JAKARTA - The head of Indonesia's expert team on Covid-19 task force has disputed the convention used by the World Health Organisation to measure the fatality rate from the disease in the country, as it faces constraints on testing.
Using the WHO convention, Indonesia's death to infected rate is at 8.1 per cent, when it should be less than half of this using a different counting method, said Prof Wiku Adisasmito.
He told a virtual panel discussion with foreign journalists on Monday night (April 27) that the count should not just include patients who are confirmed with the deadly coronavirus, but also include what Indonesia calls PDPs - which translates as patients under surveillance.
Indonesia has been on the international spotlight for having the highest fatality rate in Asia.
Neighbouring country Philippines, which has a lower GDP per capita than Indonesia, records a 6.6 per cent fatality rate. The United States, which has a similar population level to Indonesia, records a 5.6 per cent fatality rate, while India's death rate from the virus is 3.2 per cent.
Prof Wiku was responding to a question during the virtual discussion and expressed frustration on foreign media reports about the death rate among Indonesia's 270 million population which he thought was not accurately counted.
On Tuesday, Indonesia recorded total deaths at 773, the highest in South-east Asia, and confirmed cases at 9,511.
This works out to a fatality rate of 8.1 per cent.
But if suspected patients, or PDPs, of 20,428 were included in the denominator with the confirmed cases, the fatality rate drops to around 3 per cent, after taking into account deaths among the PDPs.
The deaths recorded by the PDP group are not fully reflected in the 773 total death toll.
Prof Wiku said PDPs should be included to measure fatality rates in countries with vast geographical regions faced by resource constraint on testing.
He said that the WHO convention uses only the number of confirmed cases as the denominator in the equation, but there aremany suspected patients who are in the long queue in Indonesia who have yet to be tested using the reliable reverse transcription polymerase chain reaction (RT-PCR) testing machines.
PDPs are patients who show strong coronavirus symptoms and have travelled to a 'red zone' area with many infections, within the country or overseas
"They have been diagnosed without RT-PCR but are close contacts, have pulmonary appearance and blood test that indicate coronavirus infection," Prof Wiku said.
Independent experts blamed the country's average healthcare system and poor general health among Indonesian citizens - more than 50 per cent of men are smokers - as among the cause of Indonesia's high fatality rate.
The government's slow initial response to the virus threat was also blamed by experts.
University of Indonesia epidemiologist Dr Pandu Riono said the fatality rate should be derived from all coronavirus suspects, or anyone showing Covid-19 symptoms and is an inpatient.
"As long as they are hospitalised with Covid-19 symptoms, as they are technically suspects and face risk of dying," Dr Pandu told The Straits Times on Tuesday (April 28). "The problem is that testing is often delayed, although these patients should be prioritised."
He added that to give a clearer picture "it would even be better if the government disclose two separate 'case fatality rates': one on patients who have tested positive, and another on patients who have not tested positive. Some of these patients in fact died before they were tested."
The government has not disclosed separate data on how many of those who have not tested positive died from suspected Covid-19.
Other experts have said that Indonesia is luckier than many countries as it has a younger demographic profile which has led to fewer deaths, as the virus is more lethal to older people.
The Indonesian government has said that more than 60 per cent of coronavirus fatalities were those who had pre-existing medical condition such as high-blood pressure, heart condition and diabetes. Many were aged between 50 and 60.
