Indonesia has added a grim new statistic to its COVID-19 fatality rates that are already among the highest in the world — a high ratio of doctor deaths amid warnings the country’s health system may not be able to cope with an “Italy-level outbreak”.
At least seven Indonesian doctors and one nurse have died of COVID-19 out of a total of 55 deaths — more than one in seven — across the archipelago, with the national doctors association blaming overwork and a lack of protective equipment. In Italy, where 5476 people have died of the coronavirus, 23 of them were doctors.
Medical workers across the country have been forced to don cheap plastic raincoats to protect themselves from the virus in hospitals already under strain, weeks before Indonesia’s expected caseload peaks.
Some 686 people have so far tested positive in Indonesia from fewer than 3000 tests, with the vast majority of cases in Jakarta where Governor Anies Baswedan has imposed a state of emergency, though the government has begun ramping up tests in recent days.
Modelling by Indonesian researchers suggests half the nation’s 267 million people could be infected in the next few months if Indonesia continues as it has — with little testing and no rigorous lockdowns. The figure far eclipses the government’s prediction of 700,000 COVID-19 caseload.
“In Italy, 4800 health workers were infected by coronavirus but in Indonesia we can’t afford a situation like that,” Indonesian Doctors Association spokesman Halik Malik said. “The system and the resources we have, in terms of funds, equipment and human resources, can’t handle an explosion of cases. We won’t be able to handle a worst-case scenario.”
The government has announced incentive payments for doctors and nurses and has begun distributing masks and other protective clothing after the air force picked up 105,000 pieces of protective clothing and rapid testing kits from Shanghai.
Nurses Association spokesman Harif Fadillah described the incentive payments as “ground-breaking”, particularly given nurses faced serious community discrimination. “Many nurses have been shunned by their boarding houses and some even kicked out of their rooms because people are afraid they bring the disease home,” he said.
Mr Harif said a one-off purchase of protective clothing would not meet ongoing demand, given predictions the Indonesian COVID-19 caseload is not expected to peak until the end of April.
Worst-case scenario modelling by Essex University professor of applied mathematics Hadi Susanto suggests if Indonesia locks down Jakarta — the epicentre of the outbreak — but does little else, infection rates could reach 50 per cent of the population and deaths into the millions before the Idul Fitri Muslim holiday in mid-May, when most Indonesians return to their home towns.
Without a lockdown, the scenario could be even more dire.
“Researchers usually like their calculations to be correct but in this case we don’t want our modelling to be right,” Professor Hadi told The Australian. “We do not want 1 per cent of 50 per cent of the infected population to die.”
Under Jakarta’s state of emergency, office hours are restricted, entertainment venues closed, mass gatherings banned and public transport curbed though that measure has had the perverse effect of forcing more commuters into fewer trains and buses. President Joko Widodo has urged all Indonesians to work, study and pray at home but on Tuesday once again ruled out a lockdown because of the strain it would put on tens of millions of working poor, calling instead for Indonesian to observe strict “physical distance”.
While the restrictions have had some impact on the usually smoggy capital, which enjoyed a rare blue sky day on Tuesday, millions of workers do not have the luxury of staying at home.
At central Jakarta’s Blue Sky travel, Yuli Farma told The Australian she and her colleagues had been told they could not work from home.
Gojek motorbike taxi driver Tunggal said he too had to keep working, despite his family’s fears that doing so could expose them all to the virus.
“If I don’t work, we don’t eat,” he said.