Omicron surge in Indonesia tops record for daily cases

A new record was set for daily COVID-19 infections in Indonesia, with 64,718 confirmed cases Wednesday last week. The Omicron variant, now the dominant strain in the archipelago nation, has fuelled a precipitous rise in infection rates over the past five weeks, rapidly surpassing the peak of last year’s catastrophic Delta wave.

After reaching its summit of 56,757 cases last July, the Delta outbreak gradually subsided until daily case numbers remained below 200 through November and December. With the eventual introduction and transmission of Omicron, which the Indonesian government openly refused to prevent, official cases began climbing in mid-January. Numbers leapt to the hundreds, thousands, and tens of thousands in a matter of days, in one instance more than doubling after just one day.

A further 61,488 cases were recorded on Wednesday, bringing the total to 5.3 million infections, the highest in Southeast Asia and 17th highest in the world.

As Indonesia’s testing rate remains among the worst worldwide (around 286,000 tests per million people), the official tally can only provide a limited picture of the disease’s spread. The capital city Jakarta accounts for almost half the new cases, partly due to its relatively higher testing capacity compared with rural or remote regions. Other areas reporting numerous Omicron victims include provinces West Java, Banten, East Java, and Bali, although the infectious variant is suspected to have already spread far beyond the major island of Java.

Less than a week after the Omicron surge began, nearly 20,000 hospital beds out of a national capacity of 120,000 beds dedicated for COVID-19 handling had been filled. Occupancy rates at 140 coronavirus referral hospitals in Jakarta are currently at 60 percent, up from just 5 percent in early January. Over 50 percent of hospital beds for COVID-19 patients in Jakarta, Yogyakarta, and Bali were occupied as of Monday.

The death toll is also climbing fast, increasing to 257 deaths on Tuesday from single figures three weeks ago. Over 100 people died every day for the past two weeks, mostly in the capital.

The previous Delta surge last July made Indonesia the global epicentre for coronavirus deaths, peaking at over 2,000 deaths a day. This was the result of a complete collapse of the country’s healthcare system. People seeking medical treatment at overcrowded hospitals in both major cities and provinces were turned away at the doors, causing thousands to die at home without proper care. Government statistics were therefore a serious underestimate of the real toll on lives.

Health workers were compelled to erect plastic tents as makeshift intensive care units to cope with demand, but patients had to wait days before being admitted. Spare supplies of oxygen tanks quickly ran out as they were handed out to crowds of people outside hospitals needing urgent treatment.

Facing the prospect of a similar disaster, the national government continues to avoid lockdown measures and promotes a “COVID normal” policy.

On February 7, Investment Minister Luhut Pandjaitan, coordinator of the COVID-19 response in Java and Bali, finally announced minimal social restrictions to address the Omicron surge. By this time, daily cases had already skyrocketed from approximately 1,000 to 36,000 in three weeks. Viral transmission rates in Java and Bali, moreover, had already exceeded the highs of the Delta wave.

The restrictions include attendance caps of 50 percent on places of worship, and 60 percent on supermarkets, malls, and restaurants, which will also see a reduction in operation hours. These measures are confined to Jakarta, Bandung, Yogyakarta, and Bali. Reviews are held each week by a special committee to assess whether any restrictions can be eased.

However, government officials have admitted that they expect an explosion of cases and deaths due to Omicron in coming weeks. Health Minister Budi Gunadi Sadikin has estimated that cases during this wave may rise as high as 285,000 per day, five times the Delta peak, while deaths would not exceed 500, according to Associated Press.

“Please do not panic if you see the number of cases are [sic] increasing significantly,” he said at an online briefing. “The most important thing is the hospitalisation and fatality rates are lower [than the Delta wave] and remain under control.” He urged the government to adopt calm and confidence that Omicron will not overload the healthcare system due to its “milder” character.

The extreme reluctance of the Indonesian ruling elite to impose any hindrances on economic activity stems from its growing anxiety to resume profitmaking as soon as possible.

It is particularly eager to restart the tourist operations on which a substantial portion of Indonesian business depends. Preparations are being made to lift all quarantine requirements for international travellers as early as April, in a bid to draw visitors back to the resort island Bali and other popular destinations.

In Bali, where a full-scale reopening is already underway, international flights resumed earlier this month, while the quarantine period was shortened further from seven to five days. Interviewed by the South China Morning Post, Nia Niscaya, deputy of marketing at the Ministry of Tourism and Creative Economy, described Bali’s reopening as a “kind of pilot scheme,” or a trial run for the government’s plan to “live with the virus.”

While the government is keen to follow other countries and transition from “pandemic” to “endemic” status, only 51 percent of Indonesia’s 278 million population has been double vaccinated, according to Our World in Data. The country’s exceptionally slow vaccine campaign commenced on January 13 last year. Despite an announcement in December that Indonesia would start vaccinating children, the campaign has largely consisted of ineffectual public appeals to get vaccinated, undermined by the spread of misinformation about COVID-19 and the promotion of quack cures by politicians.

Medical studies have concluded that the Omicron variant, highly mutated and potentially vaccine-resistant, significantly reduces the efficacy of Pfizer and Sinovac vaccines, the two most commonly distributed across Indonesia. The country only started rolling out its booster program in mid-January, days before the recent surge erupted.

Initially, the government proposed that Indonesians should pay for their booster dose, a decision which was revoked amid widespread outrage from scientists and the public at large. Only 3.4 percent of the population has received a booster, rendering the vast majority of the Indonesian people virtually unprotected against Omicron.

Additionally, vaccine distribution has been largely concentrated in Jakarta and Bali, where almost the entire populations have received two doses. Areas such as Aceh and West Papua, on the other hand, have managed to vaccinate only 20 percent of residents, according to Health Ministry data.

As throughout the pandemic, epidemiologists are warning that the Indonesian government’s reckless pro-business actions will end in public health crisis. Dr Dicky Budiman, from Australia’s Griffith University, has expressed concern for the consequences of both the low vaccination rate and the concentration of vaccines in certain areas.

“During the Delta-driven second wave, 20 percent of patients were hospitalised, with five percent put into intensive care units. For Omicron, 10 percent of the patients are likely to be hospitalised, while the rest are likely to be asymptomatic or showing mild symptoms,” Dr Budiman said. “But 10 percent of Indonesians [in hospitals] is a lot. Due to a low patient-to-doctor ratio, even five percent of the population [being in hospital] could make our health system collapse.”