To His Excellency Lok Chumteav in the group I just organized to consider and to prepare a step ahead. During the inter-ministerial meeting, HE Mam Bunheng proposed the arrangement for home treatment. Now we need to predict the sustainability of the hospital. If the disease does not decrease, our hospital will be overflowing with patients, both mild and heavy. We have to have an arrangement applying the approach taken by countries with a large number of patients, such as the United States, France, (other countries in) Europe, and some countries where there are more patients than the ability to provide treatment by hospitals.
As in the case of two of our diplomats infected with Covid-19 in France, the hospital did not accept them in for treatment. They were sent back home for treatment. Our Cambodian brothers and sisters abroad, both in the United States and in France, suggested to me that measures should be taken to arrange for home treatment and to take patients to hospitals only when they are seriously ill. I would like to ask our team to prepare a code of conduct for home treatment, by which, at some point, we should consider in what condition that we should admit patients to hospital and what condition we keep them home for treatment. Should there be constantly increasing number of patients, we cannot hospitalize them all. Fewer people are getting better, and more need treatments. Even if we set up a few more hospitals, it will not be enough. In this knowledge, the solution is only to leave the mild Covid-19 positive cases treated at home. There must be however a clear judgment.
That judgment, in my opinion, is based on two points. The first point is those to be kept for treatment at home must be someone who has a mild illness and has a decent home where home treatment can be done. If the person is seriously ill, we cannot leave him/her at home, but take him/her to the hospital. If his/her home is too small and confined to spread disease further to family members, we also should take him/her to a hospital. I think at least 50% of patients have homes where they can and/or like to have such treatment at home, we just prepared a code of conduct (which will) require what the patient should do? What to do to keep him in one place and his roommates? How can the community and local authorities take care of him? What should the doctor do to prevent him from leaving the house? and other related matters.
I think we will come to that stage if the February-20 Covid-19 Infection Event does not slow down from the speed it is now. In particular, it has been happening in Phnom Penh and Kandal province, which is adjacent to Phnom Penh … and is not just a problem of Cambodia. (It has been happening) even developed countries like the United States, France, and other countries in Europe. They cannot put them all in the hospitals, while in addition to Covid-19 hospitals have to treat other diseases as well. We have selected only a few hospitals for the Covid-19 patients – the Khmer-Soviet Friendship Hospital, Chak Angre Hospital, Tuberculosis Hospital, and finally the Luang Mae Hospital.
Well, at this point, I would like to ask you to take action to organize the code of conduct as soon as possible so that by the time that we find out this or that person is Covid-19 positive, we (have a code of conduct with which) to follow to tell her/him to stay and receive treatment at home. At home, we also need to facilitate them so that they can live comfortably. We can arranged to support them, in addition to treatment, in such a way as we do to those in quarantines. We provide him/her 20,000 riel/day so that the family can help prepare this food for him to supplement for treatment.
Of course, his/her family was able to help, but we also had to help more patients who we did not admit to the hospital. Therefore, it is necessary to have teams of mobile doctors providing treatment from one house to another, and if possible, the person to administer treatments should be a local doctor who we train him/her so that s/he can participate. It is difficult for us to take the doctors from the hospital to provide such home treatments, so it is good to find a group of volunteer doctors in each district to facilitate, because the people that they are going to provide treatment are not seriously ill.
In case of suspected serious illness, we need to take him/her to the hospital. This means that doctors provide (in-house) treatments within the framework of mild Covid-19 positive patients, not critically ill. In this case, the district doctors can help solve this problem. We pay for the volunteer participation of those doctors. So, please prepare this code of conduct for home treatment … If you see (that the level of the disease) is mild and s/he has a suitable place to be treated, let her/him be treated at home to reduce congestion in hospitals as it would be beyond our control and can affect patients of diseases other than Covid-19.
Thank you for your attention and please take this matter into consideration. His Excellency Mam Bunheng has to lead this work because the request that was made earlier also stated about the preparation of this home treatment, but we have not yet implemented it. In the time to come, we may proceed to take this policy into action. While staying at home, patient/s can receive care from his/her/their family, even if the family cannot be close and/or is in quarantine at the same time. We need to donate them at least 20,000 Riels per day according to the rule we set and implement for those in quarantines.
This may serve as one of the solutions, and while implementing this, the authorities can help those in treatments with food supply, as the Phnom Penh City Hall used to do – supplying rice, pork, etc. to the families in quarantines. In this development, policies will come along with the coming code of conduct. Thank you./.