Covid in Indonesia: ‘Still in the third wave’, Omicron is still attacking’, two years of pandemic in data

In fact, according to the graph below, the trend line for confirmed Covid cases shows that Indonesia is still hit by the third wave.

The daily number of Covid infections in February – which was 64,718 cases on 16/02 – surpassed the records in the second wave (July 2021) and the first wave (January 2021).

Restrictions on community mobility, ranging from PSBB to PPKM, cannot stop the increase in infections.

Although in the last few days the number of new cases per day showed a downward trend until the end of February, the death rate for Covid sufferers remained significant, still above 200 cases per day.

Signs that Indonesia is entering the third wave are when there is a sharp increase in daily cases from 11,000 to 17,000 in early February and the positive rate is already above 30 percent, said the Indonesian Doctors Association (IDI).

The spike in cases of Covid transmission at the beginning of this year could not be separated from the Omicron variant.

After last year was rocked by the Delta variant, which recorded a daily case record in the second wave of transmission, Indonesia is now struggling to overcome the threat of the Omicron variant, which has 5 times the transmission rate of Delta.

According to an epidemiologist from YARSI University, Professor Tjandra Yoga Aditama, Omicron has a number of differences with previous variants,

Omicron has a faster spread, has the possibility of re-infection and causes attacks on the immune system that can affect vaccine efficacy.

It didn’t take long, even though the government had quarantined all of its patients who had just arrived from abroad last December, Omicron spread quickly.

The Covid-19 report revealed that from the graph of the 7 daily average of the number of new Covid-19 cases that they compiled, the wave of the Omicron variant shot faster than the Delta variant during the first 30 days.

“The number of new Covid-19 cases on the first day of the Omicron wave (5 January 2022) was 404 cases, then within 30 days it became 27,197 cases or an increase of 67 times.

Meanwhile, the Delta wave shows an increase in the number of new cases for 30 days, only 2 times,” said Lapor Covid-19.

It is uncertain whether the peak in Omicron cases has passed, although the last days of February continued to show a decline in the number of new cases – not close to the record high on February 16 of 64,718 cases.

“We are still monitoring it considering that confirmed cases are still fluctuating,” said a spokeswoman for vaccination from the Indonesian Ministry of Health, Siti Nadia Tarmizi, to BBC News Indonesia (27/2).

However, the daily death rate is still relatively high. Since February 17, the daily death rate has almost always been above 200 cases – the highest of 317 cases on February 24.

Previously, from October 1, 2021 to February 10, 2022, the daily death toll did not reach 100.

The highest daily death toll during the pandemic occurred on 27 July 2021, which was 2,069 cases, when the Delta transmission peaked.

Since the pandemic, areas on the island of Java, which are inhabited by more than half of Indonesia’s population, have dominated the number of transmission cases. DKI Jakarta occupies the top position with 1.16 million more cases (21.1% of the total national cases) as of 27 February 2022.

However, for the death rate, Central Java province dominated with 30,657 cases, followed by East Java with 30,065 cases.

The government is also wary of increasing the number of confirmed cases outside Java.

In an online press conference on February 21, Health Minister Budi Gunadi Sadikin said that previously the Java-Bali ratio was 97 percent with 3 percent outside Java-Bali, now it is 72 and 28 percent, so there is a potential for a shift in the trend of adding cases.

The age group 60 years and over (elderly) is the most vulnerable when exposed to Covid.

Although not as many as other age groups confirmed positive for Covid, the death rate from the corona virus in Indonesia is dominated by the elderly group (47%).

Another vulnerable group comes from those who have a congenital disease (comorbid). Of the more than 6,100 available data, the number of deaths from Covid patients who have comorbidities are mostly those who already suffer from hypertension, diabetes mellitus and heart disease.

That is why the government on February 21 instructed all hospitals to immediately accept people with Covid who have comorbidities even though they are still experiencing mild symptoms.

Vaccination is the mainstay of mitigation measures to combat the wave of Covid transmission.

Even if the test results are positive, people who have been vaccinated will not experience severe pain as long as they don’t have comorbidities, according to health experts.

Last December, Minister of Health Budi Gunadi Sadikin targeted 208.2 million Indonesians to have been injected with the Covid-19 vaccine by March 2022. Starting from the elderly to children aged 6-11 years.

By March, the target had not yet been met. Until February 28, 2022, the first dose is still 91 percent. Then for the second dose, it has not reached 70 percent. There are still more than 30% who have not received the full dose of vaccine.

Meanwhile, giving the third dose (booster), which started last January 12, was only 4.9 percent of the target.

Likewise, vaccination for vulnerable groups has not yet met the target. For the elderly group, for example, only half of the target received the full vaccination or the second dose. and very few received a third (booster) dose.

According to epidemiologist Najmah Usman, based on several studies, the elderly who have received the full dose are still at risk of contracting Covid and experiencing critical conditions, compared to those who have received the third dose.

“This could be a consideration for the Ministry of Health to accelerate the provision of booster vaccines for high-risk groups, including the elderly, considering that Omicron is very fast in transmission and can lead to critical conditions for the elderly.”

Meanwhile, Professor Tjandra Yoga Aditama stated that if the vaccination coverage was over 60 percent, usually the challenges would be even greater.

“It is possible to face two groups, the first is a group of people whose places are difficult to reach and the second is a group who does not want to be vaccinated for any reason, from religious beliefs to health. So special efforts need to be made to reach them,” said Tjandra.

According to him, such problems are not only faced by Indonesia but also other countries in meeting vaccination targets.

Meanwhile, from 34 provinces, there are still 10 that have not reached 50% of the target in vaccinating their citizens with the full dose.

Papua is the province with the lowest vaccination achievement – both for the first and second doses which have not reached 32% – and this is very different from DKI Jakarta and Bali which have already exceeded 100 percent of the target.

Most of them are in “West Java, approximately 4 million people,” said Siti Nadia Tarmizi, a spokeswoman for the Ministry of Health’s vaccination program when confirmed by BBC News Indonesia.

The Ministry of Health also identified that at least 2.5 million people did not immediately access the second dose of vaccination for more than six months.

Given the level of efficacy (efficacy) of the Covid vaccine dropped dramatically in six months, they were asked to repeat the primary vaccination.

Of the 3120 hospitals spread across Indonesia, 76 percent (2388) serve Covid patients with around 102,000 beds (mattresses), based on data from the Ministry of Health compiled by regional health offices.

Spokesperson for vaccination of the Ministry of Health, Siti Nadia Tarmizi revealed that the occupancy rate of Covid hospitals (BOR) in the last few days until the end of February continued to show a decline.

BOR is the percentage comparison of available beds with used beds.

According to the Ministry of Health, the percentage of Covid patients treated in hospitals as of February 26, 2022 decreased to 36% from the previous day (25/2) of 37%. In the previous week’s data, namely February 19, the BOR rate was 37.46 percent.

Professor Tjandra said that considering that there are relatively few Covid patients now in the delta wave last year, it is possible that the number of available beds has not been calculated optimally.

“So if the current BOR is calculated like last June-July, it could be even lower than 30 percent,” he said.

He hoped that hospitals would no longer be overwhelmed as they faced the Delta wave last year after the government now provides telemedicine services for people with mild COVID-19 symptoms, who can self-isolate at home.