Correspondence Address:
Viroj Wiwanitkit
Dr. D.Y. Patil University, Pune, Maharashtra
India

Full Text



Sir,

COVID-19 is a new emerging pandemic global public health issue. This new respiratory disease affects >200 countries worldwide and cause disease in more than 9 million of global population. The cross-boundary infection is an important issue for disease control. Since the disease might occur anywhere at present, disease control in any country has to focus on both importation and exportation of the infectious case.[1] Normally, when a disease is diagnosed, the patient should be managed as soon as possible. Here, the author would like to discuss on the situation of international referral that COVID-19 was detected in a country and treatment in another country. Indeed, referral is a common phenomenon when the patient cannot afford or does not prefer to get medical care in a setting. According to the patient rights, the patient might request for referral. Here, the author would like to draw attention to local data in Cambodia, a tropical country in Indochina. Cambodia implements policies to give COVID-19 care for everyone regardless of nationality. Hence, it is possible that there might be international referral to Cambodia. At present (23 June 2020), there are 130 COVID-19 cases in Cambodia. Of these cases, there is at least 2 patients who is a foreigner who got the first diagnosis of COVID-19 in a private hospital in a country next to Cambodia but could not afford for treatment cost, therefore, the patient went to Cambodia and asked for treatment (see details of case at https://cambodianess.com/article/two-indonesians-becomes-cambodias-latest-covid-19-patients). The incidence is equal to 1.54%. An interesting consideration is on the system of patient referral from the first site in a private hospital in another country to Cambodia. There is no detail that there is an official record of this case in the first country or not and it is questionable whether there is a concern that there is a patient along the transportation path and international border control or not. This is an interesting situation and big challenge in disease control in developing countries. Furthermore, a country usually tries best to keep the situation in the country to be free from disease without concern for the others. Hence, there is usually an under-diagnosis of the COVID-19 case. The disease report system in developing might not effective and there might be underreported case.[2]. Sometimes, a private medical care center might neglect to follow standards for disease control.[2] During the crisis, the cost of care but the disease control should be the main focus.

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