Covid-19 Outbreak Not yet Under Control
The soaring number of new Covid-19 cases in Indonesia indicates that the outbreak is not yet under control. WHO considers Indonesia to have not met the requirements for the “new normal”.
The soaring number of new Covid-19 cases in Indonesia indicates that the outbreak is not yet under control. WHO considers Indonesia to have not met the requirements for the “new normal”.
JAKARTA, KOMPAS— The Covid-19 outbreak in Indonesia is not yet under control, as indicated by the continued increase in new cases and high death rates.
According to the World Health Organization (WHO), Indonesia has not met the six criteria to gradually lift social restrictions or to move toward the new normal. The requirements include, among others, controlled virus transmission, adequate health system capacity, minimizing the risk of transmission in areas with high vulnerability, as well as optimal citizen involvement.
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Government spokesman for the handling of Covid-19, Achmad Yurianto, said the daily increase in new cases reached 1,111 on Friday, raising the total number of confirmed Covid-19 cases in the country to 36,406. The number of recovered patients increased by 577 people, bringing the total number of recoveries from the disease to 13,213, while the death toll rose by 48 to 2,048 people.
Regions with the highest number of new cases include East Java (318 cases), Jakarta (93 cases) and North Sumatra (88 cases). The increase was partly due the release of the results of examinations of 15,333 swab samples taken from 7,476 people in 398 laboratories in Indonesia during the day.
East Java overtook Jakarta as the province with the highest number of deaths caused by Covid-19. The death toll in the province reached 575 people from the total cases of 7,103 people. In Jakarta, the death toll reached 540 from the total cases of 8,647 people.
The actual deaths caused by Covid-19 in Indonesia is thought to be much higher than the official figure because the number of people under surveillance (ODPs) and patients under surveillance (PDPs) who died is also high.
WHO records
According a report issued by the WHO on June 10, 2020, (based on monitoring on May 18 to June 7, 2020), the number of confirmed cases in several regions in Java had showed a declining trend. However, except Yogyakarta, the number of Covid-19 patients who died, including PDPs, continued rising.
WHO report indicated that the PDPs who died was higher than those who have tested positive for the coronavirus in all provinces in Java except in East Java.
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For example, the number of the confirmed Covid-19 patients who died in Jakarta totaled 35 people during 18-24 May, 2020, far lower those with PDP status, which reached 75 people. During May 25-31 period, the Covid-19 patients who died numbered 16 people, also higher than those with PDP status which reached 151 people. On June 1-7 2020, the number of Covid-19 patients who died totaled 12, far below the death toll of patients with PDP status which reached 134 people.
Irma Hidayana, a public health expert who is also the founder of Laporcovid19.org, said the high number of PDPs and ODPs who died indicated that the lack of tests and the long delay in the issuance of test results.
As a result, many patients died before the test results were obtained and even before being tested.
Based on recapitulation of data from districts / cities in Indonesia, the number of PDPs and ODPs who died was 3.5 times higher than those of confirmed patients. "Indonesia should have followed WHO’s guidelines to also report the number of ODPs and PDPs who died, not only the confirmed ones. It will reflect the real condition so that the people will be more alerts, “she said.
The first wave of the disease transmission has not yet reached its peak.
Epidemiologist from the department of the public health at the University of Indonesia, Syahrizal Syarif, explained that the curve of Covid-19 transmission cases in Indonesia continued to show an upward trend. The first wave of the disease transmission has not yet reached its peak.
With this condition, the government should not rush to ease the social restrictions and to reopen economic activities. Moreover, a survey on people\'s perceptions in Jakarta conducted by Nanyang Technological University found, from a social aspect, residents were not ready yet to face the new normal.
Indonesian epidemiologist who teaches at the University of South Australia, Beben Benyamin, said, learning from a number of other countries, easing restrictions before the plague subsided could trigger a more devastating outbreak. This happened in Iran and a number of states in the United States.
After loosening social restrictions, a number of countries, such as South Korea, Italy, Germany, and China, recorded an increase in new cases of Covid-19 or local transmission. On Thursday (11/6), the South Korean Center for Disease Prevention and Control reported 56 new cases of Covid-19, bringing the total to 12,003 cases, and 277 of them died. More than 96 percent of new cases have occurred in the Seoul metropolitan area the past two weeks.
"In Australia and New Zealand, easing was carried out after the number of new cases fell below 10 people. Even with zero cases, restrictions are still in place. In South Australia, there has been zero cases in two weeks, but the border with other regions is still closed, "said Beben.
Vice President Ma\'ruf Amin said, due to the risk of a prolonged crisis, the government eased the social restrictions as a transition to a new normal era. However, the people were so excited with the relaxation and forgot the health protocol.
Mandatory requirements
The WHO report mentions a non-negotiable condition before a country lifts social restriction as a transition to a new normal, namely the examination of swab samples using polymerase chain reaction (PCR) method 1 per 1,000 people per week in the transmission area, with test results coming out within 24-48 hours. All people suspected and confirmed of Covid-19 infections must be isolated and there should be enough health facilities.
According to Beben, PCR-based molecular diagnostic tests are key to overcoming the Covid-19 outbreak. However, up to four months since reporting the first case, Indonesia has a problem in conducting such tests causing the delay in the handling of the disease.
The requirement that the stab test should be conducted only to people whose rapid tests show reactive result should be removed.
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Tri Maharani, an emergency specialist from Kediri, East Java, complained about the complicated test procedure. "The requirement that the stab test should be conducted only to people whose rapid tests show reactive result should be removed. My rapid test showed negative, but the result of my swab test was positive. Rapid tests are not accurate, “she said.
According to Our World in Data, the number of Covid-19 tests in Indonesia is among the lowest in the world.
"Referring to the WHO recommendation, Indonesia should have tested at least 40,000 people per day. With the large population and wide spread of the virus, Indonesia should check 100,000 per day, "said Elina Ciptadi, founder of Kawalcovid19.id.
Meanwhile, a member of the expert team for the Covid-19 task force, Ari Fahrial Syam, said two main studies on Covid-19 were under way, namely stem cell-based therapy and Covid-19 drug combination. In addition, a research team from Airlangga University and the State Intelligence Agency has found five combinations of effective drug regimens that inhibit the SARS-CoV-2 virus that causes Covid-19. (Reuters/AP/ADH/SAM/AIK/TAN/INA)