Indonesia Becomes Epicenter of COVID Pandemic, as Southeast Asia is Battered by Third Wave
The health system in Indonesia is being battered by the surge in COVID-19 cases, with hospitals reaching capacity and oxygen supplies running low.

Indonesia has overtaken Brazil and India to claim the highest number of new COVID-19 cases and deaths, becoming the new epicenter of the pandemic. The surge is part of a third wave hitting all across Southeast Asia.

Countries in Southeast Asia emerged from the first year of the pandemic relatively unscathed, but SARS-CoV2 variants, inconsistent enforcement of public health measures, and slow vaccine rollouts have led to large outbreaks in Vietnam, Malaysia, Myanmar, Thailand, and Indonesia. 

As the highly transmissible Delta variant, first identified in India and classified as a WHO variant of concern in mid-May, sweeps across the world, cases, deaths, and nationwide restrictions are increasing. 

The Delta variant has been recorded in 111 countries. The three other variants of concern (Alpha, Beta, and Gamma) have been found in Malaysia, Thailand, Philippines, Singapore, and Indonesia. 

Indonesia Facing Massive Surge and Overwhelmed Health System

Over the past month, daily new cases in Indonesia have increased five-fold and the number of new deaths has doubled since the beginning of July. On Sunday, the country of 276,5-million recorded 44,721 new cases and 1,093 deaths, bringing the total cumulative cases to 2.8 million and deaths to 73,582, according to the Indonesia Health Ministry

The figures, however, are likely underestimated due to the limited testing capacity. 

“We predict that the real number of those who died from COVID-19 should be three to five times higher than the official number,” Irma Hidayana, Co-founder of LaporCOVID19, a citizen coalition for data disclosure on COVID, told Al Jazeera.

“We miss many cases and we don’t identify maybe 80% of these cases in the community,” Dr Dicky Budiman, an Indonesian epidemiologist at Griffith University in Australia, told the Guardian

“In Indonesia, the testing is passive, it’s not active. The one who comes to the healthcare facility is the one who gets tested if they show symptoms, or if they also identify as the contact,” said Budiman. 

According to WHO, one indicator that the epidemic is under control in a country is a positive rate of less than 5%. In Indonesia, some 29.3% of tests conducted return positive results. This suggests that the level of testing in the country is inadequate relative to the size of the outbreak. 

The health system is being battered by the third wave, and hospitals on the island of Java have reached capacity, oxygen supplies are running low, and four of the five designated COVID burial grounds are nearly full. 

Some 33 patients at Dr. Sardjito General Hospital in Yogyakarta died this month after the supply of oxygen ran out. 

Hospitals have set up large tents and added thousands of beds to increase capacity and meet the demands of the surge, but there is also a shortage of healthcare workers which has been exacerbated by healthcare workers succumbing to the virus. 

Tents have been set up outside of hospitals on the island of Java to treat the surge in COVID patients.

Some 114 doctors in Indonesia have died so far this month, accounting for 20% of the 545 total health worker deaths from SARS-CoV2 since the beginning of the pandemic. 

Many expect the situation to worsen, but government officials say they have the situation under control. 

“If we talk about the worst-case scenario, 60,000 or slightly more [daily cases], we are pretty OK,” said Luhut Pandjaitan, a senior minister assigned to tackle the COVID-19 pandemic. “We are hoping that it will not reach 100,000, but even so, we are preparing now for if we ever get there.” 

The government has implemented restrictions on the islands of Java, Bali, and 15 other cities, closing places of worship, schools, shopping malls and sports facilities, reducing public transit capacity, and limiting restaurants to takeout. 

The restrictions are set to end on Tuesday, but officials are considering extending them.

Malaysia Experiences Dual Health and Economic Crisis

As of 13 July, the Southeast Asia region saw a 16% increase in new cases and a 26% increase in new deaths over the course of one week. India, Indonesia, and Bangladesh are responsible for the greatest numbers of cases and deaths from the region. 

Malaysia has recorded the worst COVID infection rate per capita, with 354 new cases per million people, compared to 182 in Indonesia, 137 in Thailand, and 97 in Myanmar. 

On Monday, Malaysia recorded 10,972 new cases and 129 deaths, bringing the total cumulative cases to 927,533 and 7,148 deaths, according to the Malaysian Ministry of Health

Fatalities have tripled since early May.

Malaysia is also facing an economic crisis and thousands are in need of assistance from the government after the most recent lockdown, which was introduced on 1 June. 

“Generous and comprehensive welfare protection to support nutrition, mental health and the ability to stay home for all Malaysians” is needed, Dr Khor Swee Kheng, an independent health policy consultant for WHO, told the Guardian

Health experts have blamed the continued rise in cases on the government’s inconsistent implementation of restrictions and failure to close loopholes.  

Frustration Mounting Over Government’s Handling of COVID-19 in Thailand

Thailand recorded 11,784 new cases and 81 deaths on Sunday, marking the third consecutive day of cases over 9,000. As the country attempts to tackle its worst outbreak to date, a protest was held to criticize the government’s handling of the pandemic. 

The country has recorded a total of 415,170 cases and 3,422 deaths since the pandemic started. Over 90% of cases and deaths have occurred since April. 

COVID restrictions were expanded on Sunday to include limits on travel, shopping mall closures, and a curfew in 13 provinces, making these the strictest social and public health measures implemented in over a year. 

On the same day, protesters, armed with N95 masks, gloves and hand sanitizer, broke the ban on gathering of more than five people, to call for the Prime Minister’s resignation. Prime Minister Prayut Chan-o-cha has been criticized for his failure to secure adequate supplies of COVID vaccines and his inability to prevent the mounting infections and deaths. 

The police used teargas, water cannons, and rubber bullets to disperse protesters.

Areas of Vietnam Experiencing ‘Very Complicated Epidemics’

Vietnam has put its southern region in a two-week lockdown starting on Sunday after three consecutive days of record cases, deemed “very complicated epidemics,” by Vietnam’s Prime Minister Pham Minh Chinh.

On Sunday, Vietnam recorded 3,218 new cases and 16 deaths, the majority of which took place in the Mekong Delta and Ho Chi Minh City. Some 84% of the COVID deaths have occurred since April, after months of no recorded cases.

“The situation is getting serious with a high rate of transmission, especially with the dangerous Delta variant,” said Vietnam’s Prime Minister Pham Minh Chinh. “We have to put the health and safety of the people as the top priority.”

“We have to keep the transmission rate at the lowest possible to ensure the health system functions effectively and is not being overloaded,” said Vu Duc Dam, Deputy Prime Minister and head of the Committee for COVID-19 Pandemic Prevention. 

The surge has come as Vietnam struggles to speed up its vaccine rollout.

Booster Shots Planned to Bolster Sinovac

Vaccination rates across Southeast Asia remain low, with 30.3% of Malaysia’s population having received one dose, 15.4% of Thailand’s, 15.2% of Indonesia’s, 4% of Vietnam’s, 3.5% of Bangladesh’s, and 3.3% of Myanmar’s. 

Even Malaysia, which has done the best out of this group of Southeast Asian countries, has only fully vaccinated 9.6% of its population, compared to 52.9% in the United Kingdom and 48.1% in the United States.

Not only have fewer people across Southeast Asia received COVID jabs, but there are growing concerns that the Chinese-made Sinovac vaccine may not be performing as well as expected – particularly against rapidly spreading variants of SARS-CoV-2.

Both Indonesia and Thailand, which have vaccinated their healthcare workers with Sinovac, have announced plans to offer a booster dose of the Moderna or Pfizer/BioNTech vaccines. 

“There’s a lot of doctors and medical workers who have been vaccinated twice but endured medium and severe symptoms, or even died,” said Slamet Budiarto, Deputy Chief of the Indonesian Medical Association, to Parliament in early July. 

“It is the time for medical workers to get a third booster to protect them from the impact of more vicious and worrying new variants,” said Melki Laka Lena, Deputy Chairman of the Indonesian Parliamentary Commission Overseeing Health.

Image Credits: Sky News, ABC News (Australia), ABC News (Australia).

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