Could Bali’s unvaccinated visitors create a new COVID hotspot?

The resort island of Bali has rushed out vaccines so it can reopen to tourists, but people on short-term visitor visas aren’t included.

A lone surfer walks to the beach on Batu Balung, the main street of Canggu [Al Jazeera]
A lone surfer walks to the beach on Batu Balung, the main street of Canggu [Al Jazeera]

As the Indonesian province that has suffered the most economically as a result of the pandemic with GDP down 9.31 percent last year, Bali has been given priority under Indonesia’s COVID-19 vaccine rollout plan, so the resort island can reopen to international tourism as soon as possible.

Some 71 percent of the island’s population has had one dose of the vaccine and 19 percent have had both, compared with only 22.5 percent and 9.7 percent nationally.

But there is a glaring gap in the island’s vaccination programme: some 110,000 people – mostly Westerners – who are concentrated in the surf and nightlife hub of Canggu and, while highly mobile and sociable, have little access to vaccines.

Infectious disease experts have warned the gap threatens to create a new COVID-19 hotspot at a time when Bali’s hospitals are already capacity. On Friday, the island reported 1,365 new cases and 37 deaths.

“This is a very worrying situation,” said Dr Dicky Budiman, a virologist who has helped formulate Indonesia’s pandemic response plan for more than 20 years. “You don’t need 110,000 unvaccinated people to create a pocket of infection – 1,000 are enough.

Budiman said the Indonesia government “should consider the entire population for vaccination, regardless of their citizenship or visa status to protect the whole community”.

Bali has been working quickly to vaccinate its population but experts are concerned that a group of foreigners – mainly Westerners on short term visas – are excluded from the programme, which could leave the island vulnerable to new outbreaks [File: Firdia Lisnawati/AP Photo]

Bali’s most most senior virologist, Udayana University Professor Gusti Ngurah Mahardika, agreed.

“These foreigners should be included. In the US, there is now a pandemic among the unvaccinated.”

Neither Bali’s provincial government nor Indonesia’s Ministry of Tourism responded to Al Jazeera’s request for comment.

Anti-vaxxer cluster

Indonesia has been officially closed to foreign tourists since the start of the pandemic. But in the past 12 months, hundreds of thousands of people from Russia, Europe and the Americas have managed to get into the country with social or business visas issued at Indonesian embassies abroad. They are often organised by visa agents in Bali that charge hundreds of dollars to provide all the documentation required, including the names and addresses of de-facto “sponsors” for these visas. However, last week, the backdoor closed and foreigners with social or business visas can no longer enter Indonesia.

Foreigners on such short-term visas are not eligible for COVID-19 vaccines in Indonesia to protect supplies.

Only those with work permits, retiree visas or representatives of foreign countries can get a jab through the free government rollout or “gotong royong” – a private vaccination scheme financed by employers. The shortage is so acute that on July 20, the French government announced it would send vaccines to Indonesia for its citizens.

“Hospitals in Bali did offer vaccines to tourists for a short period but now most are being turned away,” said Stuart McDonald, the Australian publisher of travel website Travelfish who lives in Bali.

“So, now we have a situation with a lot of unvaccinated people concentrated in an area where COVID is virulent.”

There is also a large number of anti-vaxxers in Bali whose opinions reflect the eclectic roots of tourism in the island [Bali Firdia Lisnawati/AP]

The problem is being exacerbated by distrust of Sinovac, the vaccine developed in China that went through late-stage trials in Indonesia and is now the backbone of the country’s vaccination programme.

There is also a large number of so-called “anti-vaxxers” whose opinions reflect the eclectic roots of tourism in Bali that evolved from a “hippy” destination in the 1970s to become the region’s leading wellness destination.

“I believe building up my own immune system is equal to the shot, so long as you are healthy with no pre-existing medical conditions,” said a longtime expat from the US who is eligible for a vaccine in Bali and asked that their name be withheld.

“I’m always been one to choose what I put inside my body and considering I’ve studied Ayurveda and natural medicine, it’s against my personal policy to take a vaccine. I never even buy anything from the pharmacy,” said a tourist from Estonia who also spoke on condition of anonymity because her opinions contradicted Indonesia’s health policies and could cause offence.

But some anti-vaxxer expats on the island have no qualms about speaking their minds.

“F**k this, you pandering fools. This is such a f**king joke,” Dave Driskell, an American fitness influencer and gym instructor based in Canggu wrote on the Instagram page of Sinamon Bali, a local bakery that offered free coffee to vaccinated customers.

“Giving out your sugar-coated food while 78 percent of Covid mortalities had obesity issues. Me [sic] and my business do not support you. You are the problem.”

Driskell later deleted his comments following an outcry on social media.

A stall-holder at the central market in Ubud, once a hive of activity is now practically deserted [Al Jazeera]

Virus does not discriminate

Contagious disease experts have consistently said that to beat the virus, governments have to ensure that as many people as possible get vaccinated, from migrant workers to refugees and minority groups.

As Director-General of the World Health Organization Dr Teldros Tedros Adhanom Ghebreyesus has repeatedly said, “No one is safe until everyone is safe.”

A quantitative ecologist studying infectious disease dynamics at Australia’s James Cook University, Jamie Caldwell said it is dangerous to ignore any subset of the population during a vaccine rollout.

“Leaving 110,000 people who all live in a small area could lead to Canggu being a hotspot for COVID and for more resistant strains to emerge. Look at what’s happening in the UK with a partially vaccinated population,” he said, referring to the situation in the United Kingdom where 56.7 percent of the population has been vaccinated, yet more than 30,000 new infections are being confirmed every day.

“What will happen in Canggu will depend on many things, including how much that group interacts with the rest of the population and their demographic make-up,” Caldwell said.

“In my opinion, it would be worthwhile to advocate for everyone in Indonesia to have the opportunity for vaccination. Because by ignoring any group of individuals, the whole population is more vulnerable to transmission.”

India’s top virologist, Shahid Jameel at Ashoka University, also believed Indonesia was making a mistake by failing to include tourists in Bali’s vaccination strategy.

“The virus does not discriminate and neither should vaccination,” he said. “More opportunity to spread also provides more opportunity for new variants.”

Source: Al Jazeera

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