The Jakarta Post
The government announced three new deaths and 35 new COVID-19 cases, including two toddlers, on Friday as it scrambles to contain community spread and get referral hospitals ready to face the pandemic. President Joko “Jokowi” Widodo said the government had established a “fast-response” team, led by the National Disaster Mitigation Agency (BNPB).
Under the coordination of the BNPB, the Health Ministry, the Indonesian Military (TNI) and the National Police, the team was tasked with, among other things, spearheading the measures to trace the movement of COVID-19 patients and those who had come in contact with them.
"We know that this virus spreads rapidly. Thus we should carry out prevention and mitigation efforts simultaneously," Jokowi said on Friday, "The government has and will continue to carry out tracing of contacts in this case."
The fast-response team is also responsible for handling surveillance and isolation of suspected COVID-19 patients and coordinating with relevant stakeholders to ensure effective containment measures to curb possible wider contagion, including at the country's airports and sea ports.
Commuters on a train from Jakarta to Bogor on March 12. (Antara/Indrianto Eko Suwarso)
Jokowi reiterated that the government had prepared 132 referral hospitals across the country. “The Health Minister said there were 132 referral hospitals, from 100 previously. We will add more: 108 TNI hospitals, 53 hospitals under the National Police and 64 hospitals under state-owned enterprises,” he said.
A leaked document obtained by The Jakarta Post on Friday, however, showed that out of the list of 132 hospitals, only 49 were “ready”. The document is the minutes of a meeting between several institutions including the BNPB, Health Ministry, Executive Office of the President and the offices of the Coordinating Human Development and Culture Minister and Coordinating Political, Legal and Security Affairs Minister on March 10.
BNPB head Doni Monardo did not confirm the information in the document to the Post, nor did he deny the content.
A source who requested anonymity told the Post that in the meeting it was revealed that out of 132 hospitals designated as referral facilities “only 49 hospitals are really ready” for COVID-19, while the other 83 were in the “preparation stage”.
Some referral hospitals for COVID-19 in West Java have reported a lack of protective gear for medical personnel who handle patients suspected of having been infected with the virus.
Eight out of 52 hospitals in the province have been appointed as referral hospitals for COVID-19 patients, including Hasan Sadikin Hospital in Bandung – the largest hospital in the province – and Dr. Slamet Hospital in Garut.
West Java Health Agency head Berli Hamdani Gelung Sakti said the medical team at Dr. Slamet Hospital had to transfer a patient because of a lack of protective gear, although the hospital had an adequate isolation room and other medical equipment.
"The Health Ministry responded by saying it was ready to supply all the necessary protective gear requested by the referral hospitals. We are still calculating whether we have sufficient equipment [to handle COVID-19 cases],” Berli told The Jakarta Post on Monday.
The agency head said he hoped the ministry could send protective gear soon to COVID-19 referral hospitals across the province because the isolation room at Hasan Sadikin Hospital was full.
Raden Rara Diah Handayani, a pulmonologist at Persahabatan Hospital in Jakarta, one of the referral hospitals, said that when COVID-19 patients suffered from light pneumonia they could be cured faster. However, when they have developed acute respiratory distress syndrome (ARDS), that means the patient's lungs are already infected, causing respiratory failure, then they really need the ventilators to breathe.
“And now the hospitals treating the confirmed cases of COVID-19 are facing a crisis because ventilators are expensive, but we really need this technology and equipment. This is what we are thinking right now, hospitals need more ventilators and [isolation] rooms,” Diah said in a discussion on Wednesday.
“And we don’t only need the equipment but also the human resources. We need medical workers who are experienced and understand infection control,” she added.
She also said the government must pay attention and protect the medical workers treating COVID-19 patients.
“This disease is highly contagious. We must not only save the sick ones but also the healthy ones. We need healthy medical workers. They must be equipped with a protective suit when they treat patients. We must protect them because medical workers are the front line in this fight against the disease,” she said.
In West Java, due to the limited availability of personal protective equipment (PPE) such as hazmat suits, medical personnel of a public hospital in Tasikmalaya, West Java were forced to wear thin plastic raincoats, costing Rp 10,000 (70 US cents) apiece, when transporting patients under observation for COVID-19.
“Yes, it’s true that our staff were wearing just raincoats,” Tasikmalaya Health Agency head Uus Supangat said on Wednesday as reported by tribunnews.com. “The city [administration] bought 100 plastic raincoats at the store for a total of Rp 1 million.”
Some of the main referral hospitals have also reported that they have only a few isolation rooms. With growing numbers of positive patients, Sulianti Saroso Infectious Diseases Hospital (RSPI Sulianti Saroso) in North Jakarta, for example, only has 11 isolation rooms for COVID-19 patients.)
On Friday, Jokowi also stated that they were going to immediately finish the construction of a health facility specializing in treating COVID-19 patients on Galang Island in Batam, Riau Islands.
However, the plan to build a health facility in Galang was criticized by epidemiology experts.
Syahrizal Syarief, an epidemiology expert at the University of Indonesia, said building a new hospital would be a waste of money that would have been better allocated for ventilators and protective suits for medical workers.
“That’s also what we really need right now. I hope the government think thoroughly when they make policies like this,” he said.
Arya Dipa contributed to this story from Bandung.