Anticipating New COVID-19 Epicenters

Indonesia must prepare for the second wave of COVID-19 cases as the curve of confirmed cases in Jakarta has begun to flatten.

Kompas/Bahana Patria Gupta

A mural about the COVID-19 epidemic is painted by the Surabaya Mural Union at a wall on Jl Stasiun Wonokromo, Surabaya, East Java, on Thursday (2/4/2020)

The large-scale social restrictions (PSBB) policy, in place in Jakarta since 10 April, have begun to show results. Since the PSBB was imposed, there have been fewer new Covid-19 cases every day.

This is in stark contrast to the growth rate of COVID-19 confirmed cases between early March and early April, before PSBB implementation. At the time, the growth rate of positive cases in Jakarta was significant.

Nevertheless, the flattening of the COVID-19 confirmed case curve in Jakarta must be read carefully. This does not mean the PSBB has been a complete success, as the number of confirmed cases may surge again if the social distancing policy was relaxed without thorough calculations. Moreover, local transmissions occur in almost all areas in Jakarta, making social restrictions still a necessity.

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As the number of new confirmed cases goes down in Jakarta, people must be alert of the emergence of new epicenters of the disease. As of now, there are regions outside Jakarta with stable growth rates of new confirmed cases.

Looking at the area distribution, eight provinces other than Jakarta have reported huge numbers of COVID-19 confirmed cases across Indonesia. The provinces are West Java, Central Java, East Java, Banten, South Sulawesi, Bali, West Nusa Tenggara and Papua. These regions contribute to 43 percent of total confirmed cases nationwide.

Kompas

Covid-19 case in Jakarta, before (sebelum) and after (setelah) PSBB.

Java

Of these regions, four provinces in Java must be closely observed. Almost a third of all confirmed COVID-19 cases in Indonesia are in West Java, Central Java, East Java and Banten.

Between 1 April and 6 May, these four regions still showed increases in daily new confirmed cases on varying degrees.

Highest increases were recorded in East Java. This is linked to the finding of several huge COVID-19 clusters in the province, including a training for haj officials, a Surabaya wholesale center and the HM Sampoerna cigarette factory.

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Daily spikes of confirmed cases are also found in West Java. Despite flattening curves in epicenters of Depok, Bogor and Bandung, the number of new cases still increases daily province-wide. This is linked to new cases in other regions as West Java only implemented province-wide PSBB on 6 May.

Central Java also still sees daily spikes of confirmed cases. Health Ministry data on 1-6 May showed that the province saw 28 new confirmed cases each day. This was four times higher compared to the same period in April.

Highest increases were recorded in East Java.

Meanwhile, Banten is the only province of Covid-19 epicenter currently flattening its curve of daily new cases. This is on the heels of PSBB in Greater Tangerang since 18 April.

Looking at cities and regencies, Surabaya and Semarang must be closely monitored so that they do not become new Covid-19 epicenters. In Surabaya, there were 569 confirmed cases as of 5 May. This was higher than other huge cities in Indonesia, such as Bandung, Medan and Makassar.

Surabaya has 49 percent of all confirmed cases in East Java. Effective and efficient measures to anticipate the virus spread is key to stopping widespread infections in Surabaya. Currently, the city already has 1,322 patients under surveillance (PDP) and 2,788 people under surveillance (ODP).

Other than Surabaya, Semarang must also be closely monitored. The city had 270 confirmed cases as of 6 May. Of this amount, 85 people are still under treatment, 30 have died and 155 have recovered. More than 200 PDPs are still awaiting test results.

Kompas

Top 10 provinces with the highest Covid-19 positive cases.

Beyond Java

Regions outside Java must also be closely observed due to the rising number of confirmed Covid-19 cases. In Central Indonesia, West Nusa Tenggara (NTB) and Bali have the highest number of confirmed cases. Health Ministry data shows that there were 289 confirmed case in NTB and 277 in Bali.

Specifically in NTB, confirmed case curve has begun to flatten between 25 April and 6 May. Nevertheless, strict monitoring is still necessary, considering the province’s 567 ODPs and 420 PDPs as of 6 May.

Makassar records new confirmed cases every day, albeit fluctuated.

Meanwhile, in Eastern Indonesia, South Sulawesi and Maluku must be monitored due to the rising number of Covid-19 confirmed cases. Based on daily figures, South Sulawesi has a higher increase rate than Papua.

As an economic hub in Eastern Indonesia, Makassar must be closely monitored due to its high number of confirmed cases, namely 440, as of 6 May. Makassar records new confirmed cases every day, albeit fluctuated.

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Furthermore, there are also 467 PDPs and 628 ODPs. With these numbers, Makassar is among the COVID-19 epicenters in Eastern Indonesia.

KOMPAS/RADITYA HELABUMI

Staff members of the health office at Soekarno-Hatta International Airport check the documents of a passenger, including a certificate declaring he has tested negative for COVID-19, at the airport in Tangerang, Banten, Friday (8/5/2020). Domestic flights were reopened to the public under some conditions based on a recently issued government circular.

Local transmission

Other than considerations of confirmed cases and daily trends, vigilance on the emergence of new epicenters must also be directed at regions with local transmissions, which human-to-human transmissions between people in the same area.

Based on this indicator, extra attention must be given to East Kalimantan and Bali, which have local transmissions in seven regencies and cities. The number of cities and regencies reporting local transmissions in the two provinces are the highest after West Java (11 regencies/cities).

Furthermore, attention must also be given to Riau, West Sumatra, South Sumatra and North Kalimantan that have recorded local transmissions in four regencies/cities. Social and physical restrictions are necessary to prevent the number of regions with local transmissions from growing.

Rapid steps, no matter in what form, are necessary to flatten the Covid-19 curve, especially outside Greater Jakarta. We do not want to suffer through a second wave of Covid-19 as this will only lead to protracted recovery in various fields in Indonesia. (KOMPAS R&D)