Indonesia is now the epicenter of Asia’s Covid-19 crisis. Here’s what you need to know

By Rhea Mogul, CNN

For much of last year, it seemed like Indonesia had managed to keep its Covid-19 outbreak largely under control.

Now, the island nation — home to about 270 million people — has become Asia’s new epicenter of the pandemic, reporting more daily cases and deaths than hard-hit India as a devastating second wave rips through the archipelago.

With tens of thousands of infections being recorded daily, experts say the country’s health care system could be pushed to the brink of disaster if the spread of the virus continues unabated.

Here’s what you need to know about the crisis in Indonesia.

How did Covid-19 cases and deaths surge in Indonesia?

Infections started rising toward the end of May, following the Eid Al-Fitr holidays to mark the end of the Islamic fasting month — and soon grew exponentially.

According to health experts, the crisis is being fueled by the spread of the more infectious Delta variant, first identified in India.

“Every day we are seeing this Delta variant driving Indonesia closer to the edge of a Covid-19 catastrophe,” Jan Gelfand, head of the Indonesian delegation of the International Federation of Red Cross and Red Crescent Societies (IFRC), said in late June.

Experts have blamed the government for its slow response in not implementing strict lockdowns last year after cases were first reported in the country, and its alleged failure to invest in efficient testing and tracing systems.

As of July 20, Indonesia had recorded nearly 3 million total cases and more than 76,000 deaths, according to data from Johns Hopkins University. But experts fear the figures underestimate the real spread in the country due to a lack of testing.

A World Health Organization (WHO) report in July said inadequate testing continues to be a problem, with more than 50% of provinces reporting a testing rate below the recommended benchmark.

“Without appropriate testing, many provinces are unable to isolate confirmed cases on time,” the report said.

Indonesia’s Health Minister Budi Gunadi Sadikin told CNN in early July that authorities at first did not realize how quickly the virus had been spreading during this latest wave.

The islands of Java and Bali were placed under emergency lockdown on July 3 along with other cities across the archipelago. Domestic travel is not restricted, though it is dependent on a negative Covid-19 test.

On July 20, Indonesia extended Covid-19 restrictions to July 25.

Which areas of Indonesia are affected?

Indonesia’s most populous islands, Java and Sumatra, have seen cases skyrocket during the second wave.

In Kudus, central Java, cases jumped nearly 7,600% in the four weeks following Eid Al-Fitr, Reuters reported on June 11, citing Wiku Adisasmito of Indonesia’s Covid-19 task force.

Hospitals across Java are being pushed to the brink and the country’s oxygen supply is running dangerously low, while prices of oxygen have surged. More than 60 people died in a single facility in early July after a hospital on Java nearly exhausted its oxygen supply, though a hospital spokesman could not confirm if all the dead had contracted Covid-19.

In Jakarta, nearly half of the capital’s 10.6 million residents may have contracted Covid-19, according to a health survey published July 10. Out of 5,000 people tested between March 15-31, 44.5% had antibodies, indicating they had been infected with the virus.

In Riau province, Sumatra, daily cases more than doubled from early April to over 800 by mid-May, while the positivity rate was at 35.8% in early June, according to Wildan Asfan Hasibuan, an epidemiologist and provincial task force adviser.

And according to WHO, there has been an increasing trend in Covid-19 cases in most provinces in Sumatra since April.

Who is affected by Indonesia’s second wave?

The second wave has affected every age group, according to experts. However, the number of children dying from the virus in Indonesia has quadrupled in recent weeks, according to the country’s pediatric society.

More than 550 children have died since the start of the pandemic — about 27% of whom died in the first few weeks of July.

Parents often think mistake the symptoms for a common cold and don’t get children tested, according to Aman B. Pulungan, president of the Indonesian Society of Paediatrics.

“When they realize this is Covid-19, the condition is already bad,” Aman said. “When they take the children to the hospital, sometimes we do not have enough time to save the children. This is happening a lot.”

Frontline workers have also been affected by the surge. In early July, more than 350 doctors and medical workers in Java caught Covid-19 despite being vaccinated with Chinese-made Sinovac. Most of the workers were asymptomatic and self-isolating at home, but dozens were hospitalized with high fevers and falling oxygen-saturation levels.

What’s Indonesia’s vaccine rollout like?

Indonesia has mostly relied on Sinovac in its national vaccination program, which began in January, with health care workers receiving the first batch, followed by public servants and the general public.

The rollout had a sluggish start, amid concerns raised about Sinovac’s efficacy against more infectious variants — and authorities are struggling to get enough people inoculated.

Indonesian President Joko Widodo said July 14 that vaccines are the country’s “hope to recover from this global health crisis.” But as of July 20, Indonesia had fully vaccinated just 6% of its population, according to CNN’s Covid-19 vaccine tracker.

In Jakarta, more than 2 million people — about 23% of the capital’s population — have received both doses, according to government data.

Indonesia has received more than 11.7 million AstraZeneca shots through COVAX, according to Gavi, which coordinates the global vaccine sharing program. The country has also received more than 4.5 million does of Moderna’s Covid-19 vaccine, donated by the United States.

Indonesian health minister Budi said in a news briefing July 11 that all health workers would receive a third shot of Moderna’s mRNA vaccine as a priority, adding it will also be used as a first and second shot for the unvaccinated public.

On June 28, the government opened the Sinovac inoculation drive to children ages 12 to 17, with Widodo urging the expanded rollout to “kick off immediately.”

What role does misinformation play?

One major obstacle to controlling the outbreak is the spread of misinformation across the country.

According to a UNICEF report in May, false claims on social media have resulted in fear and anxiety among some people, leading to vaccine hesitancy and lax social distancing efforts.

A nationwide survey conducted last year by the Communications and Information Ministry and Katadata Insight Center also found 64-79% of respondents could not recognize misinformation online. An overwhelming majority said they primarily seek information through social media.

“Since Covid-19 is a new disease, even the experts are still learning about it,” said Rizky Syafitri, UNICEF communication specialist. “As a result, many people have struggled to find the most up to date information, giving some individuals the opportunity to benefit by making false claims.”

Are other countries helping Indonesia?

In addition to the US, several countries have donated vaccines and medical supplies to ease Indonesia’s Covid crisis.

On July 1, Japan sent almost 1 million doses of the AstraZeneca vaccine.

On July 7, Australia said it would send a health package to help Indonesia, which includes $8.8 million for medical equipment, including 1,000 ventilators, up to 700 oxygen concentrators, and more than 170 oxygen cylinders.

Canberra also sent more than 40,000 rapid-antigen test kits and 2.5 million AstraZeneca vaccine doses.

“Australia stands with our close partner and neighbour Indonesia as it responds to a significant surge in Covid-19 cases,” a statement from Marise Payne, the country’s Minister of Foreign Affairs said.

In a statement July 20, Singapore’s Ministry of Foreign Affairs said it had arranged for regular shipments of emergency oxygen supplies to Indonesia.

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CNN’s Amy Sood contributed reporting.