A zookeeper at Surabaya Zoo in Surabaya, East Java gets ready to welcome visitors as the zoo reopens on Monday. (Antara Photo/Didik Suhartono)

Flattening Active Cases, Record Recoveries Are No Reasons for Complacency


JULY 28, 2020

Jakarta. Indonesia has seen the number of Covid-19 active cases flatten and the highest number of recoveries in the past two weeks, but the country should not become complacent, a scientist warned. 

A projection using a model developed by Indonesian scientists suggested the pandemic could last well into next year if the country kept the current level of restrictions and the number of testing. According to the projection, Indonesia would see around 60,000 active cases and rising in December from about 38,000 today. 

"If restrictions are relaxed, it can be over 100,000 by the end of the year," Agus Hasan, an Indonesian researcher at the University of Southern Denmark who is also the lead writer of a paper about the model, told the Jakarta Globe on Tuesday.

The model used official data as recent as Monday. It also came with a caveat that it became less reliable the longer the model predicted into the future, Agus said.

Agus suggested the slight drag in testing capacity might be responsible for the flattening of the active cases in the past two weeks, as the number of recoveries overlapped the number of new cases that the Health Ministry could track and test. 


Also, the ministry changed the criteria of recoveries in line with the latest guidance from the Health Organization (WHO). Now asymptomatic patients can leave isolation ten days since they tested positive. Meanwhile, hospitals can release symptomatic patients after at least 13 days, with three days without showing any symptoms. The ministry used to require two consecutive polymerase chain reaction (PCR) tests with negative results for the hospital to discharge patients. 

Still, if the country continued approaching the pandemic as it was doing today, the number of active cases would continue to rise. "Our projections have not seen a peak for both active and daily cases even within the next three months," Agus said. 

Many provinces in Indonesia have relaxed social restriction imposed two months ago to restart its economy. Instead, the government urged the people to follow strict health protocol by wearing masks in public, keeping a safe distance, and washing hands regularly to keep the coronavirus at bay.

The Government Response Stringency Index for Indonesia has dropped to 62.5 today — with 100 representing the strictest response — from its peak of 80.1 in April. Oxford Covid-19 Government Response Tracker at Blavatnik School of Government developed the index to quantify governments' measures like school closures and travel ban across the world. 

Jakarta, one of Indonesia's Covid-19 epicenters, has allowed public spaces, religious services, entertainment centers, and offices to open at 50 percent of their capacity since Jun 5. The capital is now seeing a worse second-wave of Covid-19, with offices becoming new clusters for the virus to spread

Straining The Healthcare Systems

Agus said his model suggested Covid-19 real-time reproduction number in Indonesia has dropped by 79 percent to 0.99, compared to the reproduction number at the beginning of the pandemic. Should the country stay on course with the current actions, the number of active cases would continue to increase at a steady pace.

Should the country relaxed its restriction even more that allowed the reproduction number to increase to 1.3, the number of active cases would reach 140,000 by the end of this year, Agus's model predicted. 

And that could strain the country's healthcare system. "We project the active cases because this is the top issue to consider regarding the capacity of our healthcare facilities," Agus said. 

Despite the number of Covid-19 isolation beds have risen by 18 times to 188,510 today from 10,200 in April, signs of how the pandemic put health workers under pressures kept emerging across the country. 

Papua's Covid-19 task force said SARS-CoV-2 had infected 307 health workers in Indonesia's easternmost province since the beginning of the pandemic until Monday, forcing at least a hospital there to close down. 

"[The pandemic] has an enormous impact on health services in hospitals and health centers. Therefore we continue to urge people to implement health protocols [...] to reduce the spread of the virus," Silwanus Sumule, the spokesman for Papua's Covid-19 Handling Task Force, said on Monday.

According to BeritaSatu Research analysis, Indonesia's doctors are 46 times more likely to die from Covid-19 than the general population. 

As of July 20, 68, doctors have died from Covid-19 across Indonesia, according to data from the Indonesian Doctors Association (IDI). The death figure represents 0.084 percent of Indonesia's total number of doctors and specialists. In comparison, Indonesia's 4,901 Covid-19 deaths were equal to 0.0018 percent of the country's population.