The Jakarta Post
The government is ramping up efforts to carry out mass, rapid polymerase chain reaction (PCR) testing amid concerns the world’s fourth-most populous nation lags woefully behind other countries in testing people for COVID-19.
The Health Ministry issued a circular on Tuesday allowing public hospital laboratories, public and private clinical laboratories, as well as state-owned virology laboratories and university research laboratories to conduct PCR testing as long as they meet level-two biosafety (BSL-2) standards for testing SARS-CoV-2, the novel coronavirus that causes COVID-19, and have the necessary equipment and facilities.
The decision came after President Joko “Jokowi” Widodo on Monday called on the Health Ministry and the COVID-19 task force to improve and accelerate PCR testing, which scientists say is crucial in the battle against the deadly pandemic.
According to pandemic data site Worldometer, Indonesia is ranked among the lowest in COVID-19 testing with only 52 tests for every million people as of Wednesday. By comparison, among neighboring countries Singapore has tested 11,110 for every million people, Malaysia 1,717 and Thailand 1,030.
As of Wednesday, Indonesia had only tested 14,571 people using the PCR method, a low number that has prompted public scrutiny of the country’s testing capacity and confirmed cases, which many believe remain underreported. Achmad Yurianto, the government’s spokesperson for COVID -19 affairs, told The Jakarta Post on Wednesday that the country’s labs had the capacity to test more than 500 a day.
The figure is expected to increase in the next few days.
In addition to relaxing the regulations on testing, the government has imported two automatic RNA extractors and 18 PCR detectors from Swiss multinational healthcare company Roche, which will be distributed to 12 provinces; Jakarta, Banten, West and East Java, Bali, Lampung, South and North Sumatra, East Kalimantan, South Sulawesi and Papua.
State-Owned Enterprises (SOEs) Ministry expert staffer Arya Sinulingga told the Post that the machines could boost the country’s testing capacity to between 5,000 to 10,000 tests per day, reaching as many as 300,000 tests within a month.
The machines will be installed in Jakarta next week and those in other regions in the next two weeks, he said, adding that the SOEs Ministry would ensure the supply of necessary kits for PCR testing, even though the Health Ministry said that the country currently had only 200,000 reagents for the labs.
Scientists have welcomed the ministry’s move to widen its laboratory network. They had been calling for such a measure ever since the ministry insisted on conducting the tests solely through its Health Research and Development Agency’s (Balitbangkes) laboratory in Jakarta since January.
It was only in mid-March that the ministry allowed other laboratories to conduct PCR testing. At the time, a nationwide backlog of tests had overwhelmed the operational laboratories, mainly due to the time-consuming manual extraction process commonly used in these laboratories and insufficient PCR test kits, consumables, such as the viral transport mediums (VTMs), and human resources.
Data collected from a survey by the Indonesian Medical Biology
Association (PBMI) showed that as of April 5, Indonesia had at least 106 laboratories of BSL2 standard quantitative PCR (qPCR), class II biological safety cabinets (BSC II) and sufficient human resources to carry out the procedures, which are among the requirements proposed in the Health Ministry’s circular.
PBMI deputy chairman Ariananda Hariadi said that this would mean the 106 labs, if made operational, could significantly accelerate testing so that hospitals could immediately use the results for triage purposes and local administrations for policy making.
“From the beginning, we in the PBMI were certain that there were many labs in Indonesia that could [conduct the tests], such as in universities, agricultural and livestock research and development agencies, even the veterinary research agencies, as they did during the H1N1 outbreak,” he told the Post on Wednesday.
Ariananda said that in order to make the most use of these labs, the government should continuously supply them with reagents, the necessary kits and personal protective equipment (PPE), as well as training and supervision for their human resources. He noted that automated-extraction machines, which were still rare in Indonesia, could also double the number of tests processed by labs.
Herawati Supolo Sudoyo, the Eijkman Institute for Molecular Biology’s deputy for fundamental research, said that as more labs would be able to conduct testing, it was also important for the government to accelerate testing by procuring closed-system machines so that extraction could be done automatically.