Indonesian government moves to loosen restrictions amid mass deaths

Despite a surge in death rates, amid an uncontrolled outbreak of the Delta variant of COVID-19, the Indonesian government of President Joko Widodo is moving to loosen localised restrictions.

Last week, deaths due to COVID-19 broke record highs on four separate days, the heaviest toll being 1,566 on Friday. Daily fatalities were 1,487 on Monday, bringing total deaths in Indonesia, since the pandemic began, to more than 84,000. As the world epicentre of the virus, the death rate remains three times higher than the global average, according to Our World In Data.

Workers in protective gear lower a coffin of a COVID-19 victim for burial at the special section of the Pedurenan cemetery designated to accommodate the surge in deaths during the coronavirus outbreak in Bekasi, West Java, Indonesia, Monday, July 26, 2021. (AP Photo/Achmad Ibrahim)

While it took over a year for Indonesia to reach 2 million infections—a mark that was registered in early June—a million more were recorded in the past month alone. Due to dire testing levels and very limited contact tracing, the official figures likely understate real infection levels by several orders of magnitude.

The positivity rate, a key indicator of the true spread, is just under 30 percent across the country. In Jakarta, the capital city and a major hotspot, it is at 43 percent, meaning that almost half of all tests return positive. World Health Organisation (WHO) guidelines state that anything above a five percent positivity rate indicates substantial transmission that is going unrecorded.

The surge of the virus is producing a catastrophe. On the hardest hit island of Java, hospitals have “functionally collapsed,” the Indonesian Medical Association has stated. Hallways are overflowing with patients, spilling out into tents outside. Gravediggers are working around the clock, and coffin makers are struggling to keep up with the demand.

According to Edhie Rahmat, executive director for Indonesia at the nonprofit healthcare group Project HOPE, about two-thirds of adult patients are being forced to self-isolate at home, increasing the chance that other community and family members will be infected. This has led to the highest infection rate for children in the world, making up 1 in every 8 cases. The Indonesian Pediatric Society reports that more than 700 children have died from the virus, half of them under the age of five.

As the government scrambles to fast-track its inoculation program, with only 7 percent of the adult population fully vaccinated, the country has lost ground in vaccinating for other diseases, such as measles and polo.

Al Jazeera reported that thousands of puskesmas, or common vaccination centres, on Java had been converted into isolation wards and temporary morgues. This comes on the back of reports, by the World WHO and UNICEF, that last year, 800,000 Indonesian children missed out on routine vaccinations, a jump of 40 percent compared to 2019.

“It is true that there was a drop in routine immunisation for kids from March to December last year, because kids don’t go to school, public places and hospitals, so the coverage was low,” Dr. Siska Sinardja, a spokeswoman for the Indonesian Pediatrician Association, told Al Jazeera. “The effect of the delay on the immunisation of children will be an increase in infectious diseases. But no data is available on this yet, because the COVID rate is still increasing and all the focus is on fighting COVID in Indonesia.”

In the midst of this unprecedented medical disaster, President Widodo announced the easing of localised restrictions on Sunday, despite a clamour of warnings from health experts.

“With our hard work together, God willing, we can soon be free from COVID, and the socio-economic activities of the community can return to normal,” Widodo insisted.

Under the new guidelines, restaurants, small businesses, offices and even select shopping malls have been allowed to reopen, as well as parks and mosques. These measures are being applied to the hardest hit islands of Java and holiday-island Bali, even in the worst affected areas. The limited restrictions in place have only been extended for a week, until August 2, when there may be a further lifting of safety measures.

The government is seizing on a sudden drop in the number of daily cases, to press ahead with a “reopening,” based on the profit interests of big business. According to government figures, infections dropped from their daily highs of 50,000 late last week, to 28,228 on Monday.

At the same time however, testing has reportedly decreased, making it impossible to tell if transmission is actually decreasing. The government has generally fallen far short of its stated target of 400,000 tests a day, with a daily low of 115,000 last week.

Senior minister Luhut Pandjaitan, said the government factored the “sociological condition of the people” into its decision to wind back the already inadequate safety measures. This was a cynical reference to the social crisis facing millions of people, who have been given the alternative of starving at home or risking infection and death by continuing to work.

“Lifting restrictions will bring more infections and deaths,” Indonesian epidemiologist Dicky Budiman told Agence France Presse on the weekend. “Restrictions must be in place for a minimum of four weeks and [the government] needs to increase testing, tracing and treatment to have maximum results. Otherwise, it’s just the same as having no restrictions.”

Alexander Raymond Arifianto, a research fellow at the S. Rajaratnam School of International Studies in Singapore, stated: “The government has never taken this pandemic seriously from the beginning. The voice of the actual experts in how to best handle the pandemic is simply not being heard.”

With a population of over 270 million people, the removal of minimal restrictions in place threatens an even-greater catastrophe than has already occurred, including that COVID-19 becomes widely transmitted on islands of the archipelago, where transmission has been low. Virologists are also warning of the potential for new variants to emerge, something that has previously occurred when the virus has been allowed to run rampant in countries with large populations.

“All I can say is that when you give an RNA virus like this the opportunity to run wild, it will accumulate random mutations more frequently, and the chances of a new variant will increase,” said Indian virologist Shahid Jameel in an interview with Al Jazeera.

“They should learn from India’s experience,” he said, referring to the emergence of the Delta variant, which ravaged that country and has driven the humanitarian catastrophe in Indonesia. Among those lessons, Jameel said, was the need for a “very quick surge in hospital capacity and oxygen availability. Because unfortunately, the worst is yet to come for the region.”

Dr. Robert Bollinger, a professor of infectious diseases at Johns Hopkins University School of Medicine, warned that COVID-19 “has the potential to mutate into a new variant every time it infects a new person. So the risk of new variants is highest in communities and countries with the highest number of new cases, which includes Indonesia.”