A big country, in both size and population, Indonesia faces unique challenges when any infectious disease strikes. The country’s experience shows it is never easy to contain a pandemic, but not impossible to respond to the outbreak proportionally.
The respiratory virus SARS-CoV-2, which causes COVID-19, is rearing its ugly head in the country, it demands swift and strategic responses as we are racing against time, a luxury we can no longer afford. And not to mention how to orchestrate the available health infrastructure across the country; piecing it together in a vast, cohesive network of testing laboratories and reference hospitals.
As of the fourth week of March, Indonesia alone had confirmed over 1,000 positive cases with about 87 fatalities. The good news is that 35 of the confirmed patients recovered and have tested negative for the coronavirus.
Worldwide, the virus has infected over 500,000 people and killed over 24,000. To live up to its name, the COVID-19 rapid response task force, has worked fast since its formation by President Joko “Jokowi” Widodo through Presidential Decree No. 7/2020 on March 13, almost two weeks after Indonesia confirmed its first two COVID-19 positive cases.
The task force shows the level of the government’s attention to the matter by elevating the authority to an agency that has great public trust, vast assets and a network across the country to mobilize all resources to tackle emergencies or disasters, like the pandemic.
Rapid response task forces exist not only at the national level, but also at the province, regency and city level. As of Wednesday, as many as 31 task forces were already active in provinces and 125 in regencies and cities.
The decree is a somewhat powerful implement that lays the legal foundation for the task force’s work, as it helps to address the usual red tape and bureaucratic inertia, deemed to be the main challenge when it comes to coordinating measures among government offices across the board.
The task force is strategically placed under the National Disaster Mitigation Agency, a nonministerial body that directly answers to the President.
Assessing and later adding 34 laboratories in a number of provinces as reference diagnostic laboratories is essential to identifying the burden of the disease in the community. The task force is now reviewing at least 12 additional state-run laboratories to enforce the already diagnostic laboratories, so by next week there will be 46 laboratories in total to serve the need for further testing to confirm positive cases.
Next month, we ambitiously aim to add hundreds or even close to 1,000 labs by expanding our reach to existing lab networks in hospitals that were previously used to test other illnesses.
It is important to get more laboratories involved in order to increase detection capability. The main objective is to treat patients as soon as possible and prevent the severity of complications faced by patients. The work can help reduce the ravaging spread of the virus and at the end help cut off the chain of transmission.
Laboratory work is crucial to screen and filter cases so not all people are admitted to a health facility for treatment. In a way, it helps hospitals that will eventually be stretched. This will ease the workload of doctors and nurses. Remember, these health workers still need to attend to other patients with a variety of other illnesses.
Another key component in the response is the existence of hospitals, and not just any hospitals because of the nature of the ailment and the danger it poses to healthy people treating affected patients.
Currently, there are 132 referral hospitals across the country that at least have special wards, negative pressure rooms and ventilators. In total, they have 1,100 isolation wards, 175 negative pressure rooms and more than 100 ventilators. To date, this an appropriate number to treat present confirmed patients.
And the newest additions are the athletes village in Kemayoran in Central Jakarta that has been transformed into an emergency hospital with more than 2,000 beds. Outside Jakarta, a project to turn an old hospital compound, formerly used to provide health care to Vietnamese refugees on Galang Island, near Batam, into a hospital with a capacity of 400 beds for treatment and 50 isolation beds, is nearly 80 percent complete. Sebaru Island, which has been used to isolate Diamond Princess passengers is also on the list.
While the infrastructure is being beefed up, another key measure is to increase the number of doctors and nurses outside of the outbreak epicenters (Java and Bali) as their colleagues on Java, supported by health volunteers, are taking on a gruelling battle against the virus that has infected many.
Rest assured that more decisions on increasing case detection and handling will be decided, but unfortunately that is not the only formula.
It is next to impossible to slow down the transmissions without public participation. The virus has spread among us, this fact is not rocket science.
Our key messages for prevention will be the same and will be repeated over and over like a broken record, if you may say, because without 100 percent commitment, participation and discipline, flattening the curve will remain elusive for us.
The more individuals in the community heed the preventive messages, the more chance we have to beat the virus. We can win this battle by combining our forces like we are fighting a great war, the war against COVID-19.
Lead expert of the COVID-19 rapid response task force and professor of public health at the University of Indonesia
Disclaimer: The opinions expressed in this article are those of the author and do not reflect the official stance of The Jakarta Post.