Indonesia’s new coronavirus epicenter East Java in tough battle to reduce deaths

Indonesian firefighters spray disinfectant as a precautionary measure against the spread of the COVID-19 coronavirus in Surabaya on July 21, 2020. Photo by JUNI KRISWANTO / AFP

JAKARTA — Over just four days, Covid-19 decimated half of Surabaya resident Dea Winnie Pertiwi’s family, killing her parents and eldest sister, who was eight months pregnant.

Their deaths happened as May transitioned into June, just as the coronavirus was tightening its grip on East Java, including its provincial capital Surabaya, home to three million.

Ms Dea said her family members were severely ill by the time they were admitted to hospital in late May, but tests were slow in coming.

After the deaths, Ms Dea, her elder sister, and eldest sister Debby Kusumawardhani’s husband and 18-month-old daughter also tested positive for the disease, but went on to recover.

“It was like a nightmare and I was very shocked,” the infrastructure contractor, 27, told The Straits Times over the phone on Monday (July 20).

“Before Covid-19 hit my family, I didn’t realize how dangerous and deadly it was.”

Her family members had developed symptoms in mid-May, but had dismissed them as being a result of flu and had taken over-the-counter drugs for it.

But the coronavirus was making serious inroads into East Java by then.

As of Tuesday (July 21), 1,461 people in the province had died due to Covid-19, nearly double Jakarta’s 748 deaths, according to official figures. East Java recorded 18,828 infections, overtaking Jakarta’s 17,279. The province has assumed the Indonesian capital’s mantle as the epicenter of the coronavirus pandemic.

The most crucial task for the province is to reduce the number of deaths, said Airlangga University’s Dr Windhu Purnomo, an epidemiologist. As of Tuesday, its case fatality rate (CFR) – the ratio of deaths and confirmed cases – was 7.7 per cent, above the national figure of 4.8 per cent.

“The rise of the CFR is an issue at overloaded hospitals,” he said.

Across the province, Covid-19 has also killed a fair number of health workers, a sign of how the healthcare system has struggled to cope with the pandemic.

Nurse Ari Puspita Sari, who was pregnant, died on May 18 in Surabaya due to the virus.

Dr Anang Eka Kurniawan also died of the disease on June 19 in the city, following the Covid-19 deaths of his younger brother, who was also a doctor, and his parents, who were health workers, on Madura island.

So far, 116 doctors have tested positive for Covid-19, 21 of whom have died, said chairman of East Java’s branch of Indonesian Doctors Association, Dr Sutrisno, who like many Indonesians goes by one name. The disease also infected 354 nurses, 11 of whom have died, he added.

“There were so many patients, especially those without symptoms, (at the hospitals) and they were not easily recognized by the doctors at the initial stage,” he said.

Dr Sutrisno also said that many of the health workers who became sick had served at health community centers, the first point of contact for the sick, where the early warning system and detection of the disease were unavailable.

Dr Joni Wahyuhadi, who leads the curative management team of East Java’s Covid-19 task force, acknowledged that a number of hospitals had been overwhelmed when the number of cases rose sharply last month.

Dr Joni, who is president director at the Surabaya-based Dr Soetomo General Hospital, said that when infections surged in early June, the hospital could see 40 patients with moderate to severe conditions flood its emergency unit clamoring to get a bed on any single day.

He added that while 300 hospitals are ready to take in Covid-19 patients, the problem lay in the distribution of patients.

“While some hospitals are overloaded, others are lacking patients,” he said.

Putting patients with mild to moderate symptoms and those with severe symptoms in different hospitals has helped even the load, Dr Joni said.

Epidemiologists have warned that East Java still faces an uphill battle as new cases continue to rise, and without sufficient testing, the chain of infections cannot easily be broken.

Dr Windhu said that with a 40 million population, the province needs at least 40,000 weekly tests to be in line with the World Health Organization’s testing benchmark.

“Our testing capacity has indeed improved with 4,500 tests per day. But ideally, we need 5,700 daily tests, so we must catch up,” he said.

Another problem is with the speed of test results.

Dr Sutrisno said: “It still takes a week on average to get the results of the test… The quickest is three days.”

Apart from increasing the number of tests, ensuring that the public observe health protocols is also key to lowering infections, he said.

“Resilient villages” have been established across East Java in areas with a high number of cases to ensure people comply with the protocols, such as the wearing of masks and temperature-taking. Surabaya also introduced a similar initiative.

Businessman Chusnan Marzuki, a resident of Bratang Binangun in Baratajaya village, Surabaya, said that the neighborhood of up to 70 households has taken a series of measures, such as adopting a one-gate system, spraying disinfectant in public places regularly and providing free hand sanitizer, to prevent the spread of the virus.

“The situation in our neighborhood is under control. There has been no one testing positive (for the virus) so far,” he said.

Said Ms Dea: “I hope people obey the health protocols. I hope they won’t believe the Covid-19 is as dangerous as it is only when they contract it themselves or when they lose their family.”