Emma Connors, Jakarta – Indonesian scientists have doubts about the accuracy of the country's COVID-19 testing and have called on the government to work with others to speed up and improve diagnosis.
Indonesia confirmed two more COVID-19 cases on Sunday night, taking the total to six in the world's fourth most-populous country, home to 270 million people and with many trade and travel links to China where the virus originated.
On Sunday, the Australian government updated its travel advice for Indonesia, saying: "There is limited availability of testing and infection control facilities and the risk of transmission of the virus is increasing."
Ahmad Utomo, a researcher at the privately-owned Stem Cell and Cancer Research Institute in Jakarta, said he was worried about the accuracy of the test kit used by the Ministry of Health's National Institute of Health Research and Development.
"The positivity rate is very low, even in the case of patients who have been hospitalised. I am afraid that we will expand the tests to a large scale which will certainly add to the cost burden but the quality will still be in doubt," Mr Ahmad said.
As of Sunday, 483 people across Indonesia had been tested for COVID-19. Three have tested positive in Depok City in West Java, two in Jakarta and one was crew member on the Diamond Princess cruise ship. Another 454 were negative and 32 results are still unknown.
Mr Ahmad called on the government to disclose the detail of the genome sequencing tests it uses – which takes three days to deliver a result – so external parties could check for potential problems and collaborate on a more efficient design and methodology.
"In Indonesia there are many biotech experts who can design a kit that can deliver a result in 24 hours; after all the virus sequence already exists," he said.
"In Singapore, for instance, they don't buy ready-made kits; they assemble themselves. We could also do that and it would also keep costs down," Mr Ahmad said.
Amin Soebandrio, chairman of the government-owned Eijkman Institute, said there were facilities, including his, ready to help in COVID-19 testing.
"In my opinion it would be better if results were confirmed by another, independent laboratory that had no structural relationship with the Ministry of Health. That would increase the community's trust.
"We have said we are ready to help. I don't know why we are not involved," Mr Amin said.
There is also growing disquiet about the government's handling of the health emergency in the neighbourhood collectives, or kampungs, where most Indonesians live.
Every four or five years, residents most elect a leader for their Rukun Tetangga, which translates as "neighbours living in harmony together". These community organisations span hundreds of households where most people are known to each other.
Anis Hidayah lives in the same Depok housing complex as the mother and daughter who last week became Indonesia's first confirmed COVID-19s cases. She says the national government had failed to protect the privacy of patients, among other shortcomings.
Anis and her husband, who is head of the local Rukun Tetangga, did not know what to do when the information was made public. She said there was no information on what action people should take if they had been in contact with confirmed cases.
"The panic was undeniable. We were all shocked," Ms Hidayah said.
She was upset by how quickly the names and addresses of the patients spread over social media, and said higher levels of government had taken days to give them advice on what to do. Finally they received a six-step instruction guide to distribute to their neighbourhood, which did not mention washing hands but did advocate reducing outdoor activities, consuming vitamin C, eating healthy foods and praying.
In East Jakarta, another neighbourhood leader Riyatno said he had received some COVID-19 information from government organisations one or two steps up the ladder from Rukun Tetangga, but he would have also liked some practical assistance.
During the meeting, Rukun Tetangga leaders were asked to immediately call hotlines if there were any residents suspected of being infected by COVID 19.
"Unfortunately, they didn't give us any masks, soap, hand sanitisers nor disinfectant for residents, like Surabaya has done," said Riyatno, who uses only one name.
It has emerged in recent days that the Major of Surabaya had stockpiled hand sanitisers and masks, even though central government figures have spent weeks asking people not to do so.