Alarming Signals in Primary Health Services

Kompas/Priyombodo

Officers spray disinfectant at the Pondok Betung Health Center, Pondok Aren, South Tangerang, Banten, which is used as a transit point for Covid-19 patients, Saturday (23/1/2021). The government has extended the implementation period of restrictions on community activities (PPKM) in Java and Bali for the next 14 days from January 26 to February 8, 2021. This extension was carried out due to the high cases of Covid-19 transmission.

JAKARTA, KOMPAS — One hundred twenty-six medical workers of community health centers (Puskesmas) have died of Covid-19. The rising death toll in primary healthcare services marks an increasingly wide and deep spread of Covid-19 in the community.

Data from Pusara Digital ReportCovid19 show that the total number of health workers in Indonesia who have died has reached 652 people as of Sunday (24/1/2021). That number includes 277 doctors, 210 nurses, 87 midwives, 15 medical laboratory personnel and other health professionals. This data was obtained from people’s reports and data from a number of professional organizations, such as the Indonesian Doctors Association (IDI), the Indonesian Midwives Association (IBI) and the Indonesian National Nurses Association (PPNI).

Also read: Pay Attention to Safety of Health Workers

East Java is the region with the highest number of health workers who died of Covid-19, namely 195 people, followed by Central Java with 94, Jakarta 83, West Java 67, North Sumatra 40, South Sulawesi 29 and the rest from other provinces. The provinces of North Kalimantan, Gorontalo, West Sulawesi and North Maluku and not reported health worker deaths.

Fifty-nine of the health workers killed by Covid-19 were 51-55 years of age, while 54 were 46-50 years old.

Also read: Health Workers Prioritized

First service

The death toll among healthcare workers spiked in December 2020 with 126 people. In January, 103 health workers have died so far, or 4.2 people per day. In previous months, an average 1-2 healthcare workers died every day.

Kompas/Priyombodo

Medical officers inject the Covid-19 vaccine produced by Sinovac Biotech, China into medical personnel at the Pondok Betung Community Health Center, Pondok Aren, South Tangerang, Banten, Saturday (23/1/2021).

Data also show that more and more healthcare workers in primary services, namely community health centers (Puskesmas) and private clinics, have died of Covid-19. In total, more than 186 deaths were from health workers in primary services.

One hundred twenty-six of the deceased health workers had worked at Puskesmas, 31 at clinics and 29 at their own clinics. Meanwhile, the number of deceased healthcare workers of hospitals was 296 people.

Also read: Committed to Sacred Mission Despite Rejection

Consistent with the total data on the health worker deaths, East Java has also recorded the highest death toll at primary healthcare services, followed by Central Java, West Java and Jakarta. Some of the healthcare workers at primary services who died were from small cities.

The high [death toll] among health workers at primary services epidemiologically shows that transmission in the community is expanding.

Outside Java, the death of primary health workers is significant in North Sumatra. Other areas that saw the death toll of health workers at primary service facilities exceed that of non-primary services are Aceh, Central Kalimantan, West Sumatra and Bengkulu.

"The high [death toll] among health workers at primary services epidemiologically shows that transmission in the community is expanding," said Dicky Budiman, an Indonesian epidemiologist at Griffith University in Australia.

KOMPAS/RHAMA PURNA JATI

A health worker at Puskesmas 5 Ilir Palembang underwent a temperature check before being vaccinated, Wednesday (20/1/2021). Due to registration problems, many health workers have to postpone vaccination. This resulted in not achieving the vaccination target in Palembang.

Disrupting vaccinations

The transmission among primary healthcare service workers can be attributed to direct contact with people exposed to Covid-19 who may or may not display any symptoms but have not been diagnosed as positive. "When it expands to Puskesmas in rural areas, it will be more difficult for us to control the rate of illness and death. This could disrupt the vaccination program, which is expected to use the Puskesmas network," he said.

Covid-19 vaccination continues in various regions, but the coverage is low so far. For instance, only 27 percent of healthcare workers in the city of Batam, Riau Islands, have received their first shot. According to the head of the Batam Health Office, Didi Kusmarjadi, only 1,592 of 5,900 health workers were inoculated as of Friday (22/1), because many health workers had not yet registered through BPJS Kesehatan’s P-Care app.

Also read: Overcoming Vaccination Data Issues

In Magelang regency of Central Java, 2,794 healthcare workers are the first target group for vaccination. According to the head of the surveillance and immunization section of the Magelang Health Office, Dwi Susetyo, the health condition of each person must be checked before the vaccine is administered.

According to the Covid-19 task force, the number of Covid-19 cases in Indonesia increased by 11,788 people on Sunday (24/1), bringing the total to 989,262 cases with 162,617 active cases. With this data, the ratio of positive tests in Indonesia is 33.2 percent, meaning that one in three people tested is positive. That ratio is very high compared to the World Health Organization\'s maximum threshold of 5 percent.

Also read: Restrictions Still Fail to Overcome

The four areas with the highest daily addition of cases are in Java, namely Jakarta with 3,512 cases, followed by West Java with 2,328 cases, Central Java healthwith 1,515 cases and East Java with 901 cases. Outside Java, the highest addition of cases was seen in East Kalimantan, namely 432 cases.

A pulmonary specialist at the Dr. Abdul Rivai Regional General Hospital in Berau regency, East Kalimantan, said daily new cases in the region had continued to increase since the turn of the year.

This article was translated by Kurniawan H. Siswoko.