After reporting its first COVID-19 death in March, Cambodia has a recent spike in deaths from the disease, registering 111 deaths in the last eight days.
Cambodia has seen a sharp increase in cases – more than 40,000 in the last three months – since early April resulting in the lockdown of Phnom Penh and other parts of the country. And, while the number of deaths have hovered around 8 to 10 deaths a day, in the last three weeks there have been 238 reported deaths – more than half all deaths reported in the country during the pandemic.
The country also has a higher number of deaths per million citizens, as compared to its immediate neighbors. Cambodia has almost 28 deaths per million people, whereas Thailand and Vietnam – which are also seeing recent surges in COVID-19 cases – 23 and less than one death per million, respectively, according to data from John Hopkins University’s COVID-19 dashboard.
The rise in deaths is concerning, say health experts and officials, attributing it to more virulent mutations of the virus, comorbidities among the population and a weak healthcare system.
Dr. Nouth Sambath, who heads the Institute of Biology, Medicine, and Agriculture at the Royal Academy of Cambodia, said the increase in deaths reveal that Cambodians have pre-existing health conditions that are making them vulnerable to the virus.
The doctor said the country’s elderly lived through the Khmer Rouge regime, during which they faced malnutrition and testing physical conditions making their immune systems weaker.
“Most of the deaths are among people who are obese, with chronic diseases and over 65 [years],” he said.
“They don’t have enough antibodies against the virus. So, they are easily infected and die.”
Another related issue is Cambodia’s healthcare system and its capacity to deal with cases related to a raging pandemic.
“This is another factor which leads to more infections, and they are vulnerable to deaths,” Nouth Sambath said.
The World Health Organization states that people with high-risk factors, such as the elderly, people who smoke, are obese, have non-communicable diseases like cardiovascular disease or diabetes, might need further evaluation before being recommended for home treatment.
On June 19, the Ministry of Health also reported that they had detected the presence of the Delta variant of the novel coronavirus in seven people entering from Thailand.
“We must dare to face hardships in the short term rather than hardships in the long term when implementing measures that enable us to avoid the long run that we may find it difficult to recover later on,” said Or Vandine, a Health Ministry secretary of state in a message released the same day.
“Most of the time, we have often heard about people [are] afraid of COVID-19, but our fear doesn’t seem to respond to the disease transmission condition, which still infects hundreds of people every day,” she added.
While the number of deaths has increased, there is little understanding about where they are occurring or other details about these cases. The Health Ministry in May stopped issuing details of where cases were occurring and instead only provided total new daily cases, deaths and recoveries, preventing analysis of progression of the outbreak.
Or Vandine and Hok Kim Cheng, the Health Ministry’s technical director-general did not respond to requests for comment.
Yong Kim Eng, president of the People Center for Development and Peace, said the rising number of deaths was concerning. He said the government needed to make sure its treatment procedures are effective, and that hospitals and health centers are well equipped to deal with the outbreak.
“We are also worried whether there are enough ventilators or not for helping patients who are seriously ill and need oxygen,” he said.
The use of makeshift COVID-19 treatment centers has been controversial and their capacity to handle COVID-19 patients.
Phin Sodalin, 17, died of COVID-19 while at the Sen Sok makeshift health center. But, her family claims that they weren’t made aware of where she was being treated, her death or where her body was being stored.
Phin Tith, 46 and Sodalin’s father, said his daughter was being treated for kidney disease at the Preah Ket Mealea Hospital but tested positive for COVID-19 and was transferred to the Sen Sok treatment center. The family was unaware of this and had to put a call on Facebook asking for her whereabouts before authorities informed the family of her death.
“She had no symptoms of COVID like a cough, breathlessness; she only had a fever,” he said. “I don’t know whether she had COVID-19 because the doctor said she is positive.”
