Coordinating Human Development and Culture Minister Muhadjir Effendy has claimed that Indonesia recorded only a moderate number of COVID-19 cases compared to other ASEAN countries and said the number continued to go down, dismissing Indonesia’s patchy testing capability and the highest death rate in the region.
“We’re on the right track. There is a decreasing trend of cases, though not dramatically. I thank all the people who have complied with the government’s COVID-19 precautionary measures,” Muhadjir said during a press briefing on Friday.
The statement came amid the government’s policy to ease travel restrictions and plans to gradually lift social restrictions in June.
On Saturday, Indonesia’s COVID-19 team reported the highest number of new cases in a single day, which was 533, bringing the total to 13,645 cases.
The data, critics and scientists have said, were not accurate because of Indonesia’s low testing capacity, which stood at fewer than 1,600 a day since March 3. As of Saturday noon, Indonesia has tested 108,669 people, which means it has conducted 0.39 tests per 1,000 people, one of the lowest test rates in the world.
Muhadjir considered the total number of confirmed cases “unexceptional” as Indonesia had a population of 273 million compared to the 6 million in Singapore, which recorded 22,460 cases as of Saturday.
He added that the country’s current growth rate of cases was not as extreme as in Europe or North America. According to the graph made by ourworldindata.org, starting in the fourth week after its first reported cases, the cases number in Indonesia doubles every five to seven days.
“We’re grateful that the exponential growth is not as rapid as predicted. The peak is at 500 cases a day,” he said, adding that the number of fatalities was plateauing as well and that all these data were used by the government as a guide to create policies regarding COVID-19 handling in the near future.
A disease surveillance and biostatistics researcher at the Eijkman-Oxford Clinical Research Unit, Iqbal Ridzi Fahdri Elyazar, however, was skeptical about the government’s claims.
“The government is not looking at the right curve, the epi curve. They use analytical tools that are invalid, inaccurate, not trustworthy and don’t met the epidemiological standards in assessing the COVID-19 situation,” Iqbal told The Jakarta Post on Saturday.
According to the US Center for Disease Control and Prevention, an epidemic curve, or epi curve, is a visual display of the onset of illness to assess the distribution of cases over time. An epi curve shows the daily infection rate.
Indonesia had yet to have an epi curve and therefore, any claims of a decline in cases were not based on the right tool. What the government had been displaying was a curve showing the daily cases reported by the authorities, not the onset of infections, Iqbal said. The Health Ministry, he said, should have made epi curves to get a clearer picture of what was happening.
“To determine the onset of infections, a thorough epidemiology study should be done. But because it takes time and is costly, usually experts use other measures, such as the date when symptoms start showing, or the date when samples are taken, because some COVID-19 patients show no symptoms,” Iqbal told the Post.
The infection rate could not be determined by daily reported cases unless the test result came back positive for COVID-19 on the very day the people contracted the virus.
Meanwhile, the government has yet to reveal the average time gap between the sample collection and the test result. Some patients reported they had to wait for their test results for nine to 14 days, Kompas daily reported.
Wide testing is just as important in supporting the epi curve. Indonesia’s testing coverage is still very low with only 0.39 tests per 1000 people, far less than in neighboring Vietnam, which has conducted 2.68 tests per 1000 people, Singapore with 30.02 tests per 1000 people. Authorities in Iceland, meanwhile, have conducted 154.4 tests per 1000 people.
“Therefore, the claim that the peak number of cases is at 500 is groundless. The number of cases reported each day very much depends on the number of tests conducted. More test means more confirmed cases,” said Iqbal.
He criticized the government’s claim about the plateauing trend of the death toll, saying the government was once again departing from the World Health Organization’s protocol, which requires to include the death of patients suspected of being infected with COVID-19 in the number of fatalities.
As of Saturday, the government has reported 959 deaths, but some regions that reported deaths among suspected patients indicated that the toll could be much higher.
“The WHO predicts that Indonesia’s death toll is four of five times higher than reported,” he said.
The government also failed to mention that the death rate is still high at 7 percent nationwide and 8.8 percent in the capital Jakarta.
“The government needs to immediately release the epi curves of each province, city and regency as the interaction between humans, viruses and the environment are unique in each region. The Health Ministry has all the data needed [to make the epi curve],” Iqbal said.