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World Indonesia is the new epicentre of the COVID pandemic as the Delta variant surges and vaccination rates lag

23:10  22 july  2021
23:10  22 july  2021 Source:   abc.net.au

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A COVID-19 crisis has unfolded as the highly transmissible Delta variant tears through Indonesia, where health facilities have buckled under the pressure.

Cases in the fourth-most populous nation in the world are soaring — killing doctors and children — and it has become the new coronavirus epicentre, surpassing India, despite only having a fraction of its population.

On Thursday alone, official figures revealed more than 49,500 new positive cases and 1,449 deaths — the highest since the pandemic began.

But despite government efforts to lock down major islands, the number of deaths continues to grow as gravediggers work through the night, and coffin makers struggle to keep up with demand.

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So how did Indonesia end up here?

Mixed messages from the top

Local epidemiologists have repeatedly criticised the Indonesian government for not following advice from experts and scientists.

Last year in the early days of the pandemic, Indonesia's then health minister Terawan Agus Putrantro attributed the low number of infections to prayer.

Indonesian President Joko Widodo promoted traditional herbal remedies and attempted to prevent panic via positive narratives without scientific basis.

He also proudly touted nationally-made anti-malaria drug Chloroquine as a "second-line defence" against the virus, despite a lack of scientific evidence.

Last year, the Agriculture Ministry sold "antivirus" eucalyptus necklaces, which it said would kill the virus if worn for 30 minutes. The claim drew widespread mockery and criticism before being withdrawn.

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The Minister of Maritime and Investment Affairs, Luhut Pandjaitan — who is now in charge of coordinating Java and Bali's special emergency response — had also incorrectly said the virus could not survive in tropical climates.

He has since admitted the government "didn't expect" cases to increase again in June.

"We have warned [people and the government] how bad it can get without any intervention from a while ago," Indonesian epidemiologist Masdalina Pane told the ABC.

"But no-one was listening."

She said the COVID-19 issue in Indonesia was "complicated".

Indonesia's response has also been hampered by low numbers of testing due to the expensive price of imported swab tests, and a national shortage of ventilators, personal protection equipment and hospital beds.

Misinformation spreading with the virus

Even as the virus continues to spread, some people across the country still believe it to be a hoax.

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Indonesian public health doctor CSP Wekadigunawan told the ABC misinformation has had a "significant influence" on Indonesians.

"These hoaxes have made people scared of being found positive for COVID," she said.

"Where I live, people still don't understand what it means to self-isolate correctly. The knowledge regarding COVID-19 [across the country] is still very low."

One prominent epidemiologist at the University of Indonesia even went as far as calling the situation "herd stupidity", due to the combination of fake news through social media, contradictory messages from the government, and a broad reluctance to follow health protocols or get vaccinated.

A study released last month by the Yusof Ishak Institute (ISEAS) also found anti-vaccine messaging was often combined with anti-Indonesian government or anti-Chinese sentiments.

One of the authors of the study, Yatun Sastramidjaja, said it "indicates the government's chronic failure to gain the public's trust".

In order to get the information across, Dr Wekadigunawan suggested the government involve and educate all leading members of religious groups and local communities to help disseminate relevant health messages.

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Lockdown hesitancy and domestic tourism drives

Mr Widodo and his administration have long been criticised domestically for prioritising the economy over public health.

While many countries, including Australia, were gearing up to close their borders when the virus first hit last year, Mr Widodo spent close to $8 million promoting domestic tourism, and he kept domestic borders open.

Mr Widodo did attempt to enforce a travel ban last year during the religious holiday of Eid al-Fitri to prevent a mass exodus of people travelling to their regional homes.

But he stopped short of implementing a lockdown, and two weeks later cases jumped by more than 60 per cent, according to the government.

Authorities anticipated a similar increase this year and imposed another ban, but cases still increased by 50 per cent as many found a way to avoid the restrictions.

New emergency measures were announced on July 1 to contain the alarming surge in cases.

Rather than a nationwide lockdown, Jakarta opted for localised restrictions, particularly in the most populous island of Java and the holiday island of Bali.

Contact tracing no longer a priority

The more infectious Delta variant of the virus has hammered hospitals across South-East Asia, and Indonesia has been no exception.

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As the number of cases surged, so did the price of oxygen tanks.

Costs jumped from an average of $66 to $185, before supplies became almost impossible to find.

Indonesia has been relying on mass vaccinations to tackle the virus, but only 16.4 million of the 181.5 million targeted for inoculations have received the required two doses since January.

Dr Pane, who was involved with the government's contact tracing team, also said vaccinations are not enough to contain the rampant spread.

She said contact tracing, "a basic intervention used by many nations to control any form of epidemic",  was "no longer a priority for the government".

"We successfully managed to control infection numbers between mid-November to the end of March this year in 13 provinces through contact tracing," she said.

"If you ask me how long until [daily number of] cases start to decline, I can't say that it can happen soon, not until there's effective management."

Throughout the pandemic, Indonesia has recorded more than 3 million cases and 79,000 deaths, according to official government figures.

But experts predict the number to be far greater than what is reported due to limited testing.

The ABC has contacted the Indonesian Health Ministry for comment.

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