Erwida Maulia and Ismi Damayanti, Jakarta – The governor of Jakarta raised fresh alarms over the spread of coronavirus infections in the Indonesian capital as daily cases hit new records in the past week, mirroring the nation's rising trend.
As new infections in Jakarta climbed to single-day high of 404 on Sunday, Gov. Anies Baswedan said the figure reflected a 10.5% positive rate – the number of positive cases versus the number of tests. That is double the daily average in June.
"This is a warning for us to be more alert and disciplined," Baswedan said in a televised speech. "Do not play down [the threats]. Do not think we're already free from the pandemic."
The Indonesian capital had somewhat managed to keep infections at bay in May, following partial lockdowns introduced in April. But in line with the central government's policy – and against expert warnings – the city relaxed movement restrictions in early June with nonessential offices and public places allowed to reopen and run at half capacity. Daily cases soon began climbing again.
Several other provinces that had imposed containment measures – there has been no nationwide lockdown in Indonesia – have similarly relaxed them since June, in even less controlled ways than Jakarta.
Subsequently, Indonesia has continued to see surges in new cases, averaging 1,700 per day last week versus less than 1,000 through the first week of June.
On Thursday, Southeast Asia's largest economy reported its biggest 24-hour spike so far with 2,657 cases. As of Monday, the country had a cumulative 76,981 cases with 3,656 deaths, the highest in East and Southeast Asia outside China.
The unsettling figures are not unexpected. Many observers pointed out that Indonesia was slow to detect the early spread of the virus and had been reluctant to impose tough containment measures. Citing economic concerns, the government was quick to end movement restrictions in a bid to match other Southeast Asian neighbors, despite these countries having much more success in controlling the coronavirus.
In Jakarta, Baswedan said hospital-acquired infections made up nearly half of the cases since June, followed by community transmissions, and wet market clusters.
Major clusters have been identified at wet markets in several provinces over the past two month. They have not been subject to movement restrictions. As of July 7, 851 merchants in 175 wet markets around the country have tested positive for coronavirus, according to Indonesia's traditional market merchant association.
They include markets in East Java, which overtook Jakarta two weeks ago as the province with the highest number of cumulative infections in Indonesia. The country's second most populous province has reported 300 to 500 cases a day since the beginning of July. A May-June survey by East Java's Airlangga University found people in wet markets in the province showed the poorest compliance with health protocols like mask-wearing and physical distancing compared with other public places.
But East Java also has a lot of other clusters, including two cigarette factories, two Islamic boarding schools, some mosques and churches, and one entire village. Most of the cases are concentrated in the provincial capital, Surabaya, and its satellite cities.
"People kept moving around everywhere during movement restrictions. They weren't effective at all because there were no sanctions," Airlangga University public health researcher Windhu Purnomo said last week. "By the end of June, the red zones have expanded to cover half of East Java. But now there is no restriction at all, so it is getting worse day by day in East Java."
East Java's 8% fatality rate – the number of confirmed deaths vs confirmed positive cases – is also above the national average of 5%. Purnomo said this indicates hospitals are overloaded: "That... has resulted in queues of patients waiting to get beds, while some of those who have been admitted can't receive optimal treatment because [the hospitals] are packed."
The East Java chapter of the Indonesian Doctors Association, or IDI, told a local TV station last week that nearly 100 doctors have tested positive for coronavirus in East Java alone, including 14 fatalities. The Indonesian chapter of rights group Amnesty International said 60 doctors have died in Indonesia's battle against the pandemic. As of June 12, 878 medical workers had been infected, Amnesty says.
Some East Java officials have claimed rigorous testing as a major reason for its high number of cases, suggesting that some other regions might have purposefully kept their tracing and testing low to keep numbers down.
Similar claims have been made by some central government officials to justify what many see as the country's premature containment relaxation. One argument made was that it is only normal for Indonesia to have a high number of cases as it has world's fourth largest population.
As of Sunday, 271 people had been infected per million people in Indonesia, compared with 616 in India, 7,826 in Singapore and 9,812 in the United States, according to data compiled by the University of Oxford on ourworldindata.org.
But the amount of tests Indonesia has performed so far, around 2,200 per million, falls short of at the 8,200, 79,800 and 117,600 in those countries, respectively, according to the latest data from the same website.
The number of deaths may be even higher than in official reports.
On June 22, a government expert's presentation accidentally showed 11,477 deaths from both confirmed positive and suspected patients – more than four times the official death toll from confirmed cases announced by the government the same day. In Jakarta alone, the provincial administration keeps track of the number of deaths suspected from COVID-19, which has surpassed 3,000, against the official figure of 700.
But apart from Surabaya and a Jakarta satellite city, neither the central government or other regional administrations have discussed the possibility of another lockdown, fearing a deeper economic hit.
Meanwhile, the emergency health budget for COVID-19 handling – including incentives for overworked medical workers and support for coronavirus task forces – has been disbursed painfully slowly. Only 5% of the 87.55 trillion rupiah (about $6 billion) promised had been channeled as of last week.
And outside East Java and Jakarta, the two national epicenters, new clusters have continued to emerge. More than 1,200 people at an army dormitory school in West Java tested positive last week.
"The intensive new normal campaign by government institutions, which bypassed the [World Health Organization] guidelines... has created a new normal euphoria among the public," said Ahmad Arif, co-founder of local watchdog Laporcovid19.org.
"Meanwhile insufficient economic incentives have caused them to ignore COVID-19 risks, as well as [health] protocols such as physical distancing."