Accelerate Covid-19 Rapid Testing for Indonesia
Learning from South Korea’s experience, the mass testing President Joko “Jokowi” Widodo has ordered is expected to prevent the virus’ transmission and reduce fatalities.
Expanding the coverage of rapid testing for Covid-19 has proved effective in South Korea. Learning from that country’s experience, the mass testing President Joko “Jokowi” Widodo has ordered is expected to prevent the virus’ transmission and reduce fatalities.
World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus talks during a daily press briefing on COVID-19 virus at the WHO headquaters in Geneva on March 11, 2020. - WHO Director-General Tedros Adhanom Ghebreyesus announced on March 11, 2020 that the new coronavirus outbreak can now be characterised as a pandemic.
“We have a simple message for all countries: Test, test, test,” Dr. Tedros Adhanom Ghebreyesus, the World Health Organization (WHO) Director-General, said in a virtual press conference on Monday, 16 March 2020. The message is to ensure that Covid-19 prevention and control is carried out more rapidly and effectively.
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“All countries must test every suspected case, they cannot fight a pandemic blindfolded. Without testing, cases cannot be isolated and the chain of infection cannot be broken,” he said.
Dr. Tedros described testing as the backbone of the response to the Covid-19 pandemic. Large-scale testing will expedite the detection of cases. Confirmed cases are to be isolated on detection, which will break the chain of transmission. In addition, governments can also execute contact tracing of the confirmed cases.
We have a simple message for all countries: Test, test, test,
Therefore, President Jokowi on 19 March 2020 ordered mass rapid testing for Covid-19 with widespread coverage. The order follows in the footsteps of the measure several countries took to bring Covid-19 under control, including China and South Korea.
Raid testing is conducted as early detection of the virus that causes Covid-19 in humans. Testing will obtain early indications of Covid-19 infection in suspected cases.
The tests detect the immunoglobulin M (igM) or immunoglobulin G (igG) antibodies in the blood sample of the test subject. The two antibodies are generated in response to SARS-CoV-2, the virus that causes Covid-19.
The antibody develops when a person is exposed to the virus. However, it takes several days to emerge in the bloodstream, so it might be that no antibodies are detected when a person is tested.
The test requires only 15 to 20 minutes to produce a result. If the test result is positive, it is followed up with a more precise test, a molecular test through real-time polymerase chain reaction (PCR).
Rapid testing began on Friday, 20 March 2020, prioritizing those who have been in direct contact with Covid-19patients. Later, testing will be carried out in areas considered most at risk using 1 million test kits from the government.
People wait to receive a COVID-19 novel coronavirus test at a testing booth outside Yangji hospital in Seoul on (17/3/2020). - A South Korean hospital has introduced "phone booth"-style coronavirus testing facilities that avoid medical staff having to touch patients directly and cut down disinfection times.
South Korea’s success
Mass rapid testing can be viewed as an effective measure to fight the coronavirus. This is because those countries that conducted more Covid-19 testing per population have generally reported lower case-fatality rates.
This can be seen in comparing the fatality rates and tests conducted per 1 million people in various countries. The statistical data is derived from Covid-19 cases in the U.S., Italy, Japan, Hong Kong, Britain, South Korea, New Zealand, the Netherlands, Sweden and Indonesia.
Of these 10 countries, South Korea has been the most successful in its strategy to expand test coverage and reduce fatalities at the same time. By 19 March 2020, the Korean government had tested 307,204 people.
In terms of demographic proportion, 5,984.9 people per 1 million population have been tested. A total of 5,200 daily tests were conducted from the date of the first confirmed case in that country, which was on 20 January 2020.
Mass rapid testing can be viewed as an effective measure to fight the coronavirus.
What must be appreciated is South Korea’s lower fatality rate compared to the global death rate and the fatality rates of the seven other countries. South Korea has a 1.06 percent a Covid-19 death rate among 8,600 confirmed cases. The global death rate reached 4.18 percent on 19 March 2020.
The six other countries with fatality rates higher than South Korea have tested less than 2,000 people per 1 million population. Italy is not included in this analysis, as it is considered an outlier, and the calculation is based on the latest data submitted by the health ministries or other official sources of each countries.
Japan, which had a fatality rate of 3.4 percent on 18 March 2020, had only tested 14,500 people, or 114.7 people per 1 million population. Japan had 853 confirmed cases over 62 days of its local outbreak.
This photo taken on March 24, 2020 shows the Ariake Gymnastics Center, a venue for the 2020 Tokyo Olympics, in Tokyo, the day before the historic decision to postpone the 2020 Tokyo Olympic Games. - Japan on March 25 started the unprecedented task of reorganising the Tokyo Olympics after the historic decision to postpone the world\'s biggest sporting event due to the COVID-19 coronavirus pandemic that has locked down one third of the planet.
In the US, only 73,960 people have been tested, or 271.2 people per 1 million population over 58 days from the first confirmed case. The US fatality rate is 1.45 percent of 7,700 confirmed cases.
Another country with a high fatality rate is Britain, with 3.9 percent. Since its first confirmed case was reported on 31 January 2020, it has tested only 56,220 people, or 829.22 people per 1 million population.
In Indonesia has tested 1,900 people to 20 March 2020. This means only 7.2 people per 1 million population have been tested. Indonesia’s fatality rate is high at 8.67 percent of 369 confirmed cases.
Rapid, widespread testing
Expanding the coverage of Covid-19 testing is thought to be successful because this also includes asymptomatic cases. People who have been infected but display no symptoms are more dangerous in terms of transmission, because they are unaware that they are carrying the virus and can therefore infect the people around them.
In addition, the more rapid the detection of infected people, the more quickly they can be treated. They can be isolated and treatment can start before the disease worsens. In this way, potential deaths can be minimized.
South Korea confirmed its first Covid-19 case on 20 January 2020. The virus originally spread from a religious group in the city of Daegu. The government identified and tested around 10,000 members of a church in Daegu. The testing involved not just people with symptoms, but also those who appeared to be healthy.
Thereafter, the government promptly expanded the coverage of Covid-19 testing by installing a drive-through clinical testing service. The service was provided through 96 newly built private and public laboratories specifically to test for Covid-19.
The measure was taken to speed up testing and increase the number of people tested. If people who had tested positive for the virus refused hospitalization, they were fined US$8,300.
The government performed 12,000 to 15,000 tests per day, and up to a maximum 20,000 tests per day. Unsurprisingly, 307,000 people have been tested to date.
Nonetheless, all this was enabled with public participation. Lee Sung-yoon, international relations professor of at Tufts University, said that the South Korean people were culturally inclined to obey authorities and to complain less.
When the virus spread further and the government imposed social distancing, the public complied with the policy. People remained at home and avoided major public gatherings. They were also used to wearing face masks every day as protection against air pollution.
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The logistical officer is examined by the officer before entering the Wisma Atlet in Jakarta, Tuesday (24/3/2020). Already 208 people were treated at the emergency hospital, 14 of whom were positively infected by corona.
Indonesia
South Korea’s success to date is the result of its learning from experience. Emerging from the bitter experience of MERS in 2015, the country reevaluated its policy on infectious diseases.
Finally, it imposed a policy of early detection through accurate tests, followed by isolating infected individuals or at-risk groups and providing intensive care. The Korean government has also restricted travel and imposed a lockdown on a scale never seen before.
This can serve as a lesson for Indonesia in responding to the same event. Learning from the Covid-19 pandemic, Indonesia is expected to improve its system of infection prevention and control (IPC).
What it has implemented to date, like physical distancing and expanded testing coverage may be the start of improving its management of transmissible diseases in times to come.
Firefighters use a hose on Monday (23/3/2020) to clean the Candrabhaga Patriot Stadium complex in Bekasi city, West Java. The West Java provincial administration plans to convert the stadium to provide mass testing for Covid-19.
This is also inseparable from public participation. The public can start learning to follow clean and healthy lifestyles by frequent hand washing and strengthening their immune systems against infectious diseases.
Observing the restriction on daily activities also means disciplined participation in the efforts to prevent spreading the coronavirus. Prevention is better than a cure, because have no idea when a pandemic can emerge. (KOMPAS R&D)
