Indonesia Compounds its Covid-19 Problems

Cases soar across country as Jokowi threatens cabinet changes

Indonesia is beginning to seriously reap the consequences of its inability or lack of commitment to come to grips with the Covid-19 pandemic, with the virus now having spread to all of the country’s 34 provinces. Indonesia now has nearly 64,000 cases, the highest in Southeast Asia, almost certainly a significant underestimate.

That is an embarrassing fact for President Jokowi Widodo, who targeted a reduction of transmission rates in May and voiced hopes for moderate levels in June.  The virus is now routinely affecting more than 1,000 people per day, with 1,602 new confirmed cases on July 5. The country has the highest death toll in the region at 3,171, believed to be low by several factors.

East Java, the second most populous province, is the new epicenter, replacing Jakarta, which also has a high number of new cases. At least 552 new cases and 24 deaths were recorded in East Java on July 4. Based on records from the Indonesian National Nurses Association (PPNI) of the East Java branch, at least 246 nurses in the region had also tested positive, with 11 having died.

“The virus is a problem,” said a Jakarta business source. “They seem to be pretending it doesn't exist. They seem to be on drugs.”

In fact, the government has made serious misstep after serious misstep, with the Minister of Health, Terawan Agus Putranto, first saying Allah would Indonesia’s 225 million Muslims. The government has ordered millions of doses of anti-malaria products touted by US President Donald Trump which turned out to be ineffective and is now recommending an herbal remedy consisting of eucalyptus ingredients that official say hasn’t been tested for Covid-19. As many as 40 percent of tests bought from China appear ineffective. Indonesia lags Singapore, the Philippines, Brunei, Malaysia and Thailand in Southeast Asia in testing, with only 3,347 per tests per million people. 

Jokowi cabinet outburst

Rumors of a cabinet reshuffle are growing, with many insisting that the president, known universally as Jokowi, immediately replace Minister of Health Putranto following an extraordinary cabinet session two weeks ago in which the president scolded his ministers whom he accused of being slow to deal with the pandemic and for failing to take the crisis seriously.

"I will take any steps necessary, including extraordinary ones, for our 267 million people," Jokowi said in a video of the closed-door June 18 meeting, which was published by the Presidential Secretariat last week. “[I might] disband agencies. [I might] reshuffle [the Cabinet]. I have considered many options."

The President criticized the ministers for taking the situation too lightly with the country in crisis. “We should not consider [this situation] to be normal,” he said. “That is very dangerous. And I still see that many of us see this as normal.”

He specifically called out the Health Ministry for having spent only 1.53 percent of its Rp75 trillion (US$5.2 billion) budget, ordering the ministry to immediately pay out financial incentives promised to health workers on the front lines of the outbreak.

Social and political analyst from Jakarta State University, Ubedilah Badrun said Jokowi's uncharacteristic public anger indicated that coordination had fallen apart between the president and his ministers. 

"It shows how chaotic the President's management is in pushing his ministers to go the extra mile in the midst of a crisis," he said.

A source in palace circles called the fact the video had been uploaded for public consumption was shock therapy for ministers if they didn’t want to be cashiered and also warned that government agencies could be dissolved if they didn’t get behind policies related to the fight against the virus.

Virus underestimated

Ubedilah said the government made a big mistake by underestimating the virus at the beginning of its appearance and assuming it wouldn’t enter the country. Now, he said, when the extent of the damage to the economic sector has become apparent, Jokowi is shocked and angered.

In early February, for example, the government planned discounts for foreign and domestic tourists – even though the plan was finally canceled – when other countries had begun to close their borders. In the same month, although Harvard University scientists warned Indonesia that the virus may already have entered the country without detection, Putranto denied it and called it an insult to Indonesia. Jokowi didn’t announce the first Covid-19 until March 2, even though the virus was believed to have already made a major foothold far earlier.

As cases continued to increase, the Covid-19 task force and the Ministry of Health were only able to deliver 10,000 tests per day by the end of May, even though Jokowi had set that target for April 4, resulting in substantial numbers that were never tracked. Many victims are suspected of dying of the coronavirus while waiting for PCR swab test results. So-called “rapid tests” from China are an initial screening method to detect human antibodies and are considered inaccurate and the results cannot be used as a reference in determining patient status.

Even though the government has already imported hundreds of thousands of rapid tests from China, as many as 40 percent have been found to be faulty in other countries and medical personnel in Spain, Turkey and the Netherlands have refused to use them. The decision to stop using the rapid tests has recently surfaced not only because it is ineffective but it has also been commercialized. While the government ruled that prospective passengers must conduct a rapid test before using public transport, the tests are quite expensive, between hundreds to millions of rupiah, which is feared to be increasingly detrimental to the community in the middle of a pandemic.

The government also seriously erred by deciding to use the anti-malaria drug chloroquine touted by US President Donald Trump as a COVID-19 remedy only to discover that reputable international health agencies found it ineffective. Jokowi announced in March that the government had ordered 3 million chloroquine doses and claimed it was effective. The government also granted licenses to two dozen local manufacturers to accelerate domestic production of the drug. Although the World Health Organization (WHO) later urged the country to suspend such treatment over safety concerns, Indonesia ignoring the directive by continuing to recommend chloroquine for coronavirus patients but monitored use closely. 

Herbal Antivirus Drugs

The Ministry of Agriculture also made a dubious claim about the discovery of herbal medicines that can prevent contracting the coronavirus. The drugs, made from eucalyptus, will be mass-produced in August even though there have been no credible studies on its effectiveness. It will be produced in the form of necklace, inhalers, roll-ons, diffusers and balm.

Agriculture Minister Syahrul Yasin Limpo said a ministry research body had examined 700 species of eucalyptus trees to find one whose materials are claimed to kill up to 42 percent of the coronavirus after wearing an antiviral necklace within 15 minutes. It is said to kill 80 percent of the virus within 30 minutes.

That was denied by the General Chairperson of the Indonesian Traditional Medicine and Herbal Medicine Development Association, Dr. Inggrid Tania, who revealed that eucalyptus has been known to be able to overcome and relieve respiratory tract problems but can’t be claimed as a Covid-19 antidote because it hasn’t been specifically tested for the virus.

"The ministry's research has only been tested up to the in-vitro stage of influenza, beta corona and gamma corona viruses,” Inggrid said. “It has not been specifically tested for the Covid-19 virus, SARS-CoV-2.  So it is not enough just based on testing the corona virus in general. Please (the public) be careful, because this corona antivirus claim can be misleading."

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