The Jakarta Post
That coronavirus is a highly infectious disease is a well-known fact. However, many people still choose to ignore calls from experts and the government to practice physical distancing and cancel big events. Indonesia has seen several large gatherings around early March, and now many are worried that such ignorance has helped the virus spread massively to many parts of the country.
At the end of February, a week before President Joko "Jokowi" Widodo announced the first two cases of COVID-19, and while other countries were busy fighting against COVID-19, thousands of people from various cities in Indonesia gathered for two different seminars for several days in Bogor, West Java. One was a seminar on economic empowerment and the other a religious seminar held by the Protestant Churches of Western Indonesia (GPIB).
Fast forward a couple of weeks after the seminars ended, and the first death of one of the participants of the financial seminar was reported. The patient, a resident of Surakarta, Central Java, was positive for COVID-19. A friend of hers, who had not attended the seminar, died from the disease a week later.
In Batam, Riau Islands, some 900 kilometers from Bogor, a female priest who had joined the religious seminar died of the same disease on March 19.
Other participants of the two seminars have been diagnosed as COVID-19 positive. They live in various cities, like Balikpapan, Samarinda and Kutai Kartanegara in East Kalimantan, as well as Lampung and Yogyakarta.
West Java Governor Ridwan Kamil said the two public events were among four big clusters of COVID-19 cases in West Java. They were a regional conference of the Association of Young Indonesian Business People (Hipmi) in Karawang regency on March 9 and a religious conference in Lembang, Bandung, from March 3 to 5.
Indonesian Democratic Party of Struggle’s (PDI-P) West Java chapter member Gatot Tjahyono, who attended the business forum in Karawang, died on Friday. A preliminary diagnosis indicated he might have contracted the disease. He was initially diagnosed with dengue, according to a family representative.
“Now, with the help of the police, we are tracing the participants’ addresses so we can test them,” Ridwan said.
People are now worried that the thousands of seminar participants have helped spread the coronavirus across the archipelago. Some even started to wonder whether the participants in the seminars constituted so-called super-spreaders.
Detecting a super-spreader is important to prevent the individual from infecting others. Experts, however, say it will be difficult to identify super-spreaders in Indonesia because of the lack of access to government health data and lack of details on COVID-19 cases.
Disease surveillance and biostatistics researcher Iqbal Ridzi Fahdri Elyazar from the Eijkman-Oxford Clinical Research Unit (EOCRU) said tracking down possible super-spreaders was pivotal.
“It is not an easy thing to know who is a super-spreader. […] The sooner we investigate the infection chain, the easier for us to identify super-spreaders,” Iqbal told The Jakarta Post on Friday.
A super-spreader, according to Iqbal, is someone who is infected and has contacts in one transmission chain and infected many people.
In South Korea, a woman identified as Patient 31 appears to have infected dozens of others.
There are, however, still no global standards and set quantity of transmissions that would define someone as a coronavirus super-spreader.
Super-spreading was a common phenomenon in the transmission of infectious diseases, Iqbal said. It is usually triggered by the virus virulence, the environment and the person’s immunity.
“As long as there is no serious and drastic effort from the authorities to stop any gatherings that allow many people to gather in one place this phenomenon will keep happening,” he said. “The persistent attitude of people who want to keep on doing events must be seen as an act of violating public safety and order.”
Whether Indonesia already has cases of super-spreading or not, the government and experts have urged people to stay at home, practice physical distancing and avoid public events.
National Disaster Mitigation Agency (BNPB) spokesman Agus Wibowo said the most dangerous people were the ones who were asymptomatic but carried the virus, as well as people under surveillance (ODP) who still walked around outside their homes as if nothing had happened and infected more people.
“The ones who are confirmed positive are not dangerous, because they are in hospitals. […] That’s why now the policy we took is to prohibit anyone from gathering in crowds,” he said.
Although the devastating news about the highly contagious coronavirus has been circulating since January, it was only on March 15 that the government through Jokowi officially advised people to practice physical distancing, work and study from home and avoid public events.
Berry Juliandi, a neuroscientist from the Bogor Institute of Agriculture (IPB) and a member of Indonesia Young Scientists, said such a policy alone was not enough to slow down contagion.
“What we must do now is to quarantine and lock down several areas that have shown high infection spread. We must impose restrictions or sanctions on people who still want to go out of their houses for certain purposes. […] Until now there is still no sanctions and assertiveness, no law enforcement,” he said on Friday.
Indonesian health authorities have confirmed 1,155 COVID-19 positive cases and 102 fatalities as of Saturday afternoon. Meanwhile, the number of people having recovered from COVID-19 has increased to 59.