Time to Tighten Social Restrictions as Health Care at Critical Point

Some 102 doctors have died of Covid-19, and thousands of others are fighting the disease. It is high time to tighten social restrictions to curb the disease’s spread.

KOMPAS/AGUS SUSANTO

Medical workers wait for visitors on Monday (31/8/2020) at an outdoor testing facility set up at the Puskesmas (community health center) in Duren Sawit, East Jakarta. About 90 residents visited the center on Monday to take polymerase chain reaction (PCR) tests, or swab tests. The records of the Indonesian Medical Association (IDI) show that 100 doctors had died on the Covid-19 front lines by the end of August, while Indonesia’s test positivity rate continues to increase.

JAKARTA, KOMPAS – Indonesian Doctors Association (IDI) data of Monday (31/8/2020) show that two more doctors have succumbed to Covid-19, namely Elly Zaini of Padang Sidimpuan, North Sumatra, and Bawono Hasan of Jakarta. Consequently, at least 102 doctors have died of Covid-19. In addition, nine dentists and at least 68 nurses have also died of the disease.

“We are worried that the number of victims will continue to increase, as thousands of medical workers have caught the disease, with some of them hospitalized,” IDI Covid-19 task force chief Zubairi Djoerban said in Jakarta.

Zubairi added that SARS-CoV-2, the virus that causes Covid-19, continued to spread with an increasing positivity rate. More patients were being hospitalized, resulting in referral hospitals reaching full capacity and medical workers facing a swelling burden.

Also read: The Safety of Health Workers is Crucial

“The situation is getting worse. Therefore, we are pleading with the government to apply the emergency break. It is time to tighten social restrictions and reduce activities that can attract crowds. Do not open movie theaters or allow concerts. We also hope that people adhere to health protocols,” Zubairi said.

The national Covid-19 task force reported on Monday that 2,743 new cases had emerged in the past 24 hours, bringing the total number of confirmed cases nationwide to 174,796. The 2,743 new cases were identified among 14,566 tested persons, making for a positivity rate of 18.83 percent.

The situation is getting worse.

KOMPAS/RONY ARIYANTO NUGROHO

Cemetery workers in protective gear bury a Covid-19 victim on Monday (31/8/2020) at Situ Gede Cemetery in Bogor, West Java. The Covid-19 Mitigation Task Force’s records show that of 597 confirmed cases in the city, 31 patients had died of the disease by 10:00 a.m. on Monday. Bogor has again been declared a “red zone” of high-risk Covid-19 transmission.

Increasing risk

Jakarta-based pulmonologist Eva Sri Diana said the high number of patients and medical workers catching the disease had severely increased the burden of medical workers, especially pulmonologists.

“Even Jakarta has a shortage of pulmonologists. For months, I was the only pulmonologist in a private hospital, and I still have to work in a state hospital. In a day, I might handle more than 80 Covid-19 patients,” Eva said.

Eva said the heavy workload and lack of rest were the highest risk factors for transmission among medical workers handling Covid-19 patients. “This is what happened to my close friend, the late pulmonologist Andhika Kesuma from Medan, who died after helping patients fight Covid-19. As pulmonologists, we are disciplined in wearing personal protective equipment [PPE]. So, if someone says we were undisciplined, that person is wrong,” Eva said.

Also read: Dilemma of Regional Health Protocol Enforcement

Emergency specialist Tri Maharani of Kediri, East Java, also rejected the opinion that so many medical workers died of Covid-19 because they were undisciplined in wearing PPE. “I was among the most stringent in wearing PPE, but I still caught the disease from my patients,” Tri said.

Other than the workload, a lack of standardized infrastructure in hospitals may also contribute to transmission risk among medical workers. “Not all hospitals, especially in remote regions, have negative pressure rooms. Without this, the risk of airborne viruses remains high, even when we wear full PPE,” Tri said.

Also read: Pandemic: From Health, Economy, to Politics

KOMPAS/RADITYA HELABUMI

A woman passes by a wall mural reminding people to wear masks and observer physical distancing in an alley in Krendang, West Jakarta, Monday (31/8/2020). Public compliance with the Covid-19 health protocol is key to reducing community transmission.

Transmission risks are also found in medical workers’ neighborhoods. This was seen in Surabaya and Madura, East Java, where an entire family caught the disease and died from it. “In Wuhan, China, medical workers were provided with their own quarantine spaces. This would really help protect communities from infection,” Tri said.

Given the high exposure risk, medical workers should have access to routine testing. “I had this when I volunteered at the Sulianti Saroso Hospital. However, once I returned here, I have not had this, let alone routine testing. Many medical workers with a history of contact with confirmed Covid-19 patients are facing difficulty to get tested. Many of them die from delayed diagnosis and treatment. This is tragic,” Tri continued.

Ceased services

Covid-19 among medical workers has been found in several regions. In the Ciasem community health center (Puskesmas) in Subang regency, West Java, 41 medical workers were found with Covid-19. Consequently, all services have been ceased until next week.

In Jayapura, Papua, 17 medical workers have been exposed to Covid-19. “Medical workers with Covid-19 are found at almost all Puskesmas in Jayapura,” Jayapura Health Agency head Ni Nyoman Sri Antari said.

Also read: Health Protocols Should Not Be Ignored

Kompas/Hendra A Setyawan

A convenience store clerk prepares to close an Alfamidi outlet at 6 p.m. on Monday (31/8/2020) in Bojongsari, Depok, West Java. The Depok municipal administration has imposed a 8 p.m. curfew on the city starting Monday to curb the spread of Covid-19.

Meanwhile, two doctors tackling Covid-19 in Medan, North Sumatra, have also succumbed to the disease. "Let’s lighten medical workers’ burden by increasing our discipline in adhering to health protocols,” North Sumatra Covid-19 task force spokesperson Aris Yudhariansyah said.

National Covid-19 task force spokesperson Wiku Adisasmito said that one of the factors behind the high Covid-19 fatality rate among medical workers was their overwhelming workload. Hospital management must manage medical workers’ shifts properly to prevent them from getting overly exhausted.

The head of the Health Ministry’s human resource development center, Abdul Kadir, said the ministry had reduced the fatality rate among medical workers by containing the spread Covid-19 in hospitals, increasing health protocol enforcement inside of and outside of hospitals, as well as continuously providing psychological support for medical workers.

(AIK/TAN/FLO/MEL/NSA)