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East Java struggles to contain outbreak
Patients are overwhelming health-care facilities in East Java, where the scale of the COVID-19 outbreak is second only to Jakarta in the country
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Patients are overwhelming health-care facilities in East Java, where the scale of the COVID-19 outbreak is second only to Jakarta in the country.
On Thursday, East Java saw a record spike of 502 cases, bringing the case total to 2,998, with 241 deaths and 403 recoveries. Half of the cases were reported in the provincial capital of Surabaya, Indonesia’s second-largest city and a thriving trade hub.
The raise marked the highest daily spike ever recorded by a province nationwide, even surpassing that of Jakarta.
East Java has recorded 5,274 patients under surveillance (PDPs) and 23,151 people under observation (ODPs) — those who are suspected of having contracted the virus but have not yet been tested or are waiting for test results — with 601 fatalities among these two groups.
Yet the provincial administration has imposed large-scale social restrictions (PSBB) only in Surabaya, its two satellite regencies of Sidoarjo and Gresik, the city of Malang and neighboring Batu city and Malang regency, despite all of East Java’s 38 cities and regencies having confirmed at least one case each.
“We have recommended that PSBB should be enforced in the entire province before all the cities and regencies in East Java are declared red zones. The number of PDPs in East Java is very high [...] stretching throughout the province,” said Windhu Purnomo, an epidemiologist at the Airlangga University School of Public Health in Surabaya. He said the PDPs had more than a 60 percent chance of having been infected by the virus.
East Java, the home base of the country’s largest Islamic organization Nahdlatul Ulama (NU), is torn between virus-containment efforts and religious customs, especially during Ramadan. Last week, Governor Khofifah Indar Parawansa bowed to pressure from local chapters of the NU and the Muslim Ulema Council (MUI) to open mosques for Idul Fitri mass prayers. On Monday, she retracted the permit.
Experts have criticized what they consider weak enforcement and poor compliance during PSBB in Greater Surabaya, which have been extended until May 25.
Windhu blamed the central government for aggravating the situation in East Java by allowing factories to stay in operation nationwide even in areas under PSBB. The East Java Manpower and Transmigration Agency recorded more than 6,000 companies and factories continuing to operate in the province, including in PSBB areas.
Local health authorities recently discovered a new cluster of infections from the Surabaya factory of tobacco giant HM Sampoerna, which was still running during the early days of PSBB in the city and was later temporarily closed after two of its workers died of COVID-19. As of May 11, at least 41 confirmed cases had been linked to the factory.
Authorities have identified 72 transmission clusters in the province so far.
Among the first and largest clusters stemmed from a training session in mid-March for haj tour organizers at the Surabaya Haj Dormitory, which saw some 400 officials gather from health and religious affairs agencies in East Java, Bali and East Nusa Tenggara.
At least 167 confirmed cases have been linked to the event, with many of the participants becoming sources of new transmissions in their respective regions.
Dozens of confirmed COVID-19 cases in East Java were imported from Greater Jakarta, and more than half of its total confirmed cases were from unknown sources of infection.
“The higher the proportion of cases with sources of infection the authorities fail to identify, the worse the situation we are facing. It is uncontrolled, and we cannot even estimate the real number of infections,” Windhu said.
Half of the patients admitted to the Dr. Soetomo Hospital in Surabaya said they did not know where they had contracted the virus, only that they had been in a crowd in the past 14 days, the COVID-19 referral hospital’s head of emerging and re-emerging infectious diseases, Soedarsono, said.
COVID-19 national task force chief Doni Monardo said on Monday that the province had seen a 70 percent spike in weekly cases and that the proportion of filled hospital beds in East Java was higher than other provinces. About 95.2 percent of beds in Dr. Soetomo Hospital in Surabaya and 73.5 percent at Saiful Anwar Hospital in Malang were occupied, he said.
East Java has 132 beds in negative-pressure isolation rooms with ventilators, 693 beds in negative-pressure rooms, 1,500 beds in standard isolation rooms and 950 beds in observation rooms, according to data from the provincial COVID-19 task force.
Soedarsono said about 30 percent of COVID-19 patients at Dr. Soetomo Hospital had been admitted to the intensive care unit — 60 percent of whom needed breathing aid devices.
New patients, he said, kept coming to the hospital and the backlog of polymerase chain reaction (PCR) tests left current patients with no option but to stay longer at the hospital awaiting their test results, which would hopefully show them to be clear of the virus and free to leave the hospital.
