The Hardest Step When the Cases Increase Rapidly

KOMPAS/KORNELIS KEWA AMA

Medical personnel are ready to carry out contact tracing tracing "of people who have passed or had physical contact with Covid-19 patients.

Ten months of fighting the COVID-19 pandemic is quite draining for contact-tracing teams. It is becoming increasingly difficulty for them to track down people who have had contact with patients who tested positive for COVID-19. They have to find 10 to 30 people per one positive patient. Meanwhile, the addition of new cases cannot be curbed.

The tracking takes place when some of the volunteers are also exposed to the SARS-CoV-2 virus that causes COVID-19. They also face citizen stigma.

Dea, 24, has undergone several swab tests due to frequent contact with patients positive with COVID-19. However, tracing officers recruited by the National Disaster Mitigation Agency (BNPB) continue to track down residents.

Also read: Wear a Face Mask, Do Tracing

Dea and three other tracers are in charge in Pademangan Barat subdistrict, Pademangan district, North Jakarta. They have to track down residents who had contact with 87 positive patients as of Wednesday (6/1/2021). "It\'s very difficult simply to track down just 10 people," said Dea, who is also a nurse.

Some of her friends resigned from the tracing team after being infected with COVID-19.

The most difficult part of her job is to get information from positive patients. Not everyone wants to be honest with the tracing team. At the same time, Dea has to be careful while digging for information from residents in order to avoid exposure to the virus. Some of her friends resigned from the tracing team after being infected with COVID-19.

In order to prevent infection, Dea regularly takes vitamins, wears a mask while on duty, and changes clothes upon arrival at home. For this task, she receives an allowance of Rp 200,000 per day and an additional Rp 150,000 if she is able to find 10 people who had close contact with patients. However, this additional honorarium is rarely obtained because it is difficult to find traces of 10 residents who had close contact with the patients.

Also read: Local Governments Accelerate Preparation for Vaccination Officers

Residents called Dea and her friends the "formal" tracing team. They are very dependent on community assistance at the neighborhood unit (RT) and neighborhood community (RW) levels. Without them, Dea has a hard time breaking into communication with the locals. "Apart from them (Dea and her friends), we are also a tracing team. The difference is that we are not paid,” said Andi Pane, who is also the head of RW 011 of Pademangan Barat subdistrict.

Kompas/Wawan H Prabowo

A mural with the theme of calling to protect yourself and others from the corona virus on Jalan Jatinegara Barat, Jakarta, on Sunday (27/9/2020).

At RW 011, there are 40 volunteer contact tracers serving 2,472 families in 15 RTs. Currently there are 14 residents who are positive.

Similar to Dea, Andi also has difficulty tracing contacts. "Our toughest challenge is facing stigma. People are still ashamed, afraid to be shunned, and then ask to be treated at home,” said Andi.

The tracing team in Pademangan Barat currently relies on a "manual" method, namely interviews with positive patients, their closest people, and other sources. Andi and other tracers do not yet know how to use a tracing application prepared by the government.

In the eyes of residents, the tracing team\'s response is considered slow, as disclosed by Nur Rohman, 46, a resident of Tanah Abang, Central Jakarta. "Some residents who were classified as close contacts at that time were told to wait for the test, but after that there was no news from the RW all day," he said.

The head of RW 009 of Kebon Kacang, Kosasih, admitted that the tracing process in his surroundings could not be fast and accurate in 17 RTs at once. Several times, information about residents who were positive for COVID-19 was only heard one or two days after the report. "Suddenly there were people who talked about residents who were positive for COVID-19," said Kosasih.

Also read: Vaccine Diplomacy amid the Pandemic

Meanwhile, the ability of tracing officers and volunteers in this area is limited. Tanah Abang Health Center relies on 31 volunteers who are now tracing the close contacts of 250 positive patients. "We want to move quickly so that residents do not wait long for tests and other needs. However, because there are many cases, we have to prioritize people according to their level of urgency," said the head of the Tanah Abang Community Health Center, Sari Ulfa.

Towards 1 million cases

In a number of places, tracing does not even work. This was experienced by Atok, 40, a resident of Jombang regency, East Java. At the end of November 2020, this father of one child was exposed to COVID-19. He announced the case to his office, to the Community Health Center and close neighbors. However, after the announcement, there was no tracing on his wife, children, and close people who had interacted with him. Atok then went into independent isolation and asked his wife to test at the nearest health center.

In fact, the campus has reported it to the nearest COVID-19 Task Force.

The same thing was disclosed by Syahrizal Syarif, Vice Rector 1 of the Nahdlatul Ulama University of Indonesia in Jakarta. After there were three positive cases on campus at the end of 2020, there was no contact tracing. In fact, the campus has reported it to the nearest COVID-19 Task Force. "Now the situation is leading to an uncontrollable situation where the increase in cases occurs exponentially. If someone is positive, we don\'t know from whom it came,” said Syahrizal, who is also an epidemiologist.

Kompas/AGUS SUSANTO

A mural contains an invitation to carry out health protocols to prevent the spread of Covid-19 in Tebet, South Jakarta, on Wednesday (12/8/2020).

It is very possible, he said, that in early February 2021 there would be 1 million positive cases in Indonesia. At that time, he predicted there will be about 200,000 active cases.

No matter how tough the situation, the government must be able to expand the capacity of health services even though health workers are getting tired because the pandemic is not yet under control, while contact tracing is becoming increasingly difficult. The front line for mitigating COVID-19 must now be strengthened and should not be left fragile.

(This article was translated by Hyginus Hardoyo).