Health minister leads push for stricter curbs in COVID-ravaged Indonesia

Coronavirus infections in Indonesia have tripled in the past month, overwhelming hospitals in the capital Jakarta and other centres on the heavily populated island of Java.

On Sunday, the country posted its fifth record daily high for COVID-19 cases in the past week, with 21,342 people confirmed as positive, equivalent to over a quarter of those tested.

Three sources, who spoke on condition of anonymity, told Reuters that health minister Budi Gunadi Sadikin had urged tougher social restriction measures but was overruled. He is continuing to push his case, they said.

One of the sources said government meetings on the issue would take place this week.

Citing the need to safeguard Southeast Asia's biggest economy, Indonesia has rejected the lockdowns imposed by its neighbours and similar large developing countries like India. Instead Jakarta has opted for social restrictions targeting villages and neighbourhoods deemed "red zones" due to high infections, a policy known as PPKM Mikro.

President Joko Widodo on Friday said the current strategy was working but needed better enforcement.

Last week, the head of the country's COVID-19 taskforce, coordinating economy minister Airlangga Hartarto, banned religious activities at houses of worship, closed schools and bars and required offices, restaurants, cafes and malls to operate at 25% capacity in red zones for two weeks.

When Reuters enquired if the health minister wanted greater curbs on social mobility, a ministry spokesperson replied "in accordance with the current policy".

A spokesman for the president said: "Until now, we still have PPKM Mikro, empirically it is still very effective to control small areas."

INEFFECTIVE

The Indonesian Medical Association (IDI) on Sunday called on the government to implement large-scale restrictions, especially across the island of Java, home to more than half the country's population of 270 million people.

The IDI said that 24 regencies and cities had reported isolation bed capacity at 90% full, while intensive care units in several areas were nearing 100% capacity and 30 doctors had died in June from COVID-19.

"If there is no firm intervention we will be like India," said Dr. Adib Khumaidi, head of the IDI's mitigation team, noting the surge in cases in the South Asian nation in April and May and the "collapse" of its health care system.

Earlier last week, the World Health Organisation and the Indonesian Hospital Association also called for tighter controls.

Public health experts have warned the government's current policy for social restrictions can't be fully implemented by poorly resourced local officials and don't account for people moving between red zones and other areas.

How villages and neighbourhoods are designated red zones is opaque and undermined by low rates of testing and contact tracing that masks the true extent of Indonesia's overall infection rate, they said.

Dicky Budiman, an epidemiologist at Griffith University in Australia, estimated half of people in red zones didn't follow instructions to work from home.

"My analysis from the last five months of the PPKM programme is that it hasn't been effective in the field," he told Reuters.

One source said that, among several options, presidential advisers were examining the lockdowns in India, where a fivefold increase in infections in little over a month was fully reversed in a similar time frame.

If guidelines followed by Indian states were adopted in Indonesia, lockdowns would be introduced in 31 of its 34 provinces where positivity rates are at 10 per cent or higher.

Adjusting for population size, Indonesia has about 40% of the intensive care beds in India, according to a study last year by Princeton University.