The Jakarta Post
Almost unnoticeably, sometime in early May, the coronavirus crept into a house in Indonesia's emerging COVID-19 epicenter of Surabaya and ensnared four members of the family who lived there.
The father of the family, 68, died on the morning of May 30 before being tested, less than a day after he was admitted to an isolation room at a Surabaya hospital along with his 61-year-old wife.
Later that day, in a different hospital, surgeons operated on the couple's eldest daughter to remove her unborn child, whose heart had stopped beating. The woman who lost her child had tested positive for COVID-19 and had been on a ventilator for days before the operation.
In the early morning of May 31, hours after the burial of the family’s father and the unborn child, which the bereaved family could only witness from inside their cars, the eldest daughter died.
The youngest daughter begged the nurses to let her see her dead sister, a 34-year-old who had been married for two years, by video call.
On June 2, the mother of the family died before she was tested, an hour after she told her youngest daughter by phone that she could no longer bear her breathing difficulties. She passed away unaware that her eldest daughter had died before her.
Their stories were shared by the family's youngest daughter, 27-year-old Dea Winnie Pertiwi, who spoke with the media after rumors about the family made the rounds on WhatsApp groups.
The deceased family members are survived by Dea, her middle sister, as well as her brother-in-law and his 17-month-old child.
"Thank God that during the last burial, which was my mother’s, I could bathe her body and join her funeral even though I had to have full personal protective equipment [PPE] on," Dea told The Jakarta Post, referring to a common Islamic funeral rite that has all but ceased under the pandemic.
Dea and her family spent the following days separately in mandatory isolation. They were united only by their grief. There was no takziyah (vigil) nor funeral for the deceased. The graves were left plain, with simple wooden mounds displaying the deceased’s names and the hospitals where they had died.
Dea herself was waiting for test results as she had developed a cough and had lost her sense of smell.
"My parents never left the house. In fact, my father was very disciplined about [health protocols]," Dea said.
Like nearly half of those over 60 years old in the country, Dea's parents lived in a three-generation household, consisting of themselves, two of their daughters, a son-in-law and a grandchild. Dea lived further away in the suburbs of Surabaya.
Surabaya had recorded 3,439 COVID-19 cases as of Wednesday – making up half of East Java's cases – with 923 recoveries and 300 deaths. The city also had 3,426 patients under surveillance (PDPs) and 4,002 people under observation (ODPs). Eastern Surabaya, the downtown area where Dea's parents resided, has recorded the highest numbers of cases and deaths.
In mid-May, Dea's brother-in-law started developing COVID-19 symptoms a day after he took his wife, who was eight months pregnant, to a monthly prenatal check-up. This was followed by Dea's middle sister, who developed breathing difficulties. The family brushed it off as a seasonal flu.
A few days later, Dea’s eldest sister developed a fever and breathing difficulties. Her pregnancy had limited the medicine she could take, and by the time she was admitted to the hospital on May 26, it was too late. Her condition had worsened, and she had suffered a miscarriage.
"I've brought my sister to the emergency room twice. The first time we asked for her to be hospitalized, the doctor said the hospital was overloaded and that there were no isolation rooms for pregnant women,” Dea said. “My mother also requested hospitalization twice, but the hospital advised her to self-isolate first.
“Why were patients who had personally requested hospitalization because home treatment was not sufficient rejected by the hospitals?"
At Dea's mother’s first visit to the hospital on Idul Fitri, the chest X-ray showed white spots on her lungs. Her rapid antibody test indicated the presence of COVID-19, but the more conclusive swab test would only be available a week later, and its results would take even longer, Dea said.
Within five days, the white spots had multiplied, Dea’s mother’s second X-ray showed, and only then was she admitted to an isolation room with her husband, who had become too weak to walk.
Both died as PDPs before they were swabbed. Dea was told that this was because the lab was closed on Sunday and June 1 was a national holiday, coupled with a lengthy waiting list for swab testing.
"COVID-19 is real,” Dea said. “Many people seem to underestimate it, but that is because they have not experienced it themselves,”
Her case gives a glimpse of the problems haunting Surabaya's efforts to contain the outbreak: overloaded hospitals and a lingering testing backlog. These problems remain even as the city begins to ease restrictions to address economic concerns. Meanwhile, new cases continue to soar.
East Java COVID-19 task force tracing team head Kohar Hari Santoso said that although hospitals had been "relatively full", there were rooms available for new patients.
He also pointed to a newly opened emergency hospital in the city, which had a capacity of 271 beds that could be gradually increased to 512 beds. The hospital, however, only aimed to treat mild cases so as to not overwhelm the city's 20 referral hospitals.
"[Surabaya’s health care system] was already overwhelmed before restrictions were loosened. [...] If transmission continues, patients will not be able to be treated optimally – or will not be treated at all – and the death rate may increase,” epidemiologist Windhu Purnomo said.
The city, he said, should add more lab workers to allow labs to operate non-stop.