Jakarta – The government will start using rapid antigen test for tracing the Covid-19 suspects and plan to spend $100 on every person infected by the Sars-CoV2 virus, who had to self-quarantine in their homes, in its latest attempt to control the pandemic, Health Minister Budi Gunadi Sadikin told the House of Representatives on Tuesday.
The country would follow India's steps, incorporating the antigen test in the Covid-19 testing and tracing program.
Indonesia's insistence on using the slow polymerase chain reaction (PCR) test to confirm a Covid-19 case has cost it a precious few days following the disease onset when it is most infectious. That despite the World Health Organization (WHO) issued a recommendation in November that said antigen test could be used in the confirmation for positive Covid-19 cases.
The queue for PCR test results in labs across the country could stretch up to two weeks, further diminishing its effectiveness as a tracing tool.
The most populous country in Southeast Asia only managed to test just over 6.5 million people or 24,000 in a million. That is far lower than India, which tests 145,920 per million population using the antigen tests.
Budi, a former banker who just stationed to the health minister post last month replacing Terawan Agus Putranto, an Army doctor, said that he was adamant to reveal the accurate picture of the country's pandemic situation. And the antigen test would be the first step toward that goal.
"As soon as we find a close contact, we set a target to our tracers to identify 15-30 people they have been in contact with in the past two weeks within 72 hours," Budi told the House's Commission IX, which oversees healthcare and labor issues.
"Once they identify these people, they must be tested immediately. And it must be with an antigen test, which is quick," Budi said.
Unlike PCR, the antigen test result will be available in 30 minutes. The antigen test also has the highest sensitivity a week after a person was exposed to the Sars-CoV2 virus, a period when they also usually most likely to spread the virus to others.
Budi said the government would distribute antigen test kits to community health centers (Puskesmas) across the country.
The minister also said the government has committed to report all positive results detected by the antigen test as positive Covid-19 cases.
"So, I have also alerted President [Joko "Jokowi" Widodo] that as what happened in India, which follow this strategy in India, the number of cases will increase," Budi said.
"I also want to inform this respectable forum. Ladies and gentlemen, please don't panic. It's better for us to look at the real picture so that our strategy is right instead of being a little satisfied when the reality is much worse and a lot of our steps could go wrong," Budi said.
He also said that in anticipation of the rising number of cases, the government would set aside Rp 479 billion ($35 million) to spend on medicine and vitamin supplements supply for those who had to self-quarantine. Budi said each self-quarantine patients would likely get Rp 1.4 million worth of medication and supplements.
The total cases in Indonesia now have reached more than 1.17 million and just beginning to show signs of slowing down eleven months into the pandemic, with the rolling seven-day average dropped to 10,727 on Tuesday, from its peak of 12,685 on Feb 1.
In comparison, India's total cases have peaked in September and came down from 93,180 cases to around 11,500 new cases per day today.
Many estimated Indonesia's total cases could be four times that the government reported. Institute for Health Metrics and Evaluation, a Seattle-based research organization, projected that Indonesia could have 160,000 new cases per day in January. A projection from the Imperial College of London (ICL) showed Indonesia's new cases could have been around 173,000 per day.
Treating people with a positive antigen test result as confirmed Covid-19 cases would also lead to a clearer picture of the pandemic geographical distribution.
Syahrizal Syarif, an epidemiologist at the University of Indonesia, said the number of cases in Jakarta tended to remain higher than in other regions was because other surrounding cities usually sent their Covid-19 patients, who had tested positive using antigen but yet to the PCR test, for treatment in the capital.
"The regional government of Depok [in West Java] tended not to follow up on a patient who showed symptoms and tested positive using antigen test with a PCR test. Instead, they usually send the patients to Wisma Atlet," Syahrizal told the Goble's sister online publication BeritaSatu.com.
He referred to the athlete housing compound in Central Jakarta that the government has turned into a temporary hospital for Covid-19 patients with mild to moderate symptoms.
"When these patients were admitted to Wisma Atlet, they will be tested with PCR, and their results were recorded as Jakarta's," Syahrizal said.
Jakarta now recorded a total of 300,406 cases by Tuesday, about 26 percent of Indonesia's total case. The neighboring West Java, the country's most populous province, only have 169,982 cases. Meanwhile, Banten, which also borders Jakarta, had 26,740 cases. Relative to their population size, Jakarta has 2,822 cases per million population, compared to West Java (340) and Baten (203).