Indonesia's coronavirus response revealed: Too little, too late

Source tells Al Jazeera Indonesia pursuing targeted response, says no strategy to achieve herd immunity.

    At least 12 Indonesian doctors have died after contracting COVID-19 at the workplace [Tatan Syuflana/AP]
    At least 12 Indonesian doctors have died after contracting COVID-19 at the workplace [Tatan Syuflana/AP]

    Jakarta, Indonesia - With a coronavirus infection rate that has nearly quadrupled since the start of the month, and one of the world's highest mortality rates, Indonesia's response to the pandemic has led to doomsday predictions by infectious disease experts, epidemiologists and data handlers abroad.

    President Joko Widodo's original denial of the problem and his current resistance to a blanket lockdown has also sparked a heated debate on social media, with critics posting the hashtag #LockdownOrDie backed by some health experts and politicians.

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    The president's actions have also raised speculation that the archipelagic nation of 268 million people is secretly pursuing herd immunity without a vaccine - a solution abandoned by the United Kingdom after it was revealed that millions could perish.

    "At this point, we can only foresee a dark ending to our pandemic story," wrote The Jakarta Post in an expose that examined herd immunity and other potential endings to Indonesia's coronavirus health emergency.

    But a member of the government's taskforce against COVID-19, the disease caused by the novel coronavirus, refuted such claims, offering Al Jazeera detailed up-to-date information on the country's response strategy.

    Much of the information is corroborated by documents already released by the taskforce, the Indonesian Disaster Mitigation Agency and the office of the president, but is compressed and easier to understand. The information also provides insight into the politics and ideology behind the government's slow and piecemeal response.

    "Indonesia is not pursuing a policy of herd immunity. We understand that will not work as we probably do not have immunity to this virus, which means you can catch it again and again," the source said on condition of anonymity because they are not authorised to speak to the media.

    "Those doomsday predictions are not taking into account everything the Indonesian government is doing to get through this."

    'Flying a kite'

    President Widodo continues to oppose blanket lockdown because he says it would hurt the poor too much in a country where nearly one in 10 people earn less than a dollar a day.

    The country currently has 7,135 confirmed cases of COVID-19 and 616 people have so far died.

    Instead, Widodo has employed a patchwork solution that includes partial lockdowns in COVID-19 hotspots like Jakarta and West Sumatra, while allowing unrestricted movement in places like the Balinese capital Denpasar, where infection rates are seen to be low.

    In explaining the government's approach, the source used an old Indonesian metaphor about the life lessons one can learn from kite flying.

    Joko Widodo
    President Joko Widodo continues to oppose blanket lockdown in the country because he says it would hurt the poor too much in a country where nearly one in 10 people earn less than a dollar a day [Hafidz Mubarak/AP]

    "It's like flying a kite. You have to know when to hold the rope and when to let it go," the source said.

    "If you don't put in a lockdown, 10 percent of the population could die from coronavirus. But if you do, people will die of starvation. Indonesia can't enforce a lockdown for very long, and we know it could be years until a vaccine is developed.

    "So instead we are doing what Vietnam, Japan and Taiwan are doing. They test as many people as we can and if someone has the virus they trace them. If we can get that system going, we won't need a lockdown."

    However, the pandemic tallying website Worldometer shows Indonesia has one of the lowest testing rates in the world. Only 184 in every million people in the country have been tested compared with 2,043 for every million in Thailand and 20,629 for every million in Germany.

    Indonesia is also suffering from a scarcity of personal protective equipment (PPE). At least 12 Indonesian doctors, including the directors of two hospitals, died after contracting COVID-19 at the workplace, while most health workers around the country are using raincoats as medical gowns.

    Manufacturing might

    Earlier this month, Indonesia's COVID-19 taskforce said the scarcity would be addressed by retooling nearly 3,000 garment factories across the country to produce 17 million PPEs.

    "We have a very large manufacturing industry that can move very quickly to produce the things we need. Our garment industry is starting to produce hazmat suits," the source said.

    "Within one week we will be producing one million face masks per day. Within two weeks [state-owned vaccine maker] Bio Farma will produce its first batch of 4,000 test kits to analyse 100,000 suspected cases. We are working very hard to galvanise all our industries."

    The source said Indonesia was also upgrading 132 hospitals, increasing medical salaries and training new staff in pulmonary treatment: "We know this is a problem. Many of our medical staff are not properly trained. It will take another two or three months to do so."

    The source also noted several social security measures being introduced to help the 2.8 million Indonesians who had lost their jobs because of the pandemic, according to data supplied by the country's Ministry of Labour.

    "Indonesia has come up with a social safety net worth about 110 trillion rupiahs [$7bn]. Many households will not have to pay their electricity bill for three months and if you have trouble paying the mortgage for your house there will be assistance, too.

    "There will be tax relief for anyone who earns less than 15 million rupiahs [$1,000] a month, 20 percent company tax relief and VAT [value-added tax] holidays for 19 industries.

    "The government is also thinking about people not having enough food. We have opened 12 big food kitchens in Jakarta. People are going to have to stand in line; it won't be easy to enforce social distancing. This is a chaotic country and it won't be perfect. But no one will go hungry."

    Catch-22

    To examine the efficacy of the strategy outlined by the source, Al Jazeera spoke with several experts in neighbouring Australia, where a blanket lockdown, well-resourced hospitals and generous social security that allows non-essential workers to stay home have flattened the COVID-19 infection curve and kept mortalities low.

    John Mathews, a professor of medicine at Melbourne University and former head of Australia's National Centre for Disease Control says partial lockdowns in COVID-19 hotspots do not work, but Indonesia was in a difficult position. 

    "Indonesia is in a Catch-22; the country is so poor it cannot afford to do a lockdown as Australia can," he said.

    Indonesia - coronavirus
    Indonesia still has one of the lowest testing rates in the world, with only 184 in every million people in the country being tested compared with 2,043 for every million in Thailand [Tatan Syuflana/AP]

    "But everything we know about epidemiology says if you are going to stop a disastrous spread, the lockdown has to be complete and you have to start early. People in an enclave can protect themselves by remaining self-isolation as long as they can. But if there is a high frequency of infection outside their enclave, they're still at risk at the end of the day."

    Referring to the taskforce's manufacturing objectives for PPEs and ventilators, Indonesia certainly has the capacity, said Ross Taylor, an analyst who has held various board positions in Indonesia and is currently president of The Indonesia Institute, a Perth-based think-tank.

    "They have the labour, the buildings, the ingenuity and expertise," he said.

    "Indonesia probably is the biggest carmaker in Southeast Asia and its spare parts supply business is quite remarkable. There can manufacture almost anything and do it quickly, especially if things are being driven by the highest level of government.

    "But what often delays things in Indonesia is bureaucratic red tape. Corruption and self-interests also sadly always become part of every major project in the country."

    Slow to wake

    Corruption will probably impede Indonesia's ability to distribute social welfare to help people stay at home suspects Professor Tim Lindsey, director of the Centre for Indonesian Law, Islam and Society at the Melbourne Law School.

    "Indonesia has been successful with social welfare subsidies in the past - especially cash payments," he said. "But most of its social welfare programs are vulnerable to corruption as well as to tension between different levels of government that have hampered the delivery of these services in the past."

    Lindsey adds that the benefits, most of which are still to be distributed, will come too late.

    "It is now adopting measures that have been successfully used in other countries. But rolling it out so late when coronavirus has already spread and partial lockdowns are in place will reduce their impact."

    The source at Indonesia's COVID-19 taskforce acknowledged the challenges were formidable.

    "We know we have massive problems and the death rate will go higher. We know we are going into the eye of the storm," the source said.

    "But one of our strengths is our ability to improvise. Indonesia is like a big animal that takes a long time to get up. But once it starts moving, the animal can move very fast."

    SOURCE: Al Jazeera News