Seven months after its first coronavirus case was reported, the world’s fourth most populous country still has a large number of blind flights.
An archipelago of 270 million people, Indonesia has tested a smaller portion of its population than any other major economy. According to Our World in Data, a for-profit research project based at Oxford University, it has performed Covid-19 tests on eight out of every 1,000 people – less than the less developed Philippines, which has tested 34 people per 1,000.
Mexico, seen as a low-testing country, tested 13 out of 1,000 people – about 60% more than Indonesia. India has conducted 60 tests per 1000 people, reporting the number of samples tested compared to the number of people tested. That’s four times the number of samples per 1,000 people that Indonesia has reported testing.
Outcome: Policymakers and public health experts in Indonesia – such as Kovid-19 – have killed more than 11,000 people than any other country in East Asia, not knowing where and how the virus is spreading, making it more difficult. To contain the disease. Low testing is also a barrier to determining when and where economic activity is restricted or reopened.
Countries use different methods to calculate national test averages, so country-to-country statistics may not be directly comparable. Nonetheless, they give the general indication of the degree that various governments are looking for an epidemic.
Public health experts say that in Indonesia, a defect of proper testing also means that many people with covid-19 cannot diagnose and do not know when to isolate, increasing the spread of the disease.
In some cases, hospitalized Indonesians with covid-1 symptoms are given rapid antibody blood tests that cannot reliably diagnose the disease instead of saliva or nasal-swab-based polymerase chain reaction tests, which can be performed by PCR. Also known as tests, which are considered gold. Standard for diagnosis.
Yasha Chatab, director of an Indonesian tech company, said they rushed to the emergency room with a high fever last month. He was given an antibody test which came back negative and antibiotics were prescribed. He went back home, mainly keeping her in his room, but still going to buy necessities. When his condition did not improve after a few days, he went to a medical clinic and this time underwent a PCR test, which returned positive three days later.
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“It posed a very big risk because it gave me a false sense of security,” Mr Chatab said of the antibody test. If they only knew he was infected, he added, “I wouldn’t have gone out at all.”
Nationally, only 25,000 to 30,000 people in Indonesia receive PCR tests a day.
“It is difficult to ascertain the exact course of action,” said Panji Hadisomarto, an epidemiologist at Padjadarajan University in Bandung. “At the moment we don’t have the data to prove or disprove any theories – that’s the most frustrating.”
Only 300,000 cases are reported in Indonesia, the same as in Germany, which has a population of less than a third. One indication the infection is missing is that the more tests Indonesia does, the more cases are found.
Healthcare workers took blood samples from employees at a shopping mall in Tangereng, Indonesia, in Indonesia Gust.
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Mast Irham / Shutterstock c
Daily case counts increased from 2,000 at the beginning of August Gust to about 4,000 by the end of September – during which time the number of trials in a single day doubled. The rate of positive tests has remained fairly stable at around 15%. This is in comparison to the rate at which public health experts heed the warning that cases are being diagnosed and need further testing.
The increase in cases led to new restrictions in the capital, Jakarta, in mid-September, which the government said helped turn the tide. Restrictions limit the number of people who can be in offices and places of worship and restaurants only offer withdrawals.
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Throughout the epidemic, Indonesia has avoided nationwide lockdowns, although some regions have imposed restrictions on movement.
In a guideline released in July, the government said rapid tests – a term that primarily refers to antibody tests in Indonesia – should not be used for diagnosis. This type of test involves examining blood samples to see if patients have produced antibodies in response to the virus.
These tests are performed relatively quickly, but are usually used to determine if a person has been infected in the past. They cannot make a reliable diagnosis of active covid-19, doctors say, because it can take up to a week or more after the onset of the disease to produce antibodies, which means that people with early-stage disease often get negative results.
In early March, the official guidance on antibody tests stated that all results should be confirmed using PCR. But the availability of those tests is low and the distribution is patchy.
Last month, an emergency hospital in Jakarta sprayed disinfectant inside a school bus working in a hazmat suite to prepare for the transport of coronavirus patients.
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Mast Irham / Shutterstock c
Antibody tests are not counted in the country’s total test tally.
There is no reason for Indonesia’s testing problem. Researchers and doctors have blamed a lack of well-trained laboratory staff, difficulties in obtaining chemical reagents for test kits, and malfunctioning machines for processing tests.
Referring to the government, Pandu Riono, an infectious disease specialist at a university in Indonesia, said they did not know how to solve the problem.
Indonesia’s health ministry did not respond to requests for comment. A government Covid-19 task force said in a posting last month that the country had been “very successful” in increasing testing capacity, acknowledging that the test capacity had fallen below World Health Organization standards.
Public health experts also say the test began with a mistake. In late March, President Joko Widodo called for a comprehensive roll out of test kits. The tests then taken by hospitals and government agencies were in many cases antibody tests.
Emergency medicine specialist Dr. Kediri in the city of East Java, 000,000,000. “We took the wrong first step,” Tri Maharani said. She was given an antibody test when she fell ill after treating patients in June, which came back negative. She received a PCR test the same day, and five days later the results confirmed she had the virus, she said.
He said about 1 anti0 antibody tests performed at his hospital have returned positive.
A gravedigger rests during a funeral at Pondok Rangagan Cemetery in Jakarta last month.
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Adi Veda / EPA / Shutterstock
Dr Maharani said the city has a limited capacity to process PCR tests, with one machine having the right machine. The hospital’s representative, Gambiran Kediri, said it could test 24 samples a day.
Dr .. Maharani said that he wears a hazmat suit to treat typical patients without checking whether he is infected or not. He said the emergency room is like a “jungle” where doctors can’t be sure anyone has a Covid-19.
She is not a hospital designated for the disease and must refer suspicious cases elsewhere, requiring antibody testing of the patient as per hospital policy, he said. If the result is negative, she tries to persuade the doctors of the referral hospitals to accept the patient based on her symptoms.
Dr Maharani said the government should increase PCR testing using potential mobile clinics in rural areas. “The shortage has led to many silent cases,” he said.
Write to John Amont at [email protected]
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