SitRep: Indonesia

Indonesia’s first COVID-19 case was not announced until March 2, 2020, and the official number has grown to 1,980 positive cases as of April 3, 2020. The Ministry of Health reports 181 deaths as of that date, making Indonesia’s COVID-19 mortality rate (9%) the second highest in Asia. This late response, remarkably low total number reported, and high rate of death can all be attributed to lack of testing and slow national response.

Indonesia’s National Intelligence Agency predicted that by July 2020, the number of infected persons may reach 106,287, and the Public Health Faculty of Indonesian University predicted between 500,000 and 2.5 million infections, depending on the level of the government intervention. Of course, accurate data depends on the ability to test the population. After receiving hundreds of thousands of rapid test kits from China in mid and late March (including one-week delay due to red tape), Indonesia began testing in Jakarta, West Java, and Banten, focusing on areas with the most confirmed cases and deaths, and vulnerable populations including medical workers. Only 7,621 tests have been conducted as of April 4, 2020. 

Government intervention has been slow and is criticized as focusing primarily on economic impact. The Minister of Finance predicted that the pandemic would result in Indonesia’s economic growth being cut by more than half, projecting less than 2.3% growth, compared to 5.0% predicted before the outbreak.

President Joko Widodo did not declare a public health emergency until March 31, 2020, only then introducing social restrictions and urging local and regional leaders to not issue separate regulations, including lockdown orders. The president’s orders follow the measures stipulated by Law 6/2018 on public health emergency measures regulating public activities and gatherings, but the implementation and effectiveness of the order are still unclear. As the federal response has been painfully slow, state and local governments across Indonesia had begun implementing local restrictions in early and mid March. Provincial governments in the western region, for example, declared their own states of emergency as other provinces claimed to have no positive cases and conducted business as usual. The governor of Jakarta had urged President Widodo in early March to impose a lockdown, as only the president has power to do so. The public had also called for removal of Indonesia’s Health Minister for failing to take the threat seriously.

Before a public health emergency was declared, the national policy announced on March 17, 2020 and effective March 20, 2020, simply followed WHO guidance. Indonesian authorities advised the public to avoid non-essential travel, implemented public health monitoring of visitor arrivals to the country, and restricted entry of anyone who had travelled to seven countries in the last 14 days; China was notably absent from that list.

To increase the ability of the medical sector to respond, the government provided an additional IDR 400 trillion (US $24.4 billion) in the national budget allocated to importing medical kits, equipment, and drugs such as Avigan and Choloroquine, and to provide protection and financial incentives to doctors and medical assistants who directly engage with COVID-19 patients. The Athletes Village in central Jakarta has been converted into an emergency hospital, and the Pertamina Jaya Hospital in Jakarta is temporarily a special hospital designated for COVID-19 treatment. A designated COVID-19 emergency hospital on Galang Island in Riau Islands Province was built in anticipation of the need to treat Indonesian migrants returning home primarily from Malaysia.

These measures are all too-little, too-late for Indonesia, and the true extent of the virus spread is yet unknown. In light of this serious situation, Outbreak Asia recommends the following.

Policy recommendations:

  1. Implement a coherent national policy including lockdowns, quarantines, and public health campaigns to reach all residents. Coordinate with local governments on enforcement of the policy.
  2. Officially ban mass gatherings, including religious gatherings.
  3. Restrict all outbound domestic and international travel.
  4. Quarantine all international arrivals, regardless of nationality, for 14 days.
  5. Increase testing capacity across the country using rapid test kits to identify COVID-19 clusters, approve additional PCR test labs, and increase PCR testing in Jakarta.
  6. Allocate additional funds from the national budget to increase the number of health facilities, doctors, and medical staff, particularly in regions beyond the three current focal points of testing and treatment.    
  7. Establish a broader cooperation among ASEAN member countries to minimize the virus spread and follow up on the commitment of the Finance Ministers of ASEAN countries, adopted on March 10, 2020 in Vietnam.
  8. Allocate additional funds from the national budget to Indonesia’s most vulnerable populations, including cash handouts

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