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A resurgence of coronavirus cases will soon put doctors at Jakarta’s main hospital for Covid-19 in the position of having to decide who gets a precious bed in the intensive care unit (ICU) and who doesn’t.
In some respects, that is already happening at Friendship Hospital, the largest government-run medical center in the Indonesian capital.
During a seven-day period ending Thursday, the hospital received requests to receive an average of 83 patients per day, more than double the referrals requested during the same period in July.
As the number of trained staff is limited, most applications are rejected. On Thursday, the hospital received 103 referrals and only accepted 12.
Last week, infections tested new highs, nearly six months after the first cases of Covid-19 emerged.
On Friday, the number of cases in Jakarta rose again, climbing to 869, eclipsing by more than 100 the previous day’s count, a record in itself. Nationwide, infections soared to another record for the third day in a row yesterday, with 3,308 new cases reported, bringing total infections to more than 169,000.
The increase has stopped the gradual reopening of the capital. On Thursday, Jakarta Governor Anies Baswedan shelved plans to reopen bars and nightclubs.
Professor Wiku Adisasmito, spokesperson for Indonesia’s Covid-19 task force, attributed the increase in cases, at least in part, to inconsistent reports across the more than 300 laboratories in Indonesia. “The government’s objectives are very clear; a swift and rapid response … for all Indonesians to help create a safe and healthy Indonesia from Covid-19,” he said at a virtual briefing organized by the Club on Friday. of Foreign Correspondents of Jakarta.
At Friendship Hospital, or Rumah Sakit Persahabatan, doctors are grappling with the idea that they will have to classify patients, deciding what is the most serious but treatable condition, for an ICU bed.
This is not far, said Dr. Erlina Burhan, a hospital spokeswoman who also acts as a spokesperson for the Indonesian Medical Association.
“I am concerned that we will soon get to a point where we have to play God,” he said. “I’m nervous”.
The Friendship Hospital closed nearly 206 of its 700 beds in March to specialize in fighting the disease … But since beds are scarce, dozens of people are turned away every day. Since July, she has not accepted more than 17 referrals per day.
The Friendship Hospital, built in the 1960s with Soviet aid, has become one of the capital’s last lines of defense for the seriously ill or critically ill with Covid-19 since it closed almost 206 of its 700 beds in March to specialize in fighting the disease.
Two other hospitals, Sulianti Saroso and a military hospital, provide similar levels of care and have 150 beds between them.
But with its full staff of 200 pulmonary specialists, anesthesiologists and other specialists, as well as more than 100 ICU nurses, Friendship Hospital tends to receive most of the referrals from the other 64 hospitals in the capital tasked with caring for those infected with the virus.
But because beds are scarce, dozens of people are turned away every day. Since July, Friendship Hospital has accepted no more than 17 referrals per day, according to hospital data.
Indonesia has four doctors for every 10,000 people, half the proportion in India and less than a third the proportion in neighboring Malaysia, according to World Bank data.
“Our biggest limitation is human resources,” said Dr. Ernita Akmal, an anesthesiologist at the hospital’s ICU.
On CCTV behind her, a nurse in protective gear tends to a critically ill patient on a ventilator in the ICU unit where all 16 beds are full.
“After six months,” said Dr. Ernita, “everyone is exhausted.”
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