Coronavirus Asia
Weak zonal lockdowns a challenge for Indonesia
Health experts also say country faces lack of whole genome sequencing equipment
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A sign saying "Beware! Covid-19 red zone" at a residential area in Jakarta indicates a neighbourhood that has had Covid-19 cases in at least 10 households in the past seven days. However, some experts in Indonesia believe that the colour-coded system and the "micro lockdowns" are not working well, as there are no strict borders between the zones.
PHOTO: AGENCE FRANCE-PRESSE
Wahyudi Soeriaatmadja Indonesia Correspondent In Jakarta, Wahyudi Soeriaatmadja
A weak zonal lockdown system and a lack of whole genome sequencing equipment to detect more transmissible new Covid-19 variants are the two main challenges Indonesia is facing, experts say.
They call for a quick fix as the world's largest archipelagic nation with 17,500 islands saw Covid-19 cases surging past the two-million mark on Monday.
Instead of a large-scale lockdown, Indonesia has so far imposed only localised ones based on a colour-coded lockdown.
Badly hit regions are labelled red zones and subject to tougher restrictions. Those with fewer Covid-19 cases are labelled orange or yellow.
The country has 34 provinces, further divided into more than 500 cities and regencies.
The zoning system covers even small neighbourhood units with 10 to 50 households. A neighbourhood is a red zone if there have been cases in at least 10 households in the past seven days. A green zone has no infections detected.
Cities and regencies are labelled based on factors such as hospital bed occupancy ratio, positivity rate and mortality rate.
Those with an average bed occupancy ratio of above 80 per cent would be a red zone, while those with ratios of 60 per cent to 80 per cent are labelled orange or yellow, depending on other parameters such as their total hospital bed capacity relative to the total number of suspected and confirmed cases.
A green zone is one with a bed occupancy ratio of below 60 per cent.
There are 29 red zones, including Bandung in West Java province, Bangkalan in East Java province and Pekanbaru in Riau province.
But many believe the system and the "micro lockdowns" are not working well.
Dr Aman Bhakti Pulungan, chairman of the Indonesian Paediatric Society, said: "We do not acknowledge those... zones because there are no borders."
For example, it is not standard practice to set up a checkpoint between regions labelled red and green that could filter the number of people going in and out to contain the spread of the virus. The government does this in only certain emergency situations.
For instance, the local authorities set up a temporary check point on the causeway between Madura island and the main Java island earlier this month to screen people coming from Bangkalan regency in Madura. This came after a surge in Covid-19 cases in Bangkalan, with many patients dying within 48 hours of being hospitalised.
Dr Pandu Riono from the University of Indonesia's medical school said another shortcoming of the colour-coded system is that no one knows how to label a region with a low testing rate.
Dr Pandu also told The Straits Times (ST) that the government has not monitored the implementation of measures or punished breaches adequately.
"Whatever form of social restrictions we take, what is most important are implementation, evaluation and punishment," he said. "We could use the ubiquitous closed-circuit television to monitor. Next, we could take action to ensure there are penalties and incentives."
Experts are also concerned about the lack of whole genome sequencing equipment to detect new variants of the virus, and the absence of disclosure in test results.
"Not every province has it… In some cases, it is equivalent to walking in the dark and blindfolded. We want to wage a war but we cannot see the enemy," Dr Pulungan said.
Dr Siti Nadia Tarmizi, a Health Ministry spokesman, told ST that there are 17 laboratories in Indonesia that have genome sequencing equipment. "We are planning to add three to five," she said.
Dr Pulungan said there needs to be a system where hospitals or health departments of provinces and cities do sampling, regularly collect genomic sequence data and share it with the public.
"This is what the World Health Organisation wants," he said.
