Complex and Confusing

Until now Cambodia has had minimal Coronavirus infections.  Today’s count sits at a total of 121 cases and 0 deaths.  However in the face of two different clusters with contact tracing becoming more complex, and hindered by a reluctance of some cases to share the information needed to track their close contacts, Khmer New Year has started.

Advice has been to stay at home and the Cambodia Monk Committee have cancelled all pagoda gatherings.  The usual public holidays have been cancelled with the promise of a five day holiday reimbursement once pandemic restrictions are over.  A travel ban was commenced at midnight on 9 April.  Anyone who leaves work for Khmer New Year will have to stay away from work, unpaid, for 14 days as a protective measure.

Despite these measures, last night – 24 hours after the travel ban commenced – this happened:

and the travel ban had to be lifted as it became impossible to enforce.

With two clusters of connected cases now complicating the work of public health teams trying to contain local transmission, and throngs ignoring official advice, it is difficult to imagine that World Health Organisation’s recent classification for Cambodia, of only having sporadic cases, will remain the case.

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Meanwhile as I watch the latest Australian press briefing take place on a lawn in an outdoor setting with everyone practising strict social distancing, the difference with this photograph from a recent Cambodian press conference seems striking.

Masks and social distancing

Masks!  In the minds of their wearers, they exclude the need for social distancing, as this photo well demonstrates.  They increase the likelihood of the wearer touching their own face, one of the common transmission sources for respiratory infections.  They carry a risk of touching infected material with your hands when you take them off – another common transmission source.  Without adequate training very few people wear them properly.  The material normal surgical masks are made from is not woven tightly enough to prevent tiny virus particles from passing through.  These are a few of the reasons that healthy people wearing masks is a waste of time, not to mention a horrific offense against the environment.

Masks are useful in certain situations such as someone who is coughing, donning a mask to protect those nearby (as long as cough etiquette and hand hygiene are also practised), or specialised masks used with proper training and protocols to protect health care workers who are in close contact with infected individuals.  General public use of masks serves almost no purpose, except to choke our already suffering marine life.

Facemask Trash
Facemask trash (dolphin dinner) washed up on a Hong Kong beach.

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Meanwhile, as the world focuses on one virus, other infectious diseases have not stopped.  As one example, the StopTB Partnership reported this week that “the measures taken for the COVID-19 pandemic produce significant disruptions in the TB Programmes and the TB response and have a massive impact on communities and people affected by TB, and especially among the most vulnerable who are struggling to get their treatment, care and other types of support“.  The impact on national TB programmes includes:

  • National TB programmes are involved in the Covid19 response
  • TB facilities are being used for the Covid19 response
  • Fewer people are presenting to TB services for diagnosis and treatment due to curfew restrictions
  • National TB Programmes have less capacity to monitor TB treatment
  • TB patients are no longer receiving the nutritional support they rely on
  • False information circulating in vulnerable communities

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In Cambodia people are being warned not to use the (counterfeit) self test kits being sold on the private market.  People are afraid, they have low health literacy, no trust in official sources of information, very few cases of Coronavirus to date, and hunger is setting in.

The far reaching public health consequences of this pandemic and the global response are … complex and confusing.

Author: Helen T

Master of Public Health. Long standing experience with infectious disease surveillance (including influenza-like-illness monitoring), outbreak control, case management, vaccination program management. There is no health without liberty and justice. Ask anyone existing in poverty.

4 thoughts on “Complex and Confusing”

  1. The behaviour of people in places like Cambodia where there is so much fear & health illiteracy can almost be understood. The behaviour of those people in our countries where there is so much information & help available, but who continue to ignore advice is unforgivable

    Like

  2. Thanks, Helen. May the infection rate remain low in Cambodia. If it doesn’t, they will be in real trouble…Scary, confusing times for all.

    Liked by 1 person

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