While the risk of reaching a catastrophic number of cases and deaths continues to increment, the COVID-19 epidemic has had a great socioeconomic impact on people. More than 3 million Indonesians have lost their jobs due to businesses closing down and the large-scale social restrictions (PSBB). The national poverty rate is predicted to hit 10.6 percent this year, up 1.3 percent from the previous year.
Indonesia has attempted to ease socioeconomic pressures in supporting the most affected communities by expanding its social protection programs. Fiscal budget limitations, combined with the mistargeting of recipients and ineffective administration and distribution, however, have slowed these efforts.
Given the mounting socioeconomic pressures, the government is considering a plan to phase out the PSBB. There are two fundamental conditions that a country must meet to start phasing out social restrictions: a high healthcare capacity to treat the infected, and a strong containment capability to the spread of the virus. Unfortunately, Indonesia has not fulfilled either of these conditions.
In terms of healthcare capacity, Indonesia is still on the weaker side of the spectrum. Most COVID-19 hospitals in Indonesia are currently facing a shortage of medical workers, with dozens of doctors and nurses infected and dead, and many others testing positive. Moreover, insufficiency of medical equipment is also a major issue, as hospitals are still asking for personal protective equipment (PPE).
Our current containment capability also remains insufficient. Two months since the virus first emerged, Indonesia has only performed less than 200,000 polymerase chain reaction (PCR) tests, or swab tests. For comparison, this is the number of tests South Korea performs in 14 days, given its capacity to conduct up to 15,000 PCR test per day. Moreover, unlike other countries, Indonesia has not maintained an epidemic curve, a visual display of the onset of illness among cases associated with the outbreak, to predict future clusters of infection. Indonesia only maintains data on confirmed cases.
This clearly indicates that Indonesia is not ready to phase out the PSBB. Opting to end its social restrictions in the near future will mean bearing big consequences for the country. With reduced social distancing, the number of cases will spike to further burden the healthcare system. Infections will spread rapidly, illnesses increase, and the death toll will reach new heights.
Moreover, this will result in a divided and unstable society. Forcing those who feel safer at home to resume activities outside the home will be considered a risk to their health and may result in extreme resistance. On the other hand, those who must head outside their homes to make a livelihood are exposed to a higher health risk. At the end, it is a lose-lose situation for both those who want to stay at home and those who must go out. Division and inequality will then become further exposed.
However, If Indonesia remains adamant about phasing out its restrictions in an attempt to restart the economy, focusing on building a strong containment capability is a far better option, since it is cheaper, faster, and less risky compared to playing catch-up by trying to strengthen its healthcare capacity.
The following strict policies and measures can be put forward in an effort to strengthen our containment capability and complement our weak healthcare capacity before phasing out the restrictions.
First, boost the testing capacity to a preventive level. With the current testing capacity, Indonesia is barely able to cover suspected cases of COVID-19 infection. Some have said that the number of cases shows an increase only when test kits are available, which implies that the figures do not reflect the real situation.
To protect public health, Indonesia needs to aim for mass testing of all patients under surveillance (PDP) and persons under monitoring (ODP). For comparison, Wuhan, where the outbreak began, tested all 11 million residents in 10 days to ensure that it was safe to resume economic activities.
Second, ensure cross-area clearance. The regions in Indonesia all have different levels of readiness in disease management and control. Many have said that cross-regional control remains weak because of double standards and poor compliance.
To control the movement of people, countries like China and Singapore have implemented the use of QR codes at checkpoints for entering and leaving offices and public buildings. First-time users must register their ID and phone number, record their body temperature, and scan the QR code provided at checkpoints to each building and store. This mechanism works the same way as the QR payment system that has been expanding in use in Indonesia, which could help the government manage the virus’ spread.
Third, the enforcement of safety and health protocols to change public behavior must be tightened. Aside from implementing thermal imaging scanners and the use of safety equipment, the government can deploy a task force to ensure public compliance. Authority could also be reinvented in coordination with the private sector and local communities in conjunction with an intensive public awareness campaign.
Last, social unity and stability could be ensured by developing a community care plan. The Indian state of Kerala has relied greatly on community engagement in its provision of community kitchens and production of masks and hand sanitizers. The local government is also supporting citizens by providing internet access and mental health consultations.
A large proportion of Indonesian communities are working in a similar fashion. Indonesia can easily adopt the mechanism with adequate support from government and the private sector.
To conclude, Indonesia is clearly not ready to phase out the PSBB. However, if a decision to phase out the PSBB must be made, only in implementing the right measures will we be able to balance public health risk and socioeconomic hazards.
