The peak of the spike in Covid-19 cases is expected to take place in the third week of January to the first week of February 2021. At that time, more hospital rooms are needed.
By
DEONISIA ARLINTA/NINA SUSILO/AHMAD ARIF
·5 minutes read
JAKARTA, KOMPAS— The peak of the spike in Covid-19 cases is expected to take place in the third week of January to the first week of February 2021. At that time, more hospital rooms are needed.
At present, the 951 hospitals with 50,942 isolation beds and intensive care rooms (ICU) for Covid-19 patients show a fairly high bed occupancy rate. There are 11 provinces where bed occupancy rate is greater than the World Health Organization (WHO) threshold of 60 percent, including Jakarta (83 percent), Banten (79 percent), Yogyakarta (78 percent), West Java (73 percent), and East Java (69 percent).
Deputy Health Minister Dante Saksono Harbuwono said on Monday (18/1/2021) that the peak of the spike in Covid-19 cases, which is expected to occur in the third week of January to the first week of February 2021, must be anticipated. The increase in cases will occur due to increased mobility of residents during the Christmas and New Year holidays.
"The Health Ministry has prepared four strategies in handling the spike in Covid-19 cases in hospitals," said Dante in a virtual seminar held by the Hospital Accreditation Commission.
The strategies are an increase in the treatment capacity of Covid-19 patients, relaxation of the policy for registration and licensing of health workers, strengthening of the integrated referral system and strengthening of the quality of hospital services.
To increase patient treatment capacity, the Health Ministry divides the need for additional beds into three zones. In the red zone with a bed occupancy rate for Covid-19 of more than 80 percent, a minimum conversion of 40 percent of inpatient beds and 25 percent of ICU beds for Covid-19 patients is carried out.
In the yellow zone with 60-80 percent of bed occupancy rate for Covid-19, hospitals are asked to convert a minimum of 30 percent of inpatient beds and 15 percent of ICU beds for Covid-19 patients. In a green zone with a bed occupancy rate for Covid-19 below 60 percent, hospitals are asked to convert a minimum of 20 percent of inpatient beds and 10 percent of ICU beds.
According to the Covid-19 Mitigation Task Force, on Jan. 18, 2021, there was an addition of 9,086 new cases of Covid-19 with 295 deaths. Meanwhile, the total number of Covid-19 cases in Indonesia was 917,015 with 26,282 deaths and 144,798 people being treated.
Director General of Health Services of the Health Ministry Abdul Kadir said that the impact of the long holidays will usually result in an addition of 30-40 percent of cases. With the current situation, he assumed that the need for beds for Covid-19 patients is more than 40,000 beds. "The need could be higher if the increase in cases continues," he said.
Secretary General of the Association of Indonesian Hospitals (Persi) Lia G Partakusuma said the inter-hospital referral system also needs to be improved. When one hospital is unable to accommodate new patients, the referral administration must be clear so that the patients can get treatment immediately. "This referral system is crucial so that no more patients die on the way after coming to 10 hospitals," Lia said.
Cross borders
A professor of the Faculty of Medicine, Public Health, and Nursing, University of Gadjah Mada, Laksono Trisnantoro, said that the daily reports disclosed by the government regarding the Covid-19 cases, which are usually divided into provincial levels, have caused limited mitigation. "Meanwhile, this virus knows no boundaries. Mitigating a pandemic requires a surveillance concept related to the response to the spread of cases," he said.
According to him, the data that is used as the basis for decision making should be expanded in accordance with epidemiological data. This step is like using data for the Greater Jakarta area, which includes parts of West Java and Banten; Greater Surabaya, or Greater Semarang.
A cross-border approach, Laksono added, is also needed to anticipate public health emergencies, particularly a surge in hospital patients.
Convalescent plasma
The government and the Indonesian Red Cross (PMI) encouraged Covid-19 survivors to donate convalescent plasma to save Covid-19 patients. This therapy is expected to reduce the death rate due to Covid-19 in Indonesia and solve the problem of hospital over crowdedness.
Since May 2020, PMI has collaborated with the Eijkman Institute to distribute more than 7,680 bags of the convalescent plasma. From the research of PMI, the Health Ministry, and several hospitals in Jakarta, Yogyakarta and Malang, the efficacy of convalescent plasma ranges from 60 percent to 90 percent.
However, very few survivors donated their blood plasma. PMI Chairman Jusuf Kalla said, in a day, only 40 bags of convalescent plasma are donated, while the need is at least 200 per day.
Virus mutation
Of the thousands of SARS-CoV-2 mutations, currently there are three new variants of global concern. All three came from mutations in England (B.1.1.7), Brazil (B.1.1.28), and South Africa (B.1.351).
Although not yet found in Indonesia, it is necessary to increase awareness of the possibility of the entrance of these variants without being detected.
A researcher of molecular genomics from Aligning Bioinformatics and a member of the United Kingdom Covid-19 Genomics consortium, Riza Arief Putranto, said in Jakarta on Monday (18/1) that variant B.1.1.7 has dominated the UK and reached 4.7 percent of the world.