Virus Deaths May Be Three Times Official Tally in Indonesia
Volunteers compiling data show the death rate in Indonesia may be three times higher than what the government says.
(Bloomberg) --
Indonesia’s spiraling coronavirus crisis has citizens taking matters into their own hands, with networks of volunteers compiling data that shows the death rate in the world’s fourth-most populous nation may be three times higher than what the government says.
Concern that the country’s low testing rate means virus deaths were going unrecorded spurred citizens, health workers and scientists to set up LaporCovid-19 and KawalCOVID19, two open-source data platforms that allow people around Indonesia to report suspected Covid-19 deaths via WhatsApp and Telegram.
More than 4,000 deaths among suspected Covid-19 patients since early March haven’t been included in the official numbers, according to data collected by the platforms. That’s on top of the government’s tally of 1,520 fatalities, which already gives Indonesia the highest virus death rate in Southeast Asia.
While the government defends its own count -- saying it only includes deaths in people diagnosed positive using virus test kits -- the crowd-sourced numbers gel with estimates from the World Health Organization. Indonesia’s seven worst-hit provinces saw 3,285 suspected virus deaths as of May 14, according to a WHO report. A spike in burials in Jakarta in March and April where virus protocols were used indicates the death toll in Indonesia’s capital is likely four times official numbers, the WHO said.
Irma Hidayana, a public health consultant based in Jakarta, co-founded LaporCovid-19 because she was concerned about how local authorities were managing the outbreak.
“We don’t fully trust the numbers presented by the government,” she said. “The government is clearly underreporting deaths and not adhering to WHO guidelines, which mandates inclusion of deaths among virus suspects.”
Skepticism over virus data exists the world over, with experts saying the true scale of the pandemic is likely much higher than official numbers, given the varied definitions for diagnosing infections and a shortage of testing kits. But nowhere is that more apparent than in the developing world, where weak health-care infrastructure and a lack of funds hobbles countries’ ability to test.
A collection of islands held together by patchy transport links, Indonesia has one of the world’s lowest virus testing rates, below even Senegal and Sri Lanka. Geographic challenges, along with a lack of trained diagnostic personnel and labs have also hampered efforts to boost the testing rate. But an uptick in the number of health professionals succumbing to the virus and signs hospitals are becoming overwhelmed -- with staff running short of protective equipment -- has added to the picture Indonesia’s crisis is bigger than the official numbers indicate.
Anxiety over the true scale of the outbreak has escalated as the government pushes forward with plans to reopen what is Southeast Asia’s largest economy as early as next week.
‘Too Risky’
Indonesia is rushing to normalize based on unreliable data, risking inflaming the outbreak, said Hidayana.
“Entering the new normal phase now is seen as too risky, especially for the people in the lower classes as they will be more vulnerable to a potential second wave of virus transmissions,” Hidayana said.
This isn’t the first time Indonesia’s virus data has been thrown into doubt. President Joko Widodo said in April the government initially held back on reporting more than confirmed infections and deaths among positive patients for fear of triggering a panic. Even after he promised more comprehensive data, officials are yet to start reporting suspected Covid-19 deaths, as countries like Belgium do.
“We don’t cook up data that doesn’t reflect the real situation,” Achmad Yurianto, a spokesman for Indonesia’s government task force on Covid-19, said of the concerns raised by the volunteer groups.
New cases in Indonesia have more than doubled in May with the total count reaching 25,216 on Friday. That’s almost 9,000 cases less than neighboring Singapore though, which has ramped up testing after a second wave of infections and has seen just 23 deaths.
Indonesia has only conducted polymerase chain reaction, or PCR, tests on 202,585 people, official data show, and there are more than 12,000 suspected patients still waiting to be diagnosed.
While it takes between seven to 10 days for a PCR test results to come through in Jakarta and Bandung, another city on the main island of Java, it takes longer in other less developed cities, according to Panji Hadisoemarto, an epidemiologist at Padjadjaran University in Bandung.
Enil Fasoni, a 56-year-old nurse at a specialist cardiac hospital in Jakarta, has experienced the slow testing process first hand. She lost her husband to Covid-19 last month after he contracted the virus from her while she was quarantining at home. The results of her husband’s nasal swab test only came two days after his death.
In Labuan Bajo, the gateway to Komodo, an Indonesian island famous for its giant carnivorous lizards, there is a distinct lack of urgency, according to Zack Peterson, co-founder of the not-for-profit 1000 Days Fund.
“There continues to be a tremendous lack of resources,” Peterson said. “And because it takes 10 days to get the results of a swab test, it’s like you’re fighting a ghost.”
While Jokowi, as the president is commonly known, has expressed frustration over the lack of progress in testing, he’s also told Indonesians they’ll need to “live in peace with Covid-19 for some time to come.” He’s said any decision to reopen the battered economy, which is on track to contract 0.4% under a worst-case scenario this year, would be data-dependent.
Hidayana, who runs the crowd-sourced data platform LaporCovid-19, says accurate data is necessary for the government to make appropriate policy decisions.
“There’s still a lot of data homework left for the government before bringing Indonesia into the new normal phase.”
©2020 Bloomberg L.P.