After a year-long record of zero human loss, the Kingdom might have double down efforts to save her people and the economy by making several unaccustomed moves

News of Cambodia’s first Covid-19 fatality, a 50-year-old driver from Phnom Penh, sent the social media into a frenzy, and shivers across the local stock exchange, which saw a $66.6 million wipe out of the index’s total market capitalisation year-to-date on Thursday.

The index slipped 1.3 per cent from the beginning of 2021 to close at its lowest level of 632.45 points, as total trading activity fell the most in that period while investors paused to employ a “wait and see” approach.

“If this situation continues, investors may switch from companies that are more affected [by the pandemic] to less affected ones,” said Cambodia Securities Exchange chief operations officer Ha Jong Weon.

Out of the seven Mainboard-listed counters, four were losers, two gained and one remain unchanged.

Judging from the sudden turn of events, Ha felt that investors might be inclined to trade more based on company fundamentals and technical analysis.

The loss of Cambodia’s first Covid-19 patient culminates after a full-year battle of trying to keep the contagion under control without fatalities, notwithstanding two or three upheavals.

Its efforts, which were lauded by the World Health Organisation and other international bodies, saw the Kingdom charting a comparatively mild uptick to its neighbours since the pandemic began.

Still, just as the country comes off a historical contraction in gross domestic product (GDP) at minus 3.1 per cent in 2020, this latest wave, and most critical at that, is expected to press down on economic growth in 2021.

The National Bank of Cambodia projected a four per cent growth this year, far more modest than International Monetary Fund’s prediction of 6.8 per cent last October.

“If the outbreak fails to be brought under control in one or two months, it will likely drag down 2021’s growth prospect, hurting the main sectors of the economy, particularly export-oriented sectors,” said economist Dr Chheng Kimlong.

As it is, the current outbreak of community transmission has had a negative impact on the economy, particularly the rising budgetary expenses in having to cope with the spread.

Added to that is the voluntary or involuntary temporary closure of businesses and service centres, as well as travel restrictions to contain and prevent a larger spread, Kimlong said.

Having said that, he contends that the government would continue expending its maximum $2 billion current fiscal and non-fiscal stimulus programmes to support businesses and individuals affected by the pandemic.

The country has also raised over $30 million to purchase vaccines while separately receiving an estimated $40 million of foreign aid from countries such as the US and Australia to combat Covid-19.

This is independent of the loans, grants and credit line provided by the World Bank and Asian Development Bank over the course of 2020.

As of June 30, last year, multilateral partners had dispensed a cummulative sum of $4.7 billion, Ministry of Economy and Finance’s Public Debt Statistical Bulletin for the first half of 2020 showed.

“At the moment, it appears the government is able to handle the current developments with its own resources and the supports from its bilateral and multilateral sources,” Kimlong said.

Since the beginning of the latest outbreak on February 20, business activities, sales, production-related sectors, tourism and travel sectors, have been disrupted.

In that duration, Covid-19 cases have shot up to 1,163, with 653 of them related to the current incident. Overall, 597 people have recovered.

As the numbers grow, the Covid-19 inoculation campaign, which started slow, has picked up with frontline workers including government officials, journalists and garbage collectors making a beeline for vaccines.

Nevertheless, vaccination would take time before Cambodia can reach herd immunity, seeing that the nationwide target is 10 million people.

Kimlong said a faster pace of vaccination scheme is needed, along with government interventions and precautionary measures such as the “3 do’s and 3 don’ts” and the use of quick response (QR) codes for contact tracing.

This falls in line with Moody’s Analytics Inc research which found that Asia Pacific nations could be looking at 2022 and even 2023 before herd immunity is achieved due to “late starts, considerable logistics and administrative roadblocks” in rolling out the vaccines.

Drawing a parallel to China, it said, despite its lead in economic recovery and virus control, China’s current vaccination pace meant that it is looking at sometime in 2022 before travel restrictions are broadly eased.

Cambodia Investment Management Co Ltd (CIM) CEO Anthony Galliano agreed, noting that the pace in China is currently sluggish.

“I can’t see any meaningful scale of Chinese travel flow until the populace of Cambodia is substantially vaccinated, and potential tourists have a green light to enter, probably in the form of a vaccination passport,” he said.

But until that shift happens, the slow Chinese travel market would continue to hurt Cambodia’s economy which in the last few years lapped up the earnings from high Chinese tourist dollars.

In any case, Galliano suggested that for the short-term, it is prudent to limit arrivals from China, given the recent history of those infected here.

“Although economically painful, brighter skies are on the horizon as vaccinations are broadly implemented, and the country can reopen in a more safer and secure state,” Galliano said.

All that is yet to be seen.

Stop queue jumpers

In the past week, an eyebrow-raising episode has been unfolding in the capital city’s Calmette Hospital as luxury vehicles including Rolls Royces, Audis and Range Rovers pulled into the compound, as if a red carpet event was underway.

It caught the eye of hundreds of prospective vaccine receivers, and patients, who filmed the bevy of vehicles, as they waited for their doses along the hospital corridors.

“Some of these luxury cars bore green colour licence plates,” an observer said, in reference to government officials who alighted from those vehicles, adding that they were most likely there to get their Covid-19 shots.

Over at the National Paediatric Hospital, about four kilometres from Calmette, a different kind of scene unfurled as tens of people were turned away despite possessing early-bird tokens.

“I was at the hospital since 4am only to be told that there are no more doses left for the day as the daily quota of 150 people was filled up,” said a man, who declined to be named.

Accordingly, the nationwide inoculation programme for first dose receivers using state-owned China National Pharmaceutical Group Co Ltd’s Sinopharm vaccine has been suspended after stocks ran out.

Acknowledging the shortage, the man, who experienced three unsuccessful vaccine trips for similar reasons, however hoped that a proper system is strictly imposed to deter queue jumpers who were largely present on all occasions.

“I heard that this [queue jumping] was not the case earlier last month as there were fewer people interested in the vaccines. Now, everyone is trying to get the jabs because of the rapid multiplication of cases,” he said.

It did not help that two previous deaths, which were dismissed as not being related to Covid-19 or the vaccine, caused a panic among the people, caused the rush.

A general opinion is that the situation is expected to worsen with the death of the driver, an employee of a Chinese national who was also tested positive for Covid-19.

The burgeoning cases within a short period of time is evidently stressing efforts to control the situation while trying to inoculate as many people despite limited doses.

Since February 10, with the arrival of 924,000 Sinopharm and Oxford-AstraZeneca’s Serum Institute of India-licensed Covishield doses, some 190,000 people have been vaccinated.

Cambodia is on standby for the remaining 770,000 Covishield doses via the COVAX Facility while China has pledged to donate another 400,000 doses of Sinopharm by April.

Flawed consent forms

In the meantime, vaccine receivers have been subjected to a Ministry of Health (MoH)consent form that bears inaccuracies.

A check revealed that the segment on “knowing the vaccine’s risks” talked about a vaccine, presumably the very vaccine that is being administered on the receiver, uses the “messenger Ribonucleic acid” (mRNA) technology.

It noted that in the short-term there is only limited data on the safety of the vaccine and no long-term data.

Written in Khmer, the document, which is given to every receiver, be they locals or foreigners, said: “[The] vaccine is made from the mRNA technology, [which is] a completely new technology … especially [as] it is still in experiment stage … it can [unexpectedly] affect the health in the long-term.”

It should be noted here that neither Sinopharm nor Covishield, the only two Covid-19 vaccines in Cambodia available in Cambodia presently, are developed using the mRNA technology.

To be sure, this novel technology is only employed by US-produced Pfizer-BioNTech and Moderna vaccines.

Sinopharm’s technology is built on the components of an inactivated Covid-19 virus whereas Covishield uses a weakened version of a common cold virus.

The agreement also pointed out a possible risk of a severe Covid-19 re-infection that might impact the immune system after vaccination.

“So far, there is a report on the case of some severe side effects that occurred during the vaccine test of AstraZeneca which include spinal infection on one or both sides, and other nerve problem[s],” it stated.

In addition, one of the points on the document read that doctors are required to decide if vaccine receivers are at risk of falling ill.

This is pertinent, because the following point states that vaccine receivers “must be told that the vaccine producer has been given immunity from being responsible of accidents or deaths caused by the vaccine”.

According to international lawyer Chee Yoke Ling, this clause is present in Covid-19 vaccine receiver agreements, as western companies have insisted that the government buying the vaccines give them liability indemnity.

“So, some countries include it in the consent forms of vaccine recipients,” noted the director of Malaysia-based Third World Network, an independent non-profit international research and advocacy organisation involved in issues relating to development, developing countries and North-South affairs.

Chee said in Malaysia, the consent form has a clause showing that the benefits outweigh the risks, and that any risk will be borne by the recipient. “This has created concerns, of course.”

Several attempts to seek clarification from MoH spokesperson Or Vandine proved futile.

Regardless, many who signed the form did so without hesitation and unaware of the clauses because they thought it was a standard document.

Some said they did not ask for a thorough explanation as the medical staff were pressed for time due to long queues, and that the document was riddled with medical jargons, making it difficult to understand.

Others seemed unperturbed by the inaccuracies.

Medical services tested?

For most people, the quest for vaccines at any cost was spurred by the viral news of several foreigners, mostly Chinese nationals, being tested positive, in the late evening hours of February 20.

Record speed shares of videos of the escape of an alleged Covid-19 positive person from a hotel earlier in the month, police road blocks to control movement at Koh Pich, and an ensuing speech by a visibly distressed Prime Minister Hun Sen convinced people that the pandemic was far from over. By the end of that day, the tally of new cases was 49.

Up to February 19, the seven-day average for new cases ranged between zero and seven, mostly one, according to the Covid-19 Data Repository by the Center for Systems Science and Engineering (CSSE) at US-based Johns Hopkins University.

Following the spike, the seven-day average scaled up to eight, peaking at 40 before easing to 36 on March 10.

Total number of cases have propelled beyond 1,000 within two weeks of February 19, when cases stood around 484.

It also signaled the start of the country’s largest community transmission, and a rush of vaccine tawwkers who were previously unmoved by Sinopharm.

The second leg of inoculation, this time with Covishield, is at risk of running dry if the panic continues even as stricter movement control and shutdown orders for entertainment outlets, sports centres and schools are imposed.

One government source opined that a city-wide lockdown in Phnom Penh is imminent, as Siem Reap implements strict measures with roadblocks to stop entry from other risk-driven provinces.

As it is, many parts of Sihanoukville, which has seen a spiraling increase in cases, has been under locked down since February 24.

That said, the medical service has been coping well with the current infection rate for the moment, said Kimlong, who is the vice president of independent think tank Asian Vision Institute.

“It is too early to predict what might turn out,” he said, dismissing the notion that the service is being put to test.

Kimlong felt that it was important and necessary for Cambodia and other developing governments investing in epidemic and pandemic response capabilities, including medical science and research, to build a system of readiness and preparedness.

It might explain the motive behind the express passing of the Law on Measures to Prevent the Spread of Covid-19 and Other Serious, Dangerous and Contagious Diseases. As the name suggests, the law is likely to be used to curb the movement of people in time for the Khmer New Year in April.

The latest outbreak had greatly escalated the challenge of containment and maintenance of economic endurance, just as the vaccine arrived and gained traction, said CIM’s Galliano.

He opined that with a post-Covid-19 global economic prosperity in the offing, the Kingdom should consider substantial short-term measures to mitigate the spread, a sacrifice that will produce “handsome medium-term gains” if the country emerges as prepared and able when the opportunity arises.

“The recent spread has positioned [the country] at a crossroad, confronting the government with some demanding decisions, the balance of keeping the economy afloat and ensuring the security and safety of the populace,” he said.

The most serious risk is the potential to overwhelm the healthcare system which has occurred in many other countries with severely damaging results, a risk Cambodia cannot afford to assume.

“With the rising cases and border transmission, the inescapable decision is whether to partially or totally lockdown. Unless there is a reversal of the current trend, the government might need to take these significant measures, which in the end, if it is short-term would have only a modest economic impact,” Galliano said.

With the accelerations of vaccinations and more impactful measures of containment, the country can deal with the short-term economic interruption and emerge ready to take advantage for the global recovery, he added.