously affected by the pandemic. This is especially critical in times of national political instability as well as economic uncertainty due to the European Union’s partial withdrawal of Cambodia’s export privileges under the Everything But Arms (EBA) scheme.The sector currently being at risk the most is the country’s garments, textile and footwear (GTF) sector which employs more than 750,000 workers, most of whom are internal women migrants from remote provinces. Due to the significant size of its workforce as well as its capacity to produce goods in values exceeding billions of dollars annually, the GTF sector pointedly contributes to the national Gross Domestic Product (GDP). However, the sector’s reliance on raw materials from abroad has meant direct and negative effects due to the breakdown of important supply chains in China. As a result, a significant part of Cambodia’s GTF sector is currently unable to produce any goods, leading to the closures of many factories in the recent past and future (Kelly, 2020).

In the face of this global health crisis, the ILO (2020) recently issued a warning concerning global unemployment as well as underemployment in different sectors and industries, predicting working poverty of those who are already at risk, specifically women: Under COVID-19,  working poverty is likely to increase significantly. The strain on incomes resulting from the decline in economic activity will devastate workers close to or below the poverty line… Women are over-represented in more affected sectors or in occupations that are at the front line of dealing with the pandemic’’ (International Labour Organization, pp.5-6, 2020). In an attempt to minimise the economic damage and steer away from any potential political unrest, the Cambodian government recently obliged factories to pay their workforce 40% of their minimum wage and offered an additional 20% paid through governmental funds if the affected workers attended training courses (Clean Clothes Campaign, 2020; Hutt, 2020; Sokummono, 2020). In reality, some factories have already begun to lay off their workers without any pay (Kelly, 2020), which is to be expected in a country that has created and enabled rather dysfunctional law-implementing mechanisms as well as a rule of law that is tailored towards the benefits and powers of Cambodia’s ruling elite.

To conclude, COVID-19 is not ‘the great equaliser’ as superstar Madonna recently informed us from the comfort of her bathtub. This pandemic hits those hardest who are already at the core of the more vulnerable parts of societies around the world – be their vulnerability defined by gender, income group, level of education and skills, or else. Cambodia’s mostly-female garment sector is a case in point: The very real threat of losing their occupation (and therefore income) is only the cherry on top of the common exploitation of labourers in a billion-dollar sector. Therefore, the Cambodian government needs to step up its game to mitigate future ripple effects of the COVID-19 crisis in one of its most fundamental sectors. For example, policy adaptation and response are essential, but first and most importantly for the protection of workers. Also, the creation of social dialogue is indispensable: ‘’Tripartite social dialogue between Governments and Workers’ and Employers’ organisations is a key tool for developing and implementing sustainable solutions’’ (International Labour Organization, p.3, 2020).

 So far, the Cambodian government has not shown too much of a willingness and understanding to come to terms with the seriousness of COVID-19, and what the failure in effectively and efficiently addressing this could mean for the country’s future. In their current forms, neither the Prime minister nor the politically-biased and tainted Kingdom created have any capacity to deal with this crisis. In order to do so, key decision-makers must put political differences and sovereignty as well as economic priorities aside. It can only be hoped that the ruling elite, for once, puts the rights of the Khmer people before its own.

Garment factories

The Cambodian Ministry of Labour has reported that 91 garment factories have suspended their operations due to the COVID-19 pandemic, affecting as many as 61,500 workers in Cambodia. The government has provided ‘tax holidays’ for between six months to one year for factories severely impacted by the COVID-19 (Prakas No.319). In early April, the Royal Cambodian Government said it will pay factories employees who have been impacted $40 and factories will pay them $30 ($70 in total), if jobs have been suspended, without requiring employees to attend training.Cambodia said this week that 10 factories had already applied to suspend operations and would pay partial wages to about 3,000 workers. The government in Phnom Penh expects a total of 200 to slow or stop production in March because of coronavirus, affecting 100,000 of more than 850,000 employed in the US$7 billion sector, which is Cambodia's largest employer.

According to the Labour ministry, about 7,000 workers will face layoffs if the delivery does not materialise. If the shortage drags on, about 90,000 workers will be suspended at the end of march

Food and beverage industry

The food and beverage industry has seen massive closures, temporarily or otherwise, since the COVID-19 outbreak began.

Property and Construction

Tourism sector

Tourism has been one of the most impacted sectors, a direct knock-on effect of the airline industry and visa and travel restrictions implemented globally. Monthly tax exemption measures to hotels, guesthouses, restaurants and travel agents registered with the General Department of Taxation in Phnom Penh, Siem Reap, Preah Sihanouk, Kep, Kampot, Bavet and Poi Pet for 3 months from March to May 2020.

The Ministry of Tourism instructed all tourism accommodation businesses (except community housing services) to take responsibility to register all guests on the Tourism Accommodation Registration System.

Cambodian Aviation and Airline Industry

The government has announced some measures to support the airline industry in Cambodia. These include:

Schools and Education services

Agriculture

Foreign Affairs

On 3 April, the Ministry of Foreign Affairs and International Cooperation issued a letter to inform all diplomatic and consular missions that due to Covid-19, the Kingdom of Cambodia will grant automatic tourist visa extensions for some foreign tourists that arrived in Cambodia after 1 January 2020 and will exempt visa overstay fines until they are able to depart.

The Cambodian government has extended entry restrictions for travelers from the US, Germany, France, Spain, Italy, and Iran for 30 days as of Wednesday, March 18, to prevent further imported cases of coronavirus (COVID-19) in the country. March 20, the border with Vietnam has also been temporarily closed after Vietnam recently decided to suspend cross border movement.

Cambodia found itself almost sealed off  after Thailand and Laos closed their borders amid coronavirus fears.Travel by citizens between  countries  by road, water or air was subsequently banned.All the border crossings in 19 places, including the international border checkpoint with Thailand are closed. They are the international border checkpoints at Poipet-Banteay Meanchey, Phnom Chy-Battambang, O’Smach-Oddar Meanchey, Prum-Pailin; 15 regional border checkpoints in Battambang and Banteay Meanchey; and two districts border checkpoints in Battambang and Banteay Meanchey.

Topic Discussion

WHY ARE CAMBODIAN COVID19 NUMBERS LOW WHEN SO MANY COUNTRIES IN THE REGION ARE ELEVATED?

Cambodia is one of the countries of Indochina, and has experienced very low numbers of cases of Covid-19 despite their proximity to China, the country where the outbreak began.

Positive cases of Covid-19 in Cambodia have remained at 122 for the 16th consecutive day, with zero new infections reported and 120 of those patients have already recovered. There have been no fatalities recorded. The first case was reported in Cambodia’s seaside town of Sihanoukville on 27 January, so in theory the virus should have been circulating in the Kingdom for some time, but there has been no surge in death rates in the country, either from hospitals or pagodas where cremations take place. There have not been as many tests as in some countries, but the renowned Pasteur Institute has been conducting contact tracing tests on about 500 people per day. This positive news has led to the World Health Organisation (WHO) designating Cambodia as a country experiencing only ‘sporadic’ cases.

It is too early to understand clearly why the case numbers are low and the death rates at zero in the three countries of Indochina, but the Medical Attache to the US Embassy in Phnom Penh recently shared his thoughts on the matter.

In early 2020, at the onset of the global pandemic, many predicted Cambodia would experience a substantial Covid-19 outbreak, due primarily to the extremely large number of mainland Chinese tourists, business travelers, and residents in the Kingdom. Through late February, there were 25 direct flights per day arriving from 21 different Chinese cities. While Cambodia declined to halt flights to/from China, the Chinese government ultimately suspended flights between Wuhan and Cambodia on January 23, but only after thousands of travelers from Wuhan had arrived in Cambodia after the coronavirus outbreak in that city. As a result, most health experts believed that it was only a matter of time before a significant outbreak emerged in Cambodia and, once started, would spread rapidly.

These fears, however, have not yet borne out. As of April 28, there have only been 122 confirmed Covid-19 cases in Cambodia, 120 of which have recovered; there have to date been no coronavirus-related deaths reported. U.S. CDC officials note that the low numbers appear to indicate that Cambodia is not experiencing widespread community transmission, unlike other parts of Asia. Cambodia’s positive case numbers are consistent with neighboring Laos (19 cases) and Vietnam (270 cases), but are significantly less than others in Southeast Asia, including Thailand (3,000 cases – 54 fatalities) and Indonesia (9,000 cases – 765 deaths).

While it is too early to explain fully why Cambodia has not experienced a major outbreak  and one is still highly possible health experts have hypothesized that a number of factors may have contributed thus far to lowercase numbers, including: the country’s relatively small, mostly rural population (16 million people); relatively few enclosed public areas like indoor malls, arenas, and mass transit for people to gather (This comparison is also being made between New York with its high use of public transport and high case rates compared to Los Angeles with its high use of personal cars and low case rates); Cambodia’s tropical climate; mainland Chinese insular social behavior within Cambodia; and significant U.S. technical assistance in contact tracing, testing, and prevention.

“Cambodia’s relatively low population density may be one factor that has protected it from an outbreak,” an infectious disease expert from the U.S. NAMRU-2 Unit based in Cambodia related. Only 20 percent of Cambodians live in urban areas and the country’s population density (212 people per square mile) ranks 118th in the world. Even in Phnom Penh, Cambodia’s capital and most densely populated city, there are only 8,120 people per square mile, considerably lower than cities like Bangkok (13,700) and Jakarta (40,400).

A lack of modern infrastructure and relatively few large-scale, enclosed public gathering places may have also been factors. While Phnom Penh has some public buses, it does not have a network of trains or subways that force people into crowded, enclosed spaces. Instead of modern mass transportation, the majority of Cambodians often rely on motorcycles and small open-air vehicles (“tuk-tuks”) with constant air circulation that hampers transmission of the virus. Cambodia also has few malls with centralized air conditioning, which has the potential to circulate respiratory droplets within large groups of people, U.S. In contrast, Cambodian pagodas, a common place for gatherings, are mostly open-air buildings without air conditioning, built on spacious grounds.

While health officials caution that the results of studies on whether climate has an effect on the spread of Covid-19 are still pending, environmental factors in Cambodia likely do play a role in reducing the spread of the virus. Some respiratory viruses do not transmit as effectively from person-to-person in hot, humid climates, like Cambodia. Additionally, some viruses have a low tolerance for ultraviolet light. As many Cambodians spend a significant amount of time outdoors, Cambodia’s hot climate and direct sunlight may be factors slowing transmission. Colder climates also result in populations staying indoors through longer periods of the day, attempting to maintain potentially contaminated warm air inside.

Many foreign visitors to Cambodia tend to follow well-worn paths, staying in large hotels and visiting many of the same restaurants and sites in the main tourist destinations of Siem Reap, Sihanoukville, and Phnom Penh. This is particularly true of Chinese tourists. Chinese tourists in Cambodia often stay in Chinese-owned and operated hotels and restaurants and patronize businesses with a predominantly Chinese clientele. The same is often true of the various expat communities in the country, many of which due to language and cultural barriers often socialize primarily amongst themselves. Due to this behavior, there is less contact between Cambodians and potentially contagious foreigners than would be expected.

While many were concerned that Cambodia was slow to react to the pandemic, some limited measures taken by the government may have slowed the spread and raised awareness with the public. The government instituted screening for incoming visitors for fevers and closed schools and karaoke bars when there were only nine confirmed cases. In addition, these measures served to raise the public’s awareness about the disease. “Cambodians are scared of Covid-19, and many of them know what they need to do to avoid getting sick,”. Not only are Cambodians mostly compliant with government directives, but they have voluntarily taken precautionary measures. Cambodians know that the country’s poor healthcare system would not be able to handle a wave of serious illnesses and are comfortable taking measures to lower the risk of hospitalization at a personal or family level. The use of facemasks is common in Cambodia and is now widespread in Phnom Penh, and many businesses require temperature checks and hand sanitizer use prior to entering.

The technical assistance of U.S. health and medical agencies and ongoing support for Cambodia’s health system is another explanation for Cambodia’s apparent resilience to Covid-19 (at least for now). Beginning in January, Cambodian health authorities immediately turned to U.S. Embassy experts Unit -- for technical assistance with testing, disease surveillance, contact tracing, databasing, and planning to prevent community transmission. Building on 25 years of health-related cooperation and $611 million of public health assistance, Cambodian officials also acknowledge that the recent $2.1 million of additional U.S. assistance provided to combat Covid-19 has been critical for the country to respond to the crisis.

Some observers and health specialists have made another argument: that Cambodia’s Covid-19 outbreak has spread undetected. Cambodia has a large percentage of its population under 30 years of age (A cohort that recovers quickly from Covid-19). Prior to April 6, Cambodia’s testing protocols were rather strict and advised only for patients with an upper respiratory infection and either a travel history in a country with a Covid-19 outbreak or confirmed contact with an infected individual. This case definition may have resulted in decisions not to test patients with Covid-19 that were infected through community spread. In addition, testing in the provinces is inadequate and some provincial health professionals lack the skills to properly collect and transport viable samples.

Nevertheless, health officials believe a significant undetected community spread is unlikely. Current Covid-19 testing capacity in Cambodia is robust, and disease surveillance and contact tracing are improving. Moreover, the independent Institute Pasteur of Cambodia has tested over 5,200 individuals since January, far more than have been tested in neighboring countries with similar case counts.

Post-Covid19 Challenges

Hundreds of garment factories in Cambodia and elsewhere in Asia are facing serious financial problems because clothing brands have either canceled their orders or stopped placing new ones over the past several weeks. The brands say they have no other option, because the demand for clothes has decreased significantly now that many stores in the West are closed due to the coronavirus pandemic.  

In Cambodia alone up to 130 factories have asked the country's Labor Ministry for permission to suspend their operations entirely or partly. With about 750,000 workers, the garment industry is the biggest employer in the Southeast Asian nation. Around 100,000 Cambodian workers have recently lost their jobs, either permanently or temporarily. This number is likely to increase in the weeks and months to come.

The Garment Manufacturers Association of Cambodia (GMAC), which represents hundreds of employers, has also said that some factories may not survive the rapidly growing crisis, largely because the margins on which these companies operate are small.

The factories are pushed into a difficult position by some of the world's biggest clothing brands. At least 14 brands have canceled their orders and either refuse to pay for the orders or demand a discount, according to the Worker Rights Consortium, an organization that monitors factories worldwide.

Following fierce criticism, some of these brands recently announced that they are working to find a solution for the factories and their workers.

The mass cancelations of orders hit not only Cambodian factories, but also those elsewhere in Asia. In Bangladesh over 1 million people could lose their job, in Myanmar at least 70,000 jobs are at stake, according to Human Rights Watch. And in Vietnam, the Vietnam Textile & Apparel Association expects exports to shrink by 15%.

Finding new jobs will be a tough challenge for the over 100,000 Cambodian garment factory workers who are now left without work. Much of the country's economy has been affected by the outbreak of COVID-19, with many businesses in the travel and entertainment industry closed as well.

Unintended consequences in Cambodia communities

Traditionally in Cambodia, seasonal rains begin in mid-May. The rain is essential for farming and annual flooding is a normal part of many Cambodians’ lives. Yet climate change is driving more variability in the duration, timing and intensity of rainfall across the country bringing sometimes unpredictable and overwhelming consequences.

While it is still not known what a ‘State of Emergency’ would look like in Cambodia, the implications in the context of the looming wet season and natural hazards, such as flooding, are complex.

If this pandemic continues into May and will still require social distancing, the first wave of rain could disrupt the process of flattening the curve. During the wet season in Cambodia, there is an increase in fishing. This goes hand-in-hand with human migration and busier wet markets, therefore increasing the risk of transmission.

Meanwhile, if flooding occurs, restrictions on movement due to COVID-19 could be deadly as communities usually move to higher safe areas for security, food access, medical attention and shelter. The inability to practice social distancing in these areas could create major transmission issues. It could also mean that health resources are diverted.

Power-cuts – such as those caused by drought conditions across the capital of Phnom Penh last year – could compromise health systems’ capacity to provide sufficient services to both COVID-19 individuals and the wider community. All this is compounded by uncertainty about how long it will be before there is a return to ‘normal’ life.

References

 

 

 

[1]Refer to  https://kh.usembassy.gov/covid-19-information/  and  https://www.mfaic.gov.kh/covid-19

[2] https://www.who.int/docs/default-source/wpro---documents/countries/cambodia/covid-19/covid-19-joint-who-moh-sitrep-02.pdf?sfvrsn=1dfda7c0_6