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Specific contingency plans for COVID-19 urgent

As we have witnessed in China, Italy, South Korea and Iran, the risk associated with the novel coronavirus (COVID-19) pandemic is systemic, requiring a comprehensive contingency plan.

Mohamad Mova Al’Afghani and Rodri Tanoto (The Jakarta Post)
Bogor/Jakarta
Tue, March 17, 2020

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Specific contingency plans for COVID-19 urgent Crisis commute: Passengers ride the commuter line on March 3. Following the official designation of the novel coronavirus outbreak as a pandemic, President Joko "Jokowi" Widodo urged people to stay home to avoid crowds, such as on public transportation. (JP/Dhoni Setiawan)

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s we have witnessed in China, Italy, South Korea and Iran, the risk associated with the novel coronavirus (COVID-19) pandemic is systemic, requiring a comprehensive contingency plan. Countries’ contingency plans, such as that of the United Kingdom, usually contain three major phases: contain, delay and mitigate.

After President Joko “Jokowi” Widodo encouraged “social distancing” on Sunday, public transportation and the streets were still considerably full of people on Monday. Presumably, this is because at best people are only being encouraged, not ordered, to distance themselves. Nevertheless, even if forced through law enforcement, religious, cultural and community gatherings would still be challenging to manage.

One funeral in Italy reportedly became a vector of transmission, causing four infections. Another funeral in Spain is said to have caused 60 infections, prompting a lockdown of an entire neighborhood. Last week, Italian Prime Minister Giuseppe Conte issued a decree suspending civil and religious ceremonies including funerals as confirmed infections reached over 9,170 cases.

In Indonesia, the Health Ministry’s guidance on COVID-19 preparedness requires the deceased to be enveloped in plastic and put into a casket, but there is no mention of funerals. As the risk is high, funerals involving many people should be banned and left to authorized parties.

Due to such sensitivities, debates on the implications of religious and communal gatherings — especially in anticipating the Ramadan fasting month in April and the subsequent Idul Fitri celebrations accompanied by the wave of homecomings and vacations — must start, preferably, not by the government but by major Islamic organizations.

The economic consequences of social distancing measures can also be enormous. Certain types of jobs that rely on crowds would be immediately affected. Yet, certain types of businesses, such as the delivery business, would likely flourish. The government must ensure protocols for such services, for example, by requiring companies to equip drivers with personal protective equipment, prohibiting the use of paper money (as paper money transactions are usually done face to face) and dropping off packages with as little human contact as possible.

When pressure on public services mounts, the policies should move into the “mitigation” phase. Health services will be impacted first but then the crisis may spill over to other public services.

We may have much to learn from the crisis in China, Iran and northern Italy. A recent journal article from medical professional Wang Dawei revealed that in Wuhan, China, 26 percent of patients received intensive care. In Italy, a number of emergency rooms have reportedly been “collapsing” and ventilators “become like gold”.

According to 2018 data of the Organization for Economic Cooperation and Development, Indonesia has the second-lowest number of hospital beds per 1,000 inhabitants. As such, the contingency plan should include establishment of temporary hospitals. As in a number of countries with widespread infection, the government can, for example, request hotels to serve as temporary hospitals.

Read also: Jokowi finally takes COVID-19 seriously. But his leadership leaves much to be desired

In the United Kingdom, critical resources may be allocated to those who are likely to survive rather than the most vulnerable individuals under its 2007 ethical framework. Such utilitarian framework should also be implemented here but the policy, which is likely to be controversial, needs considerable clarification beforehand.

Public utilities such as water, electricity, gas, telecommunications and daily needs must be guaranteed during a pandemic. Quarantines will never work if these needs are not fulfilled.

Two factors will influence security of supply of essential services: the supply chain and operators. We have not heard about the coronavirus disrupting the performance of essential services anywhere in the world. However, utility operators must be required to submit their business continuity plan from now on. In cases where a significant number of utilities staff becomes infected with COVID-19, other personnel or the military must be ready to operate these services.

The poor will be hit hardest due to social distancing measures. They may not be able to afford their utilities bills. Existing legislation still allows for utilities services to be disconnected in the event of non-payment. As such, the government should issue a policy prohibiting the disconnection of utilities services for anyone during the pandemic. One simply cannot imagine the impact on public health if, for example, water services are cut off during a pandemic, which requires frequent handwashing.

Law enforcement services will also be affected. Iran reportedly temporarily released 54,000 prisoners. Riots have spread across Italy’s prisons due to worries about the coronavirus and also due to the prohibition on family visits. By late February, 555 people were infected in Chinese prisons. With our overcrowded prisons, authorities might consider releasing Indonesia’s low-risk prisoners.

Police forces can be affected too. During the “mitigate” phase, the UK plan for the police is to concentrate only on serious crimes and public order. Crimes such as those related to hoaxes shall not be pursued unless proven to have a major impact.

Legal avenues to mobilize such resources are already available but in some cases may not be directly implementable. Article 8 of the 2018 Health Quarantine Law guarantees the “fulfillment of basic needs” during quarantine. However, laws regulating disconnection of essential services are regulated in different sectoral legislation.

Presidential Instruction No. 4/2019 on pandemics is quite advanced but of course not a specific response to COVID-19. The Health Ministry’s 2009 guideline as a response to the bird flu mostly focuses on epidemiological intervention and thus does not deal with essential services and law enforcement.

As such, all of the aforementioned items discussed would require at least a presidential regulation in order to ensure multi-sectoral compliance. Hopefully, none of these scenarios will happen. Nevertheless, we need to plan for the worst for, if we fail to plan, we plan to fail.

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Mohamad Mova Al’Afghani is director of the Center for Regulation, Policy and Governance, an interdisciplinary research center in Bogor, West Java. Rodri Tanoto is a physician with a master’s on global health and development at University College London.



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