The COVID-19 pandemic in Cambodia was a part of the ongoing worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first imported case in Cambodia was detected in Sihanoukville on 27 January 2020. Although a number of imported cases and transmission to direct contacts were confirmed throughout 2020, no community transmission was detected until 29 November 2020. As of July 2021, Phnom Penh has been the most affected province with the majority of infections and deaths. Banteay Meanchey has the second-highest number of infections, whereas Kandal has second-highest number of deaths.
The public health response is led by the Ministry of Health with support from the U.S. Centers for Disease Control and Prevention, World Health Organization and Institut Pasteur du Cambodge. Contact tracing, quarantining, screening of arrivals and public messaging related to hygiene, social distancing and mask wearing have been central to the containment strategy. According to Global Health Security Index's report in 2019, Cambodia ranked 89th out of 195 countries in preparedness for infectious disease outbreak.
Cambodia's initial response was slow - during the initial outbreak in China, few international travel restrictions were introduced, Cambodian citizens were not evacuated from Wuhan and Prime Minister Hun Sen downplayed the threat. Cambodia allowed passengers of cruise ship MS Westerdam to disembark in February after it was refused entry to other countries. Starting in March as the pandemic spread globally, Cambodia established its national response committee, introduced restrictions on arrival, closed education institutions, garment factories and entertainment venues, and major public holidays were cancelled. A controversial State of Emergency Law was passed in April 2020 but has not been implemented to date. Most restrictions within the country were lifted by September. In November, some restrictions were reinstated in Phnom Penh and thousands of Cambodian government employees and contacts went into quarantine following a one day-visit by Hungarian Foreign Minister Péter Szijjártó, who tested positive after arriving in Bangkok. On 29 November, the first community transmission cluster was detected in Phnom Penh, with the virus suspected to have entered the country sometime during October and circulated undetected. The country began its vaccination programme and detected its largest outbreak to date in February 2021 thought to be related to a Phnom Penh quarantine breach that led to outbreaks at nightlife venues. Cambodia reported its first death on 11 March 2021. As Lineage B.1.1.7 spread in the capital's markets and garment factories, a curfew was later strengthened to the country's first lockdown across the entirety of Phnom Penh and Takhmau in April 2021 as the WHO warned Cambodia's healthcare system was at risk of becoming overwhelmed. Provincial authorities later introduced restrictions elsewhere as outbreaks occurred.
Cambodia's response up to July 2020 and its welcoming of the MS Westerdam were praised by the World Health Organization. Criticism has included Prime Minister Hun Sen's downplaying of the risk of an outbreak during the early stages of the pandemic, persecution of critics and testing and surveillance procedures, particularly in overcrowded prisons. The pandemic has had a severe impact on the economy, notably the tourism and garment sectors, with projections of a lasting increase in poverty, debt and unemployment.
Background
On 12 January 2020, the World Health Organization (WHO) confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster of people in Wuhan City, Hubei province, China, which was reported to the WHO on 31 December 2019.
The case fatality ratio for COVID-19 has been much lower than SARS of 2003, but the transmission has been significantly greater, with a significant total death toll.
Timeline
January–February - first case and docking of MS Westerdam
At 3 p.m. on 27 January, the first case had been confirmed in Sihanoukville on a 60-year-old Chinese man who arrived in 23 January from Wuhan, Hubei with his family. Three other members of his family were placed under quarantine as they did not appear to have symptoms, while he was placed in a separate room at the Preah Sihanouk Referral Hospital.
On 10 February, after two weeks of being treated and kept under observation, he had fully recovered, 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.
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 four countries due to virus concerns. About 20 passengers on board, who were unwell, took clinical tests but the vast majority had their temperature taken and filled out a form. Most of these passengers then disembarked. This move was praised by the World Health Organization (WHO), who called it an "example of international solidarity". No officials or passengers implemented social distancing or mask wearing during the ceremony, and passengers were later encouraged to tour around Phnom Penh.
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 of 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.
A comedian based in Oregon who was hired to perform on the Westerdam was said to have flouted the quarantine by sneaking a flight back to Seattle. However, he averred that the quarantine never took place and was cleared by US CDC on both ends.
Later tests on the American woman who had already returned home showed negative as she never had carried the virus after all, US CDC stated on 6 March. While the CDC had not tested the woman directly, it was confirmed that after the patient's initial positive result, two subsequent tests came back negative. It wasn't clear why she initially tested positive for COVID-19, though CDC officials have said she might have had other respiratory illness.
1-15 March 2020 - imported cases
On 7 March, the second case of the coronavirus was detected in 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 in the city.
On 10 March, 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. The woman took a flight from London straight to Hanoi on 2 March then another flight to Ho Chi Minh City with four other people, all British. Arriving to Phnom Penh on 7 March via the cruise, it was reported that a Vietnamese woman, who was seated next to the group on the plane from London, had carried the virus. The group of five were taken samples for testing. Two of them refused, claiming that they were healthy and having no symptoms, until the cruise ship reached Kampong Cham on 9 March.
Following the event, the boat had been docked to provide samples to be tested from all 29 other passengers and 34 crew and they 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 12 March, another cases 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 the confirmed cases at the time. Due to their ages, the married couple were transferred to Khmer-Soviet Friendship Hospital in Phnom Penh.
On 13 March, 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. The 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.
All cruise ships had since been prohibited to enter the country through K'am Samnar checkpoint and any other checkpoints.
14–25 March - restrictions come into place
In 14 March, MOEYS published an article declaring that they would have to shut down all educational institutes in Phnom Penh until further notice, as did an NGO where the Belgian man had been working. On 16 March, it was announced the closure of all educational institutions would be expanded nationwide.
According to a Ministry of Health press release, Cambodia announced a ban on all entries from Italy, Germany, Spain, France and the United States, with all visas indefinitely suspended. This policy would be held for thirty days, effective on 17 March. Iran was added to the list of countries whose nationals were suspended entry to Cambodia the following day, making a total of six. This would take effect on 18 March.
On 15 March, 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 were off, 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 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 the Tablighi Jamaat mosque superspreader 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.
Within the span of two days on 17 March, the total confirmed cases leapt to 33. At half past 9 a.m., 12 cases were publicly stated. 11 Khmer were found to be infected in various provinces. They were among 79 people returning from attending the Tablighi Jamaat 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.
The government mandated the extended closure to karaoke clubs and cinemas and forbid all religious gatherings and concerts.
On 18 March, four more cases were detected: two Malaysians in Kampot and two more tabligh attendees in Tboung Khmum.
In response to Vietnam's unilaterally shutting down borders with Cambodia without prior notice, the Ministry of Foreign Affairs announced to suspend all border crossings with Vietnam for a month-long period with the exception of diplomats and official passport holders. The measure would take effect on 20 March to avert inconvenience quarantine requirements for both nations.
It was reported that Thailand unilaterally closed Cambodian-Thai provincial border crossing, An Ses-Preah Vihear.
The government had established a national committee for combating the COVID-19, it had duties to set national policy and strategy related to the fight against the COVID-19 and control the impact of the virus on politics, economy, and society at national and international levels. The committee was obliged to direct the implementation of the strategic plan in preventing, containing and controlling the spread of the virus.
On 19 March, ten more cases were detected: two wives of the infected men, two more tabligh attendees, and six Malaysians.
On 20 March, the Ministry of Health announced an additional 4 confirmed cases: a Malaysian, and three Cambodians, one of whom was infected from an attendee from Malaysia and had no recent travel record overseas.
On 21 March, two more cases were confirmed at 9 p.m., a 67-year-old and an 80-year-old Frenchmen who arrived Sihanoukville as tourists on 18 March. 37 people suspected to have contacts with were put under quarantine.
On 22 March, having tested negative for a few times, a 65-year-old patient, British woman was reported that she fully recovered. She was said to be discharged later that day.
After bilateral meetings between Cambodia and Thailand was resulted in agreement upon closing all borders starting from 23 March for 14 days. An exception was made at Poipet-Aranyaprathet border crossing where only heavy-duty trucks were allowed under strict conditions.
At 10 p.m., more 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 Cambodia on 11 March, 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 23 March 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 other two Cambodians.