Increase Hospital Capacity

KOMPAS/AGUS SUSANTO

An employee from the Public Facility Maintenance Agency (PPSU) makes finishing touches to a wall mural on Friday (4/9/2020) along Jl. Bukit Duri Utara in Tebet, South Jakarta. The mural is part of a campaign to show appreciation to frontline health workers as they battle rising daily incidence rates of Covid-19 infection, due primarily to people who continue to ignore the health protocol.

The treatment rooms for Covid-19 patients in a number of hospitals are becoming fully occupied. An increase in the capacity for services is urgently needed, accompanied by the availability of health workers.

JAKARTA, KOMPAS — The increasing number of confirmed cases of Covid-19 has caused treatment rooms for the disease in a number of hospitals to become fully occupied. This has forced hospitals to increase service capacity by adding more beds and intensive care facilities. The government is expected to ensure the availability of health workers.

Indonesian Private Hospitals Association (ARSSI) chairperson Susi Setiawaty said in Jakarta, Tuesday (15/9/2020), that 36 private hospitals (RS) in Jakarta served as referrals for Covid-19 patients. Increasing the capacity of the hospitals is now being carried out because a part of the services has been fully utilized.

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"By adding more beds, the demand for health workers and other facilities such as personal protective equipment increases. We have difficulty meeting the medical personnel. Do not ever let the addition of beds even increase the workload of the health workers," she said.

Head of the Business Development, Marketing and Public Relations Division of Atma Jaya Jakarta Hospital Ferry Herwindo said, of the 11 beds provided for Covid-19 patients, now all of them are fully occupied.

According to the plan, Atma Jaya Hospital will add 24 beds for the isolation of Covid-19 patients. "The increase of the capacity is still being financed by the hospital. To meet the demand for human resources is still carried out independently because there has not been any regulation on mandatory state defense nor a state call for paramedics to work at the Covid-19 referral hospitals," he said.

An increase in the number of Covid-19 patients also occurred at Pertamina Central Hospital (RSPP). Therefore, Deputy Director of Medical Support at the Pertamina Central Hospital Jakarta Syafik Ahmad said the capacity was increased from 90 to 260 beds. "We will add up to 300 beds," he said.

In a number of areas, such as Tangerang city, the rise in the number of Covid-19 patients has made the availability of beds in hospitals run increasingly low. Meanwhile, Depok Mayor Mohammad Idris said that the availability of intensive care units (ICU) and high care units (HCU) has been running out. "There are 19 referral hospitals in Depok, 63 percent of the capacity for patients with mild symptoms of Covid-19 has been occupied, 81 percent of the capacity for patients with moderate symptoms is occupied, and the capacity for severely-ill patients is 100 percent utilized," he said.

The West Sumatra Health Office has asked all hospitals to help treat Covid-19 patients.

Even, Dr. Achmad Mochtar Regional Public Hospital in Bukittinggi, West Sumatra, has been forced to turn down a number of Covid-19 patients because the treatment room capacity is insufficient. Another Covid-19 referral hospital in West Sumatra is starting to serve an excessive number of patients. The West Sumatra Health Office has asked all hospitals to help treat Covid-19 patients.

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Deputy Chairperson of Covid-19 Mitigation at Dr. Achmad Mochtar Regional Public Hospital in Bukittinggi Dedi Herman said, in the last two weeks, the hospitals often had to treat an excessive number of Covid-19 patients. "We are forced to turn down several Covid-19 patients with declining health condition because no room is available. We provide them with medicine and ask them to find oxygen at home,”said Dedi.

Meanwhile, 42 private hospitals in Bekasi city that handle Covid-19 patients are overwhelmed to take care of the patients due to limited availability of facilities, health personnel, and finances. Of the 51 beds designed as ICUs for Covid-19 patients with moderate to severe symptoms, 48 have been occupied. As a result, the risk of death for Covid-19 patients is high, especially those with mild symptoms.

The head of ARSSI’s Bekasi city office, Eko Nugroho, said that as of September 2020, the hospitals have increase the bed capacity five times, namely with 550 beds. The Bekasi City Government has prepared a stadium as a place for the independent isolation of Covid-19 patients.

KOMPAS/FERGANATA INDRA RIATMOKO

Medical workers in protective gear prepare to set up a polymerase chain reaction (PCR) swab test program on Tuesday (8/9/2020) for traders at the Sunggingan livestock market in Boyolali, Central Java. The Boyolali Health Agency provided a mass testing program at the market after two traders there tested positive for Covid-19, and expected around 100 traders to take swab tests. The agency concurrently ran a public health campaign on the dangers of Covid-19 at the market.

To anticipate a spike in the number of Covid-19 patients, the West Java Provincial Government has increased the capacity of isolation rooms in hospitals and non-hospital isolation centers as places to treat asymptomatic patients. West Java Governor Ridwan Kamil said, to anticipate the accumulation of patients in an area, the patients may be treated outside the area.

The President’s target

President Joko Widodo has been targeting nine provinces with the highest Covid-19 cases, including Jakarta and East Java, to improve their conditions in the next two weeks. The President assigned the Coordinating Maritime Affairs and Investment Minister Luhut Pandjaitan, Health Minister Terawan Agus Putranto, and the Head of the National Disaster Mitigation Agency Doni Monardo to coordinate with local governments.

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"The target is to reduce the number of additional daily cases, increase the recovery rate, and reduce the death rate," said Wiku Bakti Bawono Adisasmito, a spokesman for the Covid-19 Task Force.

On Tuesday (15/9) there were an addition of 3,507 confirmed cases of Covid-19, thereby bringing to a total of 225,030 cases of Covid-19 in the country. The number of recovery cases reached 161,065 cases or 71.6 percent, below the world average of 72.2 percent. Meanwhile, the number of patients who died reached 8,965 or 4 percent, higher than the world average of 3.16 percent.

Medical personnel

The number of health workers who died because of Covid-19 continues to grow. With uncertainty as to when the outbreak will end, they must receive extra priority protection from the risk of transmission and social stigma. "Many health workers get infected at work. This is evidence of the high risk,” said Terawan at an event of the nurses\' prayer for the country.

According to Terawan, the main key to reducing this risk is discipline in adhering to the health protocols. "Every action, from picking up, treating, to releasing the patients, must apply the health protocols. When taking a rest, eating, and others, they must still adhere to the health protocols," he said.

Head of the Covid-19 Task Force Doni Monardo said, even though efforts have been made to obtain vaccines and medicines, we must be prepared to face the outbreak in the long term.

All parties are expected to give their full capability, including medical personnel.

Chairperson of the Indonesian National Nurses Association (PPNI) Harif Fadhillah said that synergy from various sectors, including non-governmental organizations, is needed to strengthen the mitigation of the Covid-19 pandemic. All parties are expected to give their full capability, including medical personnel.

"Medical personnel, nurses, and all other medical workers are a vital part in mitigating the Covid-19 pandemic," Harif said.

At least 78 nurses died due to Covid-19 infection. Moreover, not a few have contracted Covid-19. The nurses who are affected could not be on duty so that services are hindered.

KOMPAS/KRISTI UTAMI

Employees line up to pay their final respects on Monday (14/9/2020) as an ambulance bearing the body of a fellow health worker leaves Dr. Soeselo Regional General Hospital in Tegal regency, Central Java. One of the hospital’s nurses died of suspected Covid-19, pending the results of a polymerase chain reaction (PCR) swab test.

Erick Thohir, the chief executive of the Covid-19 Mitigation and National Economic Recovery Committee, said total protection for nurses and other medical personnel must be ensured. The government is looking for the best solutions and strategies for mitigating the pandemic.

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"Breakthroughs have been made, such as ensuring the availability of vaccinations which is targeted early next year. Nurses and medical personnel are the top priority in the vaccination," he said.

Moreover, self-isolation care for people without symptoms for Covid-19 will be facilitated. This service is provided especially for residents who do not have adequate space for the independent isolation. (TAN/AIK/LAS/RTG/JOL/ SYA/BRO/MEL/IKI/TAM/NSA/LAS/DIT/IGA/GIO/VAN/DNE)