Anticipating Health Care Crisis Outside Java

KOMPAS/YOLA SASTRA

Deputy Governor of West Sumatra Audy Joinaldy (center) monitors the availability of oxygen at Dr M Djamil Hospital, Padang, West Sumatra, on Sunday (11/7/2021).

The number of new Covid-19 cases and fatalities continues to increase outside Java because of the lack of health facilities. The government must anticipate the problem.

JAKARTA, KOMPAS — The number of new Covid-19 cases in a number of areas in Java and Bali has shown a declining trend although it is still high. However, a number of indicators in areas outside Java indicate that the government needs to pay special attention.

These indicators include the increase in the occupancy of hospital beds, the rise in daily Covid-19 cases, the large number of health workers being exposed to Covid-19, low vaccination coverage and increasingly severe oxygen shortage.

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The acting chairman of the Mitigation Team of the Indonesian Medical Association (IDI,) Mahesa Paranadipa Maikel , said new Covid-19 cases continued to increase nationally, although there was a declining trend in Jakarta.

According to the latest data issued by the Health Ministry, the number of new Covid-19 cases nationally increased by 47,791 on Wednesday (28/7/2021) with the fatality rate reaching 1,824. Outside Java, the highest number of new daily cases was recorded in East Kalimantan with 2,129 cases and 87 deaths. In North Sumatra, the additional daily cases totaled 1,588, with 23 deaths.

The number of the deaths due to Covid-19 rose 36 percent in the past week. Nadia said the fatality rate would become the focus of the government\'s evaluation, in addition to strengthening the monitoring of the people undergoing self-isolation so they can be handled immediately when symptoms become severe.Seven provinces have entered the highest level of public activity restrictions (PPKM level 4), as the death rate has exceeded five people per 100,000 people this week. The provinces include Jakarta, Yogyakarta, East Kalimantan, North Kalimantan, Riau Islands, West Papua and the Bangka Belitung Islands.

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Two mobile PCR test vehicles were launched in Makassar, Wednesday (12/8/2020). The vehicle organized by the South Sulawesi Covid-19 Handling Team is expected to increase the number of massive tests, especially PCR as part of handling the Covid-19 pandemic.

Along with the surge in Covid-19 cases in Indonesia, new variants of the virus have also been detected . In addition to the discovery of Delta Plus variant, there is a local variant. "Variant AY.1, a derivative of the Delta variant, has been detected in Indonesia,” the head of the National Genome Center of the Institute Eijkman, Safarina G. Malik said.

Oxygen crisis

The spokesperson for the West Papua Covid-19 Task Force, Arnold Tiniap, said the province was experiencing a medical oxygen crisis. The production of oxygen in Manokwari, the capital city of West Papua, which totals only 100 cylinders per day is only enough to meet the daily needs of one hospital. There are six hospitals in Manokwari.

In West Papua, 23 hospitals have suffered a shortage of oxygen. "We have informed the central government about this," said Arnold, who is also the director of the West Papua Regional General Hospital, on Wednesday. Three patients at the West Papua Regional Hospital and six other patients at Manokwari Hospital died due to the lack of oxygen supply.

Only Arfak Mountains regency has green zone status. The 12 areas with red zone status include Sorong, Manokwari, Raja Ampat and Kaimana.

At present, one city and 11 regencies in West Papua have been categorized as red zones, or areas with high risk of Covid-19 transmission. Only Arfak Mountains regency has green zone status. The 12 areas with red zone status include Sorong, Manokwari, Raja Ampat and Kaimana.

Papua province is also experiencing an oxygen crisis. Eight hospitals in Jayapura city, for example, have a shortage for Covid-19 patients. The bed occupancy rate at hospitals there has exceeded 90 percent.

In West Kalimantan, the provincial government has bought oxygen from Malaysia to cope with the oxygen supply shortage in the province. On Wednesday, Pontianak received additional oxygen supply consisting of three ISO tank containers, or about 45-48 tons, which is equivalent to 7,500-8,000 cylinders. In West Kalimantan, the oxygen need for Covid-19 patients is around 3,000-3,500 cylinders per day. "The oxygen will be used for medical purposes, especially in hospitals," West Kalimantan Governor Sutarmidji.

At present, most regions in the country lack health workers. “Facilities have been added, but we don’t know where to find the human resources. Recruitment for new doctors has been opened, but no one has applied," the chairman of the IDI in West Sumatra, Pom Harry Satria said.

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Of the 2,100 doctors in West Sumatra health facilities, 420 people have been exposed to Covid-19 since the pandemic. Now about 80 doctors are being treated. "From the data [420 people], three doctors died," he said.

In Jambi, as many as 90 doctors have been exposed to Covid-19, and 48 of them are undergoing self-isolation. The Jambi Covid-19 Task Force is tracking patients exposed to the Delta variant. The chairman of the IDI’s Covid-19 Task Force in Jambi, Nirwan Satria, said the number of Covid-19 cases in Jambi had increased rapidly since 18 July. “Previously the cases were below 100 people per day, on that date [18 July] it exceeded 400 people. Now it\'s stable at about 200 people," he said.

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The Covid-19 vaccination for the elderly in Jambi City begins Saturday (6/3/2021). The program is expected to be optimal in suppressing the spread of the new corona virus. An elderly citizen registered himself.

The spike in new cases has resulted in the increase in the bed occupancy rate in local hospitals. "At Raden Mattaher Hospital, the only Covid-19 referral hospital in Jambi, the isolation beds are 90 percent occupied, as are the ICU [intensive care unit] rooms," he said.

The head of the South Sumatra Health Office, Trisnawarman, said the bed occupancy rate in the local hospitals had reached 80 percent with an increasing trend. "Many patients are rejected because the hospitals are full," he said.

An IDI representative in Riau Islands, Rusdani, also reported a spike in cases in the province. Two Covid-19 ICUs in Batam are full. In remote areas, there are no ICU rooms. In some districts there are no pulmonary specialists and anesthesiologists.

An emergency situation also occurred in South Sulawesi, especially Makassar city. Last month, the number of additional cases reached between 800 and 1,200 per day.

In Cirebon, West Java, Home Affairs Minister Tito Karnavian said the disbursement of state funds for Covid- 19 in regions had not been satisfactory. The central government will take over the funds if the regional government is slow in disbursing them. (FLO/JOL/ITA/IKI/REN/ESA/AIK/TAN)

(This article was translated by Hendarsyah Tarmizi).