Transmission of New Variants Found in Indonesia

New, possibly more contagious and virulent variants of the virus that causes COVID-19 have been found to have spread in Indonesia. Surveillance must be heightened.

JAKARTA, KOMPAS - Three new variants of SARS-CoV-2 – the virus that causes COVID-19 – first discovered in UK, South Africa and India, are suspected to have been transmitted among residents of Indonesia.

This suspicion has arisen from the discovery of the three variants in local cases even though the patients had no recent records of traveling abroad.

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The new variants are likely to be more transmissible and may pose threats of increasing severity. A failure to anticipate the spread of new variants has sparked a second wave of COVID-19 in India.

In addition to tightening the implementation of health protocols, there need to be more serious efforts in the field – including measures to prevent people from participating in the Idul Fitri tradition of mudik (exodus) – so that the new variants of the SARS-CoV-2 virus do not spread more widely. Contact tracing and surveillance at international entrance points also need to be improved.

The patient who was infected with the B.1.351 variant was a tourism worker who had never traveled abroad.

Siti Nadia Tarmizi, the Health Ministry’s director of prevention and control of contagious diseases, said on Tuesday (4/5/2021) that a resident in Bali was infected with the South Africa B.1.351 strain. Samples were taken from the patient on Jan. 25, and on Feb. 16, the patient died.

"The patient who was infected with the B.1.351 variant was a tourism worker who had never traveled abroad. However, he had many contacts with foreigners,” Nadia said.

The sample was taken to the hospital as the patient suffered from serious symptoms and underwent treatment in an intensive care unit (ICU). Contact tracing of the patient, Nadia said, had resulted in the discovery of another case, but the second case did not result in death. Further contact tracing was ongoing.

HUMAS POLDA JATIM

Commander of Brawijaya Regional Military Command, Maj. Gen. Suharyanto, Head of East Java Regional Police, Irjend Nico Afinta and East Java Provincial Secretary Heru Tjahjono, observing the arrival of migrant workers at Juanda Airport in Sidoarjo, Saturday (1/5/2021).

The India B.1.617 strain was first discovered in Indonesia through samples from a patient in Jakarta on April 3. The patient was a health worker who had no record of overseas travel but who engaged frequently with foreign patients.

According to Nadia, the health worker, who has already received the vaccine, showed mild symptoms and is now undergoing self-isolation, along with her children and husband.

Meanwhile, an Indian visitor whose sample was taken on April 22, was also confirmed to have contracted the B.1.617 variant. The patient is reported to be in stable condition at RSPI Sulianti Saroso Hospital in Jakarta.

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The UK B.1.1.7 variant was found in 13 cases in six provinces: four in Karawang, West Java, and one each in Tapin, South Kalimantan; Balikpapan, East Kalimantan; Palembang, South Sumatra; Medan and Tanjung Balai, North Sumatra; and Bogor, West Java; with the remaining three from undisclosed locations.

"In Karawang, it is suspected that local transmission has been occurring," Nadia said, adding that of the four positive cases, two were found in migrant workers who had just returned from Saudi Arabia, one from contact tracing and the other from a sample in the laboratory.

In Karawang, it is suspected that local transmission has been occurring

Nadia suspected that transmission of the B.1.1.7 variant had been occurring in South Sumatra, North Sumatra and South Kalimantan since February, while the transmission of the B.1.617 and B.1.351 variants was still being analyzed.

KOMPAS/COKORDA YUDISTIRA

One of the sailors, a migrant worker, received an injection of the Covid-19 vaccine at the Bali Branch of the Secretariat of the Indonesian Seafarers\' Union (KPI) on Jalan Hayam Wuruk, Denpasar City, Friday (16/4/2021).

Riza Arief Putranto, a molecular genomics researcher from Aligning Bioinformatics and member of the COVID-19 Genomics UK Consortium, said local transmission occurred if a patient infected with a new variant had no history of traveling abroad or meeting people arriving from abroad.

"Based on the recorded data, B.1.1.7 and B.1.351 entered Indonesia in January 2021," he said.

He added that attention was particularly directed to the South African B.1.351 strain, which, according to a number of studies, could render vaccines less effective. A study by the Beijing Institute of Microbiology and Epidemiology, China, published in New England Journal of Medicine (NEJM) on April 7, found that the COVID-19 vaccines made by Sinopharm and Sinovac would experience a slight decrease in their resistance to B.1.1.7 and would significantly lose their effectiveness against B.1.351.

Based on the recorded data, B.1.1.7 and B.1.351 entered Indonesia in January 2021.

Other vaccines, such as Pfizer, Moderna, and AstraZeneca, may also experience a decrease in effectiveness against those variants.

Time bomb

Dicky Budiman, an epidemiologist at Griffith University, blamed slack border control and loose quarantine rules for the spread of new variants in Indonesia. Enhancing contacting tracing and identifying COVID-19 clusters is necessary to prevent cases from spreading widely, and a failure to do so, according Dicky, would leave a ticking time bomb.

Vigilance in efforts to detect new variants of COVID-19 is being imposed at international entrance gates in East Java. The hospital at the Surabaya Defense Region II Joint Command Field is now treating 34 migrant workers who have tested positive for COVID-19.

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First Admiral IDG Nalendra Djaya Iswara, the person in charge of the hospital, said the patients were under close scrutiny to determine if they were carrying new variants of SARS-CoV-2.

Meanwhile, the Batam administration in Riau Islands has seen thousands of migrant workers returning home from Malaysia and Singapore. Hundreds have tested positive for COVID-19. With the budget running low, the regions hope that the central government will provide financial assistance. (AIK/NIK/BRO/NDU)

This article was translated by Musthofid.