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COVID-19 in Indonesia: What should we expect in the coming months?

Behavioral changes at the individual, family and community level are needed to put coronavirus transmission under control. 

Mutiara Indriani (The Jakarta Post)
Jakarta
Tue, July 27, 2021

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COVID-19 in Indonesia: What should we expect in the coming months?

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trict mobility curbs, initially called emergency public activity restrictions (PPKM Darurat) now is PPKM level 4, are a necessary and much-awaited response from the government, although this measure has come too late from the public health perspective.

Putting the controversy aside, the implementation of PPKM Darurat from July 1 to July 25 deserves appreciation because the government had repeatedly demonstrated reluctance to take tough measures and had even shown denial during the first wave of COVID-19 outbreak.

Yet stricter measures are only the first step to lessen virus transmission within the community. The government has a limited capacity to monitor micro-interactions in private spaces, where transmission risk is considerably high. The next step depends on community behavior and cooperation to achieve herd immunity or a low transmission rate.

The Institute for Health Metrics and Evaluation has calculated three scenarios for COVID-19 cases in Indonesia. The first scenario involves higher mobility among those who are vaccinated, resembling pre-COVID-19 levels, the second scenario is a current projection based on officially reported data, and the third scenario supposes nearly universal (95 percent) mask use in public.

Indonesia’s COVID-19 cases will hit a plateau (the same transmission level as before the second wave) in mid-October 2021, based on the first scenario, early October in line with the second scenario and mid-September for the third scenario. This means the higher the community adoption of preventive behavior, the faster the second wave will end.

On the other hand, monitoring the daily death rate is the best indicator of the progression of the pandemic, since it takes about 17 to 21 days from the start of the infection to the occurrence of deaths. According to the above institute, by mid-July of this year, Indonesia's total COVID-19 deaths had hit 70,000. By Oct. 1, the number is projected to reach 222,606 in the first scenario, 207,623 in the second scenario and 186,012 in the third scenario. This means the COVID-19 mortality rate will continue to accelerate in the next few months at paces never seen before.

Public health experts from John Hopkins say herd immunity is achieved when 50 to 90 percent of the population is immune to the virus. Stopping the pandemic apparently lies in the majority of the population being vaccinated and keeping coronavirus transmission under control.

Taking Vietnam’s communist regime and New Zealand’s insularity into account, both countries present success stories in controlling the COVID-19 pandemic without achieving the herd immunity threshold. Both countries’ vaccination rates are considerably lower than the global average, at about 0.29 percent and 10 percent of the respective populations as of July. This proves that when deliberate policy making is followed by compliant community behavior, coronavirus containment measures work.

During the second wave, the spread of COVID-19 in Indonesia has followed the pattern of India. What Indonesia is experiencing today happened in India in March. Single-day cases in India gradually fell after months of a mass vaccination program and country-wide mobility restrictions. By early July, COVID-19 cases in India had hit a plateau. Sharing similarities in socioeconomic conditions with India, Indonesia should be able to learn from its South Asian neighbor.

As far as the government’s response is concerned, the support of communities will define the course of the fight against COVID-19. Behavioral changes at the individual, family and community level are needed to put coronavirus transmission under control.

While the government alone cannot cope with the adverse consequences of the pandemic, we are reminded of steps that we heard frequently at the start of the pandemic.

First, at an individual-level, the risk of being infected increases when surrounded by other people. Therefore, it is important to avoid mingling at all costs. The key to staying safe during the pandemic is restricting personal mobility and refraining from seeing others in person. When face-to-face contact is unavoidable, maintain COVID-19 protocols religiously. 

Second, at a family-level, providing support to other family members is crucial. If we are living with high-risk people, such as an elderly person or children, we need to be mindful when returning from work, shopping or other outdoor activities. Refrain from touching others before taking a shower and changing clothes. If a family member gets sick, they need to be given space for self-isolation and provided necessities such as food and medicine.

Third, at the community level, avoid hosting events that could amass crowds. We should remind each other not to make any visit unless it is urgent. During the pandemic, these steps are a show of compassion, by not putting neighbors and loved ones at risk. 

Finally, lessons from other countries can go a long way in helping Indonesia avoid mistakes. The first is to improve healthcare infrastructure and facilities, especially increasing the number of intensive care beds to treat patient in critical condition. By Aug. 9, the Institute for Health Metrics and Evaluation has projected, 45,157 intensive care beds will be needed, while the data from the Indonesian Hospitals Association shows that less than 10,000 are available.

Second, despite much-improved testing capacity, Indonesia still needs to ramp up daily testing to lower the positivity rate. By mid-July 2021, Indonesia's daily positivity rate had exceeded 30 percent, five times the World Health Organization’s prescribed rate of 5 percent.

Third, Indonesia must formulate policies based on rigorously verified data as evidence to support the government’s decisions on the relaxation of restrictions.

Last but not least, because of a potential third wave of the virus, preventive measures and persistent health communication are always necessary.

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The writer is international relations lecturer at Bina Nusantara University, Jakarta, with a master’s degree in international relations from Leiden University in the Netherlands and a bachelor’s degree in health, environmental and life sciences from the Ritsumeikan Asia Pacific University in Japan.

 

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