The World Health Organisation (WHO) is working closely with the Ministry of Health (MOH), the Royal Government of Cambodia and technical partners, including the US Centres for Disease Control and Prevention (US CDC) and Institute Pasteur Cambodia, to support the public health response to the Holland America MS Westerdam cruise ship event in the context of the coronavirus disease 2019 (COVID-19) outbreak.
According to a press release from WHO, 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 Feb. 14, 2020, a decision was made by the Royal Government of Cambodia to allow passengers to disembark based on the following measures taken:
Maritime Declaration of Health that was received by the port authority indicating 18 persons on board had been ill during the voyage. A health declaration form issued by the MOH was also completed by all persons. Samples were taken from 20 persons who had reported mild flu-like illness or gastro-intestinal symptoms either currently or during the trip. All the samples tested negative for COVID-19 at the Institute Pasteur Cambodia prior to disembarkation.
Before disembarkation, temperature screening was conducted by the Ministry of Health and the local public health authorities for all persons and no fever was detected.
On Feb. 14, 2020, passengers began disembarking the Westerdam in Sihanoukville and were transported to Phnom Penh en route to their home countries. Some of the passengers were subsequently allowed to leave by plane, including via Kuala Lumpur, Malaysia.
Following temperature screening by Malaysian authorities on Feb. 14, 2020, an 83-year-old American woman and her husband arriving in Kuala Lumpur from Phnom Penh (who were passengers on the Westerdam) were isolated for testing for COVID-19 based on temperature screening. The tests by Malaysian authorities were positive for COVID-19 for the woman passenger; her husband tested negative. The woman passenger remains in isolation in Kuala Lumpur and is in a stable condition.
In response to the newly confirmed case in Malaysia, the Ministry of Health of Cambodia convened an emergency working group meeting to agree upon the priority actions required. Key public health measures have been implemented and are ongoing:
Health screening of all persons for symptoms who were on board the Westerdam and are currently in Phnom Penh and in Sihanoukville.
COVID-19 laboratory testing for the persons who were on board the Westerdam and are still in Cambodia.
Self-monitoring for symptoms by all persons who were on board the Westerdam. Persons who have symptoms such as fever, cough or difficulty breathing, are asked to contact their local health authority and share their previous travel history.
WHO, US CDC, Pasteur Institute Cambodia and concerned Embassies have been actively on the ground in Sihanoukville and Phnom Penh supporting the Government of Cambodia's response.
WHO response to the Westerdam Cruise Ship event
In collaboration and coordination with key partners, WHO is providing technical and operational support to the Ministry of Health to strengthen their public health response, including:
Conducting public health risk assessments to inform risk management based on the information available and the current understanding about the new virus.
Advising on public health measures at the international points of entry (i.e. Sihanoukville Port).
Facilitating information sharing and situation awareness among Member States, in line with the International Health Regulations (2005) or the IHR (2005).
Coordinating international efforts to support Ministry of Health's public health response, in close collaboration with the US CDC, Institute Pasteur Cambodia and other key partners.
Providing technical and operational support in response to the newly confirmed case in Malaysia linked to the Westerdam cruise ship event, including contact management, public health advice and information sharing, including to other countries through WHO Country Offices and the IHR (2005) Event Information Site.
Providing situation updates and advice on preparedness efforts through various existing mechanisms such as the MOH-led Technical Working Group for Health (TWGH), the UN Country Team (UNCT), Health Partners Group (HPG), and development partners.
WHO has established an Incident Management System (IMS) across three-levels of the organisation to manage the ongoing COVID-19 outbreak, as guided by the WHO Emergency Response Framework.
In the WHO Country Office in Cambodia, WHO has activated its IMS to support the MOH's preparedness for and response to COVID-19. The functions of the IMS include leadership and coordination; health operations and technical expertise; information and planning; operations support and logistics (including personal protective equipment or PPE); and finance and administration. WHO provides technical advice in the areas of surveillance and risk assessments, lab testing, clinical management, infection prevention and control, risk communication, and public health interventions.
Preparing for future outbreaks
The COVID-19 outbreak is still evolving and it remains a Public Health Emergency of International Concern (PHEIC) which was declared by the WHO Director-General on Jan. 30, 2020. All Member States, including Cambodia, are strongly advised to prepare for a good response to additional cases and possible widespread transmission, as guided by the COVID-19 Strategic Preparedness and Response Plan.
In Cambodia, while WHO has been technically and operationally supporting the Ministry of Health in responding to its first imported case as well as the Westerdam cruise ship event, just as important is preparing for the possibility of wider transmission. So far, Cambodia has had only one confirmed case of COVID-19, who has now recovered and been tested negative for the disease. But as the Westerdam cruise ship event shows, preparedness action is needed to ensure a rapid response.
To prepare for community transmission, WHO is working with the Ministry of Health and other partners to update Cambodia national preparedness and response plan and identify gaps for priority preparedness actions. The priority areas to be prepared for community transmission include:
Incident management, planning and multisectoral coordination; including surveillance and risk assessment, laboratory, clinical management and health care services, infection prevention and control, non-pharmaceutical public health measures, risk communication, points of entry, and operational logistics.
Source: Agency Kampuchea Press