By Tom Allard
JAKARTA (Reuters) – The scenes in Indonesia’s hospitals in the past week have been eerily similar to those in India two months ago – hospital corridors jammed with COVID-19 patients and frantic families trying to find oxygen to treat sick loved-ones.
Instead of the makeshift funeral pyres in the streets of New Delhi, the capital of predominantly Muslim Indonesia, Jakarta, has seen truckloads of corpses being transported to newly dug grave sites.
Since the peak of its recent crisis, India has engineered an eight-fold reduction in recorded coronavirus infections, and Indonesian President Joko Widodo called Indian leader Narendra Modi for guidance as his nation grappled with a trebling of positive COVID-19 cases in the past three weeks.
“We can learn from there,” Jokowi, as the president is widely known, told business leaders on Wednesday.
But, say epidemiologists and health professionals, Indonesia has failed to fully heed the lessons of India.
Indonesia announced a two-week lockdown on Thursday limited to the islands of Java and Bali covering only 12 of the country’s 34 provinces and about 55% of its population.
By contrast, “almost all” states and territories in India introduced stricter movement restrictions during its COVID-19 crisis, according to a World Health Organisation (WHO) analysis. This followed guidance from India’s central government that lockdowns should occur where positivity rates – infections per person tested – were 10% or more.
All of Indonesia’s 34 provinces have positivity rates above 10%. The WHO says a positivity rate above 5% indicates COVID-19 is out of control.
Ten provinces outside Java and Bali saw positive cases double in the week to June 27, according to the most recent government data published by the WHO. Only two in Java and Bali saw the same surge.
“This lockdown should have been done earlier. Not only in Java and Bali, but in all regions,” said Irwan Muryanto, an epidemiologist based in Riau province, on the island of Sumatra.
Jokowi said in a statement the focus on Java and Bali followed input from ministers, experts and regional leaders. The restrictions, he added, “are more stringent than those that have been in effect so far”.
Epidemiologist Pandu Riono said the coronavirus was more easily transmitted on densely populated Java island.
Even so, he said, the lockdown “is not strong enough” and should have been done before the Eid al-Fitr holiday in early May when millions of Indonesians flouted modest controls to return home to their villages.
Indonesia’s ability to treat severely sick COVID-19 patients is significantly less than India’s. Indonesia, with 270 million people, has 8,485 intensive-care beds, according to data from the Indonesian Hospitals Association. This is less than half than intensive care beds, per capita, in India.
Erlina Burhan, a pulmonologist at one of Jakarta’s main hospitals, said the facility was already over-capacity. Staff were jamming 11 patients into emergency isolation wards designed for seven.
“The people are very panicked,” she said.
Hospitals in Jakarta and other parts of Java are operating at 90% capacity or higher, but Irwan said hospitals in the outlying regions are more vulnerable.
“Our concern is that if there is a further spike in cases outside Java and Bali, the availability of beds and hospital intensive care units will be a major problem,” he said.
The government also plans to rapidly increase testing, flagging a fivefold increase until positivity rates begin to fall. If successful, it will remedy a long-standing deficiency. India currently tests three times more than Indonesia, per capita. Indonesia has also set ambitious targets to boost contact tracing and vaccinations
This, said Riono, was welcome. “The key, as always, is implementation.”
(Reporting by Tom Allard. Additional reporting by Tabita Diela; editing by Robert Birsel)