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Jakarta Post

Top Indonesian doctors call for lockdown, say physical distancing not enough

  • News Desk

    The Jakarta Post

Jakarta   /   Fri, March 27, 2020   /   03:11 pm
Top Indonesian doctors call for lockdown, say physical distancing not enough Medical workers at Bogor City Hospital conduct an examination of a patient suspected of having COVID-19 during a simulation in an isolation room at the hospital in Bogor, West Java, on March 4. (Antara/Arif Firmansyah)

Dozens of Indonesian medical professors have called for “local lockdowns”, saying that the government’s policy of physical distancing is not “effective”.

The call comes after medical workers and scholars in the midst of the fight against COVID-19 have died, while others continued working in dire conditions.

In a statement made available to The Jakarta Post on Thursday, the Medical Professors Council at the University of Indonesia’s (UI) School of Medicine said Indonesia had recorded the fifth-highest fatality rate in the world at around 8.7 percent with 790 cases and 58 fatalities as of Wednesday.

On Friday, the figures had climbed to 1,046 confirmed cases and 87 deaths.

“More than 500 scholars in the world have stated that physical distancing is not enough to control the spread of SARS-CoV-2, so what we need are further restrictions. Strict rules are needed to make sure people stay at home. [The government] should apply fines for individuals or companies that violate the rules,” the council’s chair, Siti Setiati, wrote.

Using Wednesday’s figure and factoring in the global fatality rate of around 4.3 percent, however, the council suggested that the disease might have infected some 1,300 Indonesians, not 790.

“Our health facilities are not ready. With Greater Jakarta and Surabaya [in East Java] becoming the epicenters of the infection, our health facilities are still having trouble in getting protective equipment,” the statement went on.

“Moreover, only a few hospitals have ventilators available, leading to a high mortality rate,” the council wrote.

“Studies show that Indonesia only has two intensive care unit (ICU) beds per 100,000 people. That is the lowest proportion in Asia,” the statement continued. “Imagine if the disease spread throughout Indonesia, not only would citizens be affected but medical workers on the front-lines would fall one by one as well,” the council said in the statement.

The professors council has about 75 active members, all veteran doctors.

Last week, a professor from UI’s School of Public Health, Bambang Sutrisna, an epidemiologist, and another pharmacology professor from Gadjah Mada University, Iwan Dwiprahasto, died of COVID-19.

The two professors were among 10 doctors who were members of the Indonesian Medical Association (IDI) to die from COVID-19 amid the fight against the disease, according to IDI’s official Instagram account. Seven of them were confirmed to have contracted COVID-19.

One of them, Toni Silitonga, died not of COVID-19 but he was busy helping prepare health facilities for COVID-19 in his last days, IDI said. On Friday, the IDI reported the deaths of two of its members but the association had yet to confirm the cause of death.


IDI berduka...

A post shared by PB Ikatan Dokter Indonesia (@ikatandokterindonesia) on

To prevent further disease transmission, the doctors advised that the government impose local lockdown measures by closing some areas or provinces where the COVID-19 spread had soared.

As of Friday, the disease had been reported in 28 provinces out of the 34 in the country. Provinces in Java have recorded the highest number of COVID-19 cases, with Jakarta, West Java, Banten, East Java and Central Java making up 84 percent of total nationwide cases. Many cases outside Greater Jakarta had been imported after the patients visited Greater Jakarta.

The council took examples from other countries that had enforced lockdowns, such as China, which had restricted movement and social activities in Hubei provinces, ground zero of the disease.

“Implementing lockdowns and strict social activity restrictions in Hubei province, China have shown to be effective in reducing cases by 37 percent more than other cities that do not implement this system,” the statement wrote, adding that enforcing a lockdown in Hubei had severely reduced the transmission rate in the area.

The council also cited a study by the United Kingdom’s University of Southampton, which shows that implementing isolation and early detection policies in China one week earlier would have cut the number of cases by 67 percent out of the 81,000 cases the country has recorded.

As authority to declare a lockdown falls in the hands of the central government, President Joko “Jokowi” Widodo has dismissed the possibility several times due to social and economic concerns. He instead advised people to stay home, reduce social activities in crowds and maintain a distance from others in social interactions. The council, however, believes that the current measures have been ineffective.

Locking down some areas, however, would affect informal workers that relied on a daily income the most. The council, however, said that money received from taxes could be allocated back to the people in the case of a lockdown.

The council took examples of Jakarta, where ensuring the livelihood of its 9.6 million residents for two weeks would cost around Rp 4 trillion compared to the country’s Rp 1.3 trillion tax income in November.

“With such calculations, it seems possible to impose a local lockdown or quarantine of the area in order to prevent the further transmission of COVID-19. Returning some of the tax money from the people, for the people in the event of a pandemic like this is common sense,”.

The council ends its statement by making a call for the government to exercise evidence-based decision-making. “The government should involve experts, including those in the public communication field,” it said. (mfp)