COVID-19 in Indonesia is Underreported and Under-Addressed

25 March 2020 Jarryd de Haan, Research Analyst, Indo-Pacific Research Programme

Background

After confirming its first case of COVID-19 on 2 March, more than a month later than Singapore and Malaysia, the Indonesian Government has begun ramping up efforts to slow the spread of the virus. Its initial response had been described as ‘worryingly blasé’, but in the past week there seems to have been an upsurge in preventive and protective measures at a regional level. At the time of writing, there have been 686 confirmed cases of COVID-19 with a mortality rate of eight per cent.

Comment

The reported mortality rate, which is one of the highest in the world, suggests that there are many cases that have gone undetected. If anything, the mortality rate of COVID-19 should be lower than average, given the significantly lower median age of Indonesia’s population compared to Italy and China. The primary reason for the low rate of detection is the lack of testing. As of 20 March, tests for COVID-19 in Indonesia sit at a rate of 7.4 tests per million people, whereas in Malaysia the rate is 422.2 tests per million people and in Australia 4,473.4 tests per million people.

Simply put, Indonesia’s health care system does not have the capacity to adequately test for the virus given the large population it is dealing with. Adjusting for a more realistic mortality rate, a closer estimate of COVID-19 cases in Indonesia is between 1,800 and 5,500, assuming a mortality rate of one to three per cent. That said, poorer access to and quality of health care may also be responsible for a higher than usual mortality rate.

Perhaps the biggest challenge facing the Indonesian Government now is implementing social distancing policies to slow the spread of the virus. Despite calls from the World Health Organisation for the Indonesian Government to implement nationwide regulations under the banner of a national state of emergency, Indonesian President Joko “Jokowi” Widodo has so far left those measures up to regional heads. Jokowi’s justification for that course of action, is that: ‘As a large country and an archipelago, the spread of COVID-19 varies from region to region’.

While that may be true, regional governments do not have the necessary powers to apply partial or total lockdowns, so their options are limited. Moreover, as the virus spreads outside of Java, many regional heads and governments do not have the capacity, or even the competence, to deal with the pandemic. Leaving social distancing measures to regional governments has the added consequence of causing confusion among the public. Consequently, there is a tendency for many to not take social distancing seriously, whether that be because of personal financial reasons or a lack of understanding of the issue.

An additional challenge to Indonesia is dealing with those attending mosques who ignore social distancing advice. Enforcing any such restrictions on mosques or religious gatherings is likely to anger the more zealous members of the religious community. That could amount to political suicide for regional heads, or even the central government. Enforcing such restrictions in the next two months will be vital, however, if the Indonesian Government is to have any hope of addressing the problem at the upcoming Idul Fitri festivities on 23 May. During Idul Fitri, many Indonesians typically travel across the archipelago to gather with their families. If that were to take place without restriction, cases of COVID-19 could be expected to surge in the weeks following the holiday.

Any opinions or views expressed in this paper are those of the individual author, unless stated to be those of Future Directions International.

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