Regional Innovations Crucial for Mitigating Pandemic

KOMPAS/RONY ARIYANTO NUGROHO

The police control the traffic flow at the Jagorawi toll exit in Baranangsiang, Bogor city, West Java on Saturday (6/2/20201) following the implementation of the odd-even licence plate policy in the city. The policy is part of the Community Activity Restrictions (PPKM) in Bogor. Motorcycles and four-wheeled cars are all checked at a number of locations on the main road in the city and the entrance to the city.

The creativity and innovation of regional heads determine the success of mitigating the pandemic.

JAKARTA, KOMPAS — The central government\'s Covid-19 pandemic control policies will not be effective without the seriousness of the regional heads.

President Joko Widodo said in a limited meeting broadcast via the Presidential Secretariat’s YouTube channel, Sunday (31/1/2021), that the implementation of public activity restrictions (PPKM) had not been able to curb the transmission of Covid-19. This was caused by the fact that the PPKM have not been consistently implemented.

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From Tuesday (9/2) to Feb. 22, the PPKM are being implemented on a micro scale. This program is the same as the previous PPKM, but its handling is concentrated in the neighborhood units and community units (RT/RW).

A professor at the Institute of Public Administration (IPDN), Djohermansyah Djohan, said on Friday (5/2) that these policies were more comprehensive in nature and could not be made uniform across all regions. If it is expected to be effective, each policy must open up space for regional proposals, since the regional heads are the ones who really understand the condition of their respective regions.

KOMPAS/KRISTI DWI UTAMI

A health worker conducts an antigen test on a shop owner in South Tegal, Tegal city, Central Java on Saturday (6/2/2021). A number of traders still opened their shops during the first day of the Stay at Home program launched by the Central Java administration. After being given an explanation of the program, the traders were asked to undergo an antigen test and close their shops until the two-day program ended on Sunday.

The creativity and innovation of the regional leaders are considered crucial for successfully mitigating the Covid-19 pandemic. Although there are central policies, adjustments in the regions are no less important.

Creativity and innovation

"So, the regions must follow central directives, but are allowed to introduce local content as long as it is reported and approval is requested from the center. This local content can help resolve the problems according to local conditions," said Djohermansyah, adding that reporting to the center was important so that the development of the pandemic control as a whole could be monitored.

The instruction of the Home Affairs Ministry also sets a number of restrictions related to office activities, with 50 percent of the personnel working from home and 50 percent from offices, as well as online teaching and learning activities.

The micro-scale PPKM are regulated in Home Affairs Ministry Instruction No. 3/2021 concerning micro-based PPKM and the establishment of Covid-19 mitigating command posts at the village and subdistrict levels to control the spread of Covid-19. The instruction of the Home Affairs Ministry also sets a number of restrictions related to office activities, with 50 percent of the personnel working from home and 50 percent from offices, as well as online teaching and learning activities.

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There are also rules stipulating a 50 percent dine-in capacity for restaurants, shopping centers and malls, which are allowed to open until 9:00 p.m., 50 percent capacity at places of worship, temporary suspension of public facilities and sociocultural events that lead to crowding, and regulation of public transport capacity and operating hours.

Strong leadership

The regional administration development director general of the Home Affairs Ministry, Safrizal, agreed with Djohermansyah’s remarks. The local leadership determines the final results of the PPKM at the micro scale.

"It means, with strong leadership, all programs will be implemented successfully. However, without attention, without control, without attention, it will be difficult," he said.

KOMPAS/RONY ARIYANTO NUGROHO

A woman walks along an unusually quiet Jl. Suryakencana, Bogor City, on Sunday (7/2/2021). The implementation of the Community Activity Restrictions (PPKM) and the odd-even licence plate policy in the city has severely affected traders due to the lack of customers. The Suryakencana area is a culinary tourism destination, especially for tourists visiting the city on weekends.

Apart from the factor of regional leaders, said Safrizal, other factors that influence the success of PPKM include collaboration, involvement and infrastructure. "However, regional leadership is the main thing. [Regional leaders] must be able to make quick decisions regarding the changes that occur," he said.

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In Surabaya, according to East Java Governor Khofifah Indar Parawansa, the pandemic situation improved after the second phase of PPKM from Jan. 26 to Feb. 8. Improvements can be seen from the daily number of patients recovering, which is higher than the number of new patients, although not consistent in all indicators.

Another indicator, the BOR in intensive care units (ICU), fell from 72 to 69 percent.

According to Khofifah, after the PPKM, the isolation bed occupancy rate (BOR) of patients fell from 79 percent to 54 percent, already below the World Health Organization (WHO) recommendation of 60 percent. Another indicator, the BOR in intensive care units (ICU), fell from 72 to 69 percent. However, the ratio of cases to tests (positivity rate), which fell from 20 to 18 percent, is still above the WHO standard of 5 percent.

In West Java, compliance with health protocols is claimed to have increased during the PPKM. However, Covid-19 cases have soared.

KOMPAS/RADITYA HELABUMI

People cross the multi-use pedestrian bridge at Tanah Abang Market in Central Jakarta on Sunday (7/2/2021). The Community Activity Restrictions (PPKM) in Java and Bali have been extended twice and will end on Monday (8/2/2021). The social restrictions have been implemented for a month, but they have not been effective in reducing the number of new Covid-19 cases. The government will implement the PPKM on a micro scale such as in neighborhood units (RT) and community units (RW) in addition to imposing stricter controls on health protocols and contact tracing.

West Java Governor Ridwan Kamil said the increase in daily case reports was caused by the fact that the data was still mixed with old data. He has proposed to the central government to improve the case reporting system.

According to Kamil, PPKM are effective in increasing public compliance with the 3M (wearing masks, maintaining distance, and washing hands with soap). He said that based on a survey of reports from the National Police, TNI (Indonesian Military) and public order and safety officers, public discipline had increased from 50 to 80 percent. "If citizens are disciplined, economic productivity will no longer be limited," he said.

The number of infected people was higher than those who were infectious.

Iwan Ariawan, a University of Indonesia (UI) biostatistician who is also a member of the Synergy Team for Mahadata UI on Covid-19, said the PPKM had started to reduce public activities, but had not decreased the addition of positive cases. The team\'s study concluded that PPKM were not as effective as the first stage of the large-scale social restrictions, from March to April 2020. The number of infected people was higher than those who were infectious. "In general, on Java and Bali, PPKM reduced the number of cases. It is estimated that if Java and Bali were without PPKM, the number of daily cases as of Jan. 31 could be more than 12,000. Data show that as of Jan. 31, the number of daily positive cases was in the range of 10,000," said Iwan, Sunday (7/2).

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According to data from the UI team, it is necessary to have at least 85 percent health protocol coverage for every aspect of 3M. In reality, as of the end of January 2021, none of the aspects had reached that figure.

Data processed by the Center for Metropolitan Studies (Centropolis) at Tarumanagara University is not much different. They categorized the areas with 100 or more positive cases as black areas. According to data on Feb. 6, out of 265 subdistricts, there are 88 with active cases above 100. The Thousand Islands chain is the only area with active cases below 100.

KOMPAS/AGUS SUSANTO

Online motorcycle taxis await orders at a shopping center in Central Jakarta, on Sunday (7/2/2021). The Community Activity Restrictions (PPKM) in Java and Bali, and several other regions in the archipelago, have been implemented for two rounds. The second round will end on Monday (8/2/2021). Even so, the social restrictions have failed to suppress Covid-19 transmission. The number of new cases continues to increase in the country especially in small communities. The latest report issued by the World Health Organization (WHO) shows that community transmission in Indonesia is categorized as CT 4 (community transmission), or transmission that occurs in the smallest communities.

The highest percentage is in North Jakarta, where 52 percent of its subdistricts are black areas, followed by East Jakarta (45 percent), South Jakarta (35 percent), West Jakarta (32 percent) and Central Jakarta (5 percent).

"The problem is, there was no explanation of why the cases were high in these subdistricts. Where did the cluster come from? Even if it was a family cluster, surely there should be a traceable pattern,” said a senior researcher at Centropolis, Suryono Herlambang.

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The head of the Disease Prevention and Control Division of the Jakarta Health Office, Dwi Oktavia T. Lestari Handayani, said 33 percent of positive patients in Jakarta were symptomatic, including many with critical symptoms that needed to be treated at referral hospitals.

Now, the occupancy rate of beds at Covid-19 referral hospitals in Jakarta is 72 percent and the occupancy rate of intensive care units (ICU) is 74 percent. (BOW/BRO/TAM/XTI/DNE/AIK)

(This article was translated by Hyginus Hardoyo).