Health Facilities Limited, Self-Mitigation During Isolation Increasingly Important

KOMPAS/AGUS SUSANTO

Medical workers man the Covid-19 rapid testing post at Pasar Minggu Regional General Hospital (RSUD) on Saturday (4/4/2020) in South Jakarta. Pasar Minggu hospital, which has been providing the Covid-19 testing facility since 20 March 2020, is one of several referral hospitals that have been designated in Jakarta for treating suspected cases of Covid-19 infection, people under monitoring (ODP), and patients under surveillance (PDP).

People with COVID-19 undergoing self-isolation need to improve their self-awareness to anticipate further risks amid limited health facilities.

JAKARTA, KOMPAS —Amid difficulties finding hospital rooms for COVID-19 patients, at last, many people who were confirmed positive for COVID-19 had to choose to undergo self-isolation. The ability to mitigate oneself while undergoing self-isolation is very urgent at this time.

Data from the Health Ministry as of 1 p.m. on Thursday shows that the bed occupancy rate (BOR) for COVID-19 services at the national level has reached 76 percent with the BOR for isolation at 77 percent and for intensive care units at 72 percent.

Currently, the highest bed occupancy rate is in Banten (92 percent), Yogyakarta (91 percent), West Java (87 percent), Jakarta (85 percent), Central Java (83 percent), East Java (82 percent) and Lampung (82 percent).

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These high bed occupancy rates have forced many COVID-19 patients to undergo self-isolation at home. Indonesian Lung Doctors Association (PDPI) secretary-general Erlang Samoedro said people undergoing self-isolation needed to be vigilant and ensure that their oxygen saturation level did not dip below 92 percent or that their respiratory rate did not exceed 25 breaths a minute.

“If your oxygen saturation is below 92 percent and the respiratory rate is above 25 breaths per minute, you need to be immediately taken to the hospital. Rescue efforts with proning [lying on one’s stomach] can be done, but it is only a temporary measure that can raise the oxygen saturation one to two levels. Therefore, further assistance with the help of oxygen needs to be given immediately,” he said.

KOMPAS/DAHLIA IRAWATI

Bags of donated food hang from the gate of a resident in self-isolation on 5 May 2020 in Malang, East Java.

In the Self Isolation Guidebook compiled by the Association of Indonesian Internal Medicine Specialists (Papdi), it is stated that under normal conditions, a COVID-19 patient is asymptomatic if their respiratory rate is 12-20 breaths per minute at an oxygen saturation of more than 95 percent.

The oxygen saturation level can be measured with an oximeter. Therefore, people undergoing self-isolation need have access to an oximeter and thermometer to measure their body temperature twice a day, every morning and evening.

People with COVID-19 who can undergo self-isolation are those who are asymptomatic, have mild symptoms and have an adequate home or room environment.

Regarding treatment, they can take vitamin C, vitamin D and zinc according to the doctor\'s advice. Asymptomatic patients must usually isolate for 10 days after being confirmed positive for COVID-19, and patients with mild symptoms must isolate for 10 days from the onset of symptoms with the addition of three days with no symptoms.

They should also sit in the sun for 10 to 15 minutes between 10 a.m. and 1 p.m. daily.

People undergoing self-isolation are encouraged to open their bedroom windows every day to let in sunlight and ensure sufficient air circulation. They should also sit in the sun for 10 to 15 minutes between 10 a.m. and 1 p.m. daily.

Health protocols, such as keeping a distance, always wearing a face mask and washing hands regularly, must still be in place. In addition, exercise three to five times a week and regularly eat a balanced diet.

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On Tuesday (6/7), the World Health Organization published guidelines for the treatment of COVID-19. It states that two biological agents, namely Tocilizumab and Sarilumab, are considered capable of overcoming an excessive immune response, known as a cytokine storm, in severe or critical COVID-19 sufferers.

Significantly increased

In addition to the depletion of health facilities for COVID-19 patients, the availability of health workers also continues to decrease. A total of 74 health workers died within eight days in July.

"The death of health workers is very worrying and needs serious attention," said the Indonesian Doctors Association’s (PB IDI) Resident Assistance Team-Doctor Mitigation Team coordinator, Jagadditho Probokusumo.

KOMPAS/RADITYA HELABUMI

Volunteers prepare food in a public kitchen caring for Covid-19 in Karet Semanggi, Setiabudi, South Jakarta, Thursday (8/7/2021).

According to Jagadditho, even though the majority of health workers have received the vaccine, those with comorbidities should not directly treat patients. High levels of exposure can increase the risk of infection and death.

Data from Pusara Digital LaporCovid-19 shows that 1,133 medical workers have died of COVID-19. Tri Maharani, the emergency specialist for Pusara Digital LaporCovid-19, said that apart from comorbid factors, limited personal protective equipment and fatigue must also be taken into account. (TAN/AIK/ATK)

(This article was translated by Kurniawan Siswoko).