The Jakarta Post
Indonesia is struggling to acquire the necessary kits to conduct polymerase chain reaction (PCR) testing on a massive scale given the surge in global demand, the government’s spokesperson for COVID-19 affairs has said.
Achmad Yurianto, who is also the Health Ministry’s disease control and prevention director general, told The Jakarta Post on Wednesday that the government was scrambling to procure reagents from other countries as Indonesia’s current stock of reagents would only last a week.
The supply would only be enough for 35,000 tests, he said.
“The problem for our existing labs, which use open-circuit machines, is that the whole world is scrambling to acquire reagents for RNA [ribonucleic acid] extraction. Because these reagents are certainly used by all labs with open-circuit [machines]”.
Yurianto said that, as testing kit factories had reached their full production capacity, many countries, including Indonesia, were looking to countries that had an oversupply of kits. “The pandemic has brought about this consequence; any country will meet its own needs and prioritize itself first,” Yurianto said.
President Joko “Jokowi” Widodo reiterated his call for the Health Ministry and the COVID-19 task force to conduct more PCR testing on Monday, saying that they should aim to conduct at least 10,000 tests a day amid criticism that the country had one of the lowest testing rates in the world.
Yurianto said that, according to government estimates, the country would need to conduct some 1.2 million tests, which it should look to accomplish by May.
The government needs to reach the figure not only to detect new cases but also to find out whether there have been any recoveries, as patients with moderate symptoms might need to undergo the test four times, while those with severe symptoms might need to get tested even more than that.
Aside from efforts to obtain supplies of reagents, Yurianto said the government would opt to use rapid molecular testing equipment commonly used to detect tuberculosis bacteria, which with adjusted cartridges can detect the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) that causes COVID-19.
Yurianto said there were 957 such machines in 456 cities and regencies across the country, but only 305 were compatible, as they were produced after 2018.
This option, however, is not without its share of problems, as the demand for such cartridges, produced in a limited amount by the United States, was on the rise elsewhere. Yurianto said the government had ordered 23,000 cartridges this month, which could be used to run the same number of tests, but they would arrive in stages, with the first 3,000 cartridges currently on the way.
A similar concern was shared by Arya Sinulingga, an aide to State-Owned Enterprises (SOEs) Minister Erick Thohir, who said in a press briefing earlier this month that almost all countries in the world were scrambling to acquire testing kits and machines. The SOEs Ministry recently imported two RNA extractors and 18 PCR detectors, which Arya said would be distributed to labs in 12 regions.
The Health Ministry has a nationwide network of 32 laboratories that can run a total 5,000 tests a day with a declining supply of reagents, according to Yurianto, as the Health Ministry was assessing several other labs, including private ones, to run the tests.
Read also: Govt wants 78 laboratories to conduct COVID-19 tests
A survey by the Indonesian Medical Biology Association (PBMI) showed that, as of April 5, Indonesia had at least 106 laboratories that met the standards to run PCR tests as proposed by the Health Ministry. However, for the government to make the most of these labs, it must ensure a sustainable supply of testing kits, experts said.
Yogyakarta’s spokesperson for COVID-19 affairs, Berty Murtiningsih, said that reagents were often unavailable from the central government. She said her administration supported Jokowi’s aim of testing 10,000 people per day, as long as the reagents were available.
There are four labs running PCR tests in Yogyakarta; two in Gadjah Mada University Hospital, one in Dr. Sardjito General Hospital and the Health Ministry’s Environmental Health and Disease Control Center (BBTKLPP), which also processes samples from nearby Central Java. There is usually a long backlog at the BBTKLPP, Berty said.
“Each lab could process between 100 and 150 samples, provided the reagents are available,” she added.
West Java Health Agency head Berli Hamdani said there were currently three labs processing the tests in the province with a total capacity of 1,400 tests per day, but the figure is expected to double when machines imported by the SOEs Ministry arrive.
The province’s COVID-19 task force secretary, Daud Achmad, said on Monday that his administration had 20,000 PCR testing kits and, as a result, the most urgent tests should be prioritized.
Bali is planning to double its testing capacity by preparing Udayana University Hospital’s lab as it also expects PCR testing machines from the central government. Currently, Sanglah Hospital’s laboratory is the only laboratory conducting PCR testing on the resort island with a capacity of 68 tests a day.
— Bambang Muryanto, Arya Dipa, Ni Komang Erviani and Asip Hasani contributed to this story from Yogyakarta, Bandung, Denpasar and Blitar.