Household Profiles in Preventing Coronavirus Clusters

Kompas/Priyombodo

A woman crosses a Covid-19 educational mural near the KS Tubun apartment, West Jakarta, Wednesday (9/9/2020).

The home, as a place of rest and family gatherings, has proven vulnerable to the risk of Covid-19 transmission.

On 2 March 2020, President Joko Widowo and Health Minister Terawan Agus Putranto announced the first two cases of Covid-19 in Indonesia. The first two confirmed cases involved a 64-year-old woman and her 31-year-old daughter, both residents of Depok, West Java. According to tracing results, the daughter contracted the disease when she went dancing with a Japanese national at a Jakarta nightclub on 14 Feb. 2020. Meanwhile, her mother was infected at home.

The incident started on 16 Feb. 2020, when the daughter sought medical treatment at Mitra Keluarga Hospital in Depok, but the doctor did not diagnose Covid-19 and allowed the woman to go home.

Also read: Strengthening Family Resilience

The woman’s mother contracted the disease as she was tending to her daughter at home. On 1 March 2020, the pair was confirmed to have contracted Covid-19 after they were tested at Dr. Sulianti Saroso Infectious Disease Hospital.

The above two cases were the first instance of a viral cluster in a single household. This occurs if at least two people in a single household are infected with Covid-19. The disease then spreads among family members who live in the same house. The virus is usually “imported” into the household by a family member from outside the home.

Increase in cases

These household clusters are increasing in number across Indonesia, including a household cluster in Tangerang municipality, Banten. By mid-September, Covid-19 cases in the city had exceeded the 1,000 mark. According to Tangerang Mayor Arief R. Wismansyah, 46 percent of all cases had originated in household clusters (Kompas.com, 15/09/2020).

The same phenomenon has occurred in Bogor municipality, West Java. As of 19 Sept. 2020, Bogor had a cumulative tally of 1,008 Covid-19 patients. According to the records of the local health office, the highest occurrence of viral transmission in the city, 44.84 percent, also originated in household clusters. (Kontan.co.id, 20/09/2020)

KOMPAS/I GUSTI AGUNG BAGUS ANGGA PUTRA

Residents with their friends and family enjoy an afternoon on an empty land in Pagedangan, Tangerang Regency, Banten, Thursday (24/9/2020). On average, they don\'t wear masks properly, so they have the potential to contract Covid-19

Household clusters are increasingly contributing to the spread of Covid-19 clusters in Indonesia. According to Health Ministry data, 1,146 transmission clusters had developed in various regions of the country as of 22 Sept. 2020. Apart from households, thousands of clusters also originated at offices, public markets, Islamic boarding schools, student dormitories, prisons, orphanages and dining outlets.

Family activities

Virus transmission in a single family is inextricably tied to the individual activities of each member of a household, in particular the head of the household, who is typically responsible for earning an income to support their family. Meanwhile, not all regions are imposing social restrictions, and not all types of work can be done from home.

This can be seen from the proportion of workers active outside the home based on their job sector. According to the February 2020 data from Statistics Indonesia (BPS), the majority of the Indonesian population, at 18.8 percent of the work force, have jobs in manufacturing. This is followed by agriculture, forestry and fisheries (13.2 percent), wholesale and retail trade, and automotive maintenance and repair (11.6 percent), and finally, construction (11.3 percent).

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In the midst of fulfilling their jobs that requires working outside the home, these workers live with their families, which are generally not small on average. The BPS’ 2019 data show that the majority of household heads have families with four members (30.7 percent), followed by three members (26.5 percent), five members (14.8 percent), and then two members (12.3 percent).

It was even found that a fairly large proportion of workers in a number of provinces headed households with more than seven members. For example, such households comprise 14 percent of all households in Maluku, 12.3 percent in West Papua, 10.8 percent in Papua, 7.4 percent in Southeast Sulawesi, and 7.3 percent in East Nusa Tenggara (NTT). These provincial figures are well above the national average of just 2.9 percent.

Not all regions are imposing social restrictions, and not all types of work can be done from home.

KOMPAS/RONY ARIYANTO NUGROHO

A poster containing a message to protect yourself and your family from the dangers of corona at Baranangsiang Terminal, Bogor City, West Java, which is one of the places for mass swab tests to detect the spread of corona in the Bogor City area, Friday (10/7/2020).

Occupant density

The density of occupants in a household also poses a risk for Covid-19 transmission, because not all houses are home to just one family. Indonesian household averaged 1.3 families each in 2019.

In the regions, the figure is even higher, for example in North Sulawesi, where one residential house is home to 1.49 families. This is followed by West Java with 1.35 families per household, Banten (1.34), Central Java (1.33), East Java (1.33), North Maluku (1.31), and Jakarta (1.31).

Also read: Focus on Family

This condition is caused by a number of reasons, including filial obligations and financial difficulties in home ownership. It is not uncommon for an adult child who has their own family to still live with their parents. Apart from these are cultural reasons, such as the Walengwangko, a communal house of the Minahasa culture in North Sulawesi that typically houses 6-9 families.

The risk of transmitting the virus is even greater if, in addition to many people living under the same roof, several family members must tend to activities outside the home. For example, housewives must shop for basic needs every day, both from itinerant vegetable vendors and directly at markets. Moreover, these activities are taking place when the health protocols are not being properly enforced among large groups of people.

Household hygiene

Meanwhile, many houses in Indonesia do not yet have adequate hygiene and sanitation. Observing the conditions in the field, this means that trying to prevent Covid-19 transmission in household is not an easy task.

In 2019, only 76.1 percent of all households in Indonesia had hand-washing facilities at home. Meanwhile, the remaining 23.9 percent did not have hand-washing facilities, and some did not even have indoor toilets.

KOMPAS/KRISTI DWI UTAMI

Tegal police and military officers deliver food assistance to Covid-19 positive patients and their families who are undergoing independent isolation in Debong Tengah Village, South Tegal District, Tegal City, Central Java, Monday (21/9/2020).

This is worsened by families that live in houses that a very narrow living space. Also in 2019, it was discovered that 8.7 percent of the population had less than 7.2 square meters of living space per capita. The percentage is even higher in the regions. The highest proportion of local populations living in small spaces was found in Papua at 32.5 percent, Jakarta (28.05 percent), West Papua (18.62 percent), and Maluku (16.67 percent).

The extremely limited space for movement makes it difficult to self-isolate at home if a family member tests positive for Covid-19. Instead of isolating at home until they recover, the virus is easily transmitted to other family members.

Household protocols

Seeing the large number of Covid-19 household clusters, it would be best if the health protocols were also implemented at individual households. In addition to other measures, every member of a family must always wear a new mask each time they leave the house. If they are showing symptoms of Covid-19, such as a dry cough or fever, there is nothing wrong with wearing a mask at home.

Another protocol that is no less important is to make a habit of washing hands with soap and water once family members return home. This habit can at least reduce the potential for virus transmission through commonly shared household objects, from eating utensils to toiletries and to light switches.

Also read: Taking Care of Indonesian Children

A number of conditions in the abovementioned profile of Indonesian households present a need for focused attention to curb virus transmission to prevent the emergence of household clusters. In particular, each household should implement the health protocols at home. This can be done through family members reminding each other to wear new and clean masks and to make a habit of washing hands with soap and water, if they have access to such facilities.

Local governments must also raise awareness by encouraging strict adherence to the health protocols at public facilities where people from various families gather. They must also enforce the protocols, starting from obligating everyone to wear masks, to providing hand washing facilities, and to regular disinfection of public facilities.

As long as this pandemic continues, the home should be the refuge of a family. This is also because not all individuals in a single household have the same resistance to this virus, especially elderly parents who fall within the at-risk group. The combined implementation of the health protocols at home and in public can help reduce viral transmission. (KOMPAS R&D)