Vaccine’s Long Road to Reducing Death

KOMPAS/P RADITYA MAHENDRA YASA

One of the residential areas of residents undergoing regional quarantine after the increase in Covid-19 cases in Pedawang Village, Bae District, Kudus Regency, Central Java, Sunday (6/6/2021).

A vaccine is not the "ultimate solution" that can prevent an explosion of COVID-10 cases. Through data analysis, the Kompas team predicts that it will take about four more years to reach optimal (vaccination) coverage to slow down the spread of the pandemic.

As of Sunday (6/6/2021), only 28.8 million doses of COVID-19 vaccines have been administered, of which 17.7 million people have received their first dose and 11.1 million their second dose — nearly six months after the vaccination rollout started in Indonesia in mid-January.

If the second dose is used as the best immunity parameter, it means only 4.12 percent of the Indonesian population has been fully protected by the vaccine.

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If 60-70 percent of the population is required to be immune, either through vaccines or as a result of previous infection, to stop the spread of COVID-19 (herd immunity), how long will it take for the vaccination program to reach the target of 181.5 million people?

The answer: still a long time — maybe beyond the end of President Joko “Jokowi” Widodo\'s second term in 2024. Using the number of vaccinations in April, it is projected that 181.5 million people will be fully vaccinated by mid-January 2025.

In a day, 128,596 second doses of the COVID-19 vaccine were distributed in April on average. In May, there were many national holidays, so the number of daily vaccinations dropped.

In order to achieve even the short-term targets, efforts to accelerate vaccination need to be carried out immediately and drastically.

The target of vaccinating 70 million people was moved back from March to September.

HUMAS PEMPROV JAWA TENGAH

Central Java Governor Ganjar Pranowo reviews the handling of Covid-19 as well as a centralized isolation building at the Midwifery Academy Dormitory, Kudus Regency, Central Java, Monday (31/5/2021).

This target will be difficult to achieve without a drastic increase in vaccination efforts. To reach the new target, the vaccination rate must be increased 6.42 times from the average rate in the past week (May 30 to June 5).

In this regard, the public has been calling on authorities to optimize the vaccination drive as shown in assessment reports by Lapor COVID-19 and Wahana Visi Indonesia.

“It [the assessment] shows that public satisfaction of the vaccination drive is on the decline. Those who see it [the program] as worsening cite lack of information, obstacles for vulnerable groups to get their jabs and interruptions during vaccination," said Lapor COVID-19 volunteer Amanda Tan (Kompas, 5/6/2021).

No impact

Indonesia’s low vaccination coverage, even below the world average of 5 percent, has not succeeded in reducing the fatality rate (CFR) of COVID-19. The rate is still too small to provide any tangible benefits.

Central Java, for example, is at 3.83 percent, Aceh at 1.96 percent and the Riau Islands at 3.13 percent.

In the provinces that experienced the largest increase in cases after Lebaran (Idul Fitri), the coverage of the second dose was even lower than the national figure. Central Java, for example, is at 3.83 percent, Aceh at 1.96 percent and the Riau Islands at 3.13 percent.

Through data analysis, the fluctuating mortality rates for COVID-19 patients and CFR figures have not shown a correlation with the growth in the number of people who have received the vaccine.

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^ Community Transmission Rates High

The absence of a correlation between CFR and vaccination progress so far has even been seen in the three provinces with the second-largest number of vaccine doses, namely Jakarta (17.4 percent), Bali (15.3 percent) and Yogyakarta. (9.7 percent).

In the three provinces, the daily growth in vaccine coverage has not directly helped decrease the CFR rate. In Yogyakarta, for example, the correlation between vaccine coverage and CFR is directly proportionate in the period from January to the end of May. In fact, during vaccination, Yogyakarta\'s CFR still shows an increasing trend.

A number of experts say vaccination would only have an impact or reduce the death rate if vaccine coverage has reached 40-50 percent of the population or about 100 million Indonesians.

"Currently, the vaccine has no effect because [the number of people being vaccinated] is still small," said Tri Yunis Miko, an epidemiologist at the University of Indonesia\'s School of Public Health.

KOMPAS/ADITYA PUTRA PERDANA

The atmosphere in front of the Regional General Hospital (RSUD) Dr Loekmono Hadi, Kudus Regency, Central Java, Thursday (3/6/2021) night. This hospital is the main referral hospital for Covid-19 patients.

In addition, mutations of the SARS-CoV-2 virus can reduce the effectiveness of the vaccines that have been developed so far. Herd immunity can become increasingly difficult to achieve.

Dicky Budiman, an epidemiologist at Griffith University, Australia, in a discussion last week described vaccines as an “expensive toll road” in controlling the COVID-19 pandemic. In other words, few countries are able to quickly access vaccines.

Vaccine coverage is not evenly distributed around the world, which will make it difficult for COVID-19 to be eradicated globally. According to Dicky, this is an issue that the world will face in the next two to three years.

Therefore, it is necessary to prepare non-pharmaceutical interventions, namely the prevention of crowds and more effective restrictions on mobility; in particular, to deal with the spike in cases and deaths after a long holiday.

In reality, the first challenge that must be faced is the spike in cases due to the Idul Fitri holiday and its impact on Indonesia\'s health facilities.

Based on data from the COVID-19 task force as of 30 May, there are seven provinces with COVID-19 referral hospitals whose bed occupancy ratio (BOR) exceeds 50 percent, namely West Kalimantan (62.4 percent), North Sumatra (59.3 percent), Jambi (54.7 percent), West Sumatra (53.8 percent), Riau Islands (52.9 percent), Riau (52 percent) and South Sumatra (52.1 percent).

KOMPAS/P RADITYA MAHENDRA YASA

Workers have lowered oxygen cylinders in recent weeks as a vital medical facility when there was a spike in Covid-19 cases at the Dr Loekmono Hadi Hospital in Kudus Regency, Central Java, Sunday (6/6/2021).

West Kalimantan is also the province with the most drastic increase in BOR, which was up 23.6 percent from April 18.

“We have to look to the past to see the future. Simply looking at the first year of this pandemic will provide a very good lesson to improve our response going forward," said Dicky.

(This article was translated by Kurniawan Siswoko).