Indonesia is battling a devastating Covid-19 crisis. And its peak is likely still to come

By Masrur Jamaluddin, Atika Shubert and Julia Hollingsworth, CNN

The last time Aris Suharyanto saw his wife was through a hospital window. He never got to meet their newborn baby.

When Suharyanto’s pregnant wife Rina Ismawati and two of their three children fell ill last month, he initially thought it was a common cold. But with Covid-19 cases rising in Indonesia, he took them to get tested.

The whole family tested positive for Covid-19, including Suharyanto — and 43-year-old Ismawati was admitted to hospital, where she lay in bed, occasionally sending Suharyanto messages through WhatsApp. “She told me that her condition was getting worse,” Suharyanto said. “She couldn’t breathe.”

Fearing for her baby, the doctors performed a Cesarian. But when Riski Aulia was born last month, he tested positive for Covid-19 and was struggling to breathe, too. His wife asked him to take her home, away from the intensive care unit where so many other patients had died, but her condition was too bad for her to be moved.

On June 22, Riski died in hospital. Suharyanto had only ever seen him in a photo. The following day, Ismawati died, too.

Suharyanto’s wife and child are just two of the devastating and growing Covid-19 toll in Indonesia, the world’s fourth-most populous country, which is fast becoming the new center of Asia’s coronavirus crisis.

For weeks, Indonesia, home to about 270 million people, has been reporting thousands of daily cases and hundreds deaths as the highly contagious Delta variant ravages the country. Social media is flooded with posts from users who have lost loved ones to the virus. Hospitals are running dangerously low on supplies, excavators are frantically digging burial plots, and isolating remains impossible for the millions like Suharyanto living on a daily wage. The country is also facing the added challenge of widespread, rampant misinformation, and a vaccination rate of less than 6%.

With more than 2.7 million people infected and more than 70,000 dead, onlookers caution the country may not have reached its peak.

How did this happen

For much of last year, Indonesia managed to keep its Covid-19 outbreak largely under control. Then, as cases rose in June, overwhelming hospitals, the International Federation of Red Cross and Red Crescent Societies warned Indonesia was “on the edge of a Covid-19 catastrophe.“

The country had seen a “dramatic increase in confirmed cases” after the festive holidays, Indonesia’s Health Minister, Budi Gunadi Sadikin, said earlier this month. He put the explosion in cases down to the fast-spreading Delta variant, which was first identified in India and has since spread to almost 100 countries.

Indonesia entered a lockdown on July 10, by which point the country was reporting more than 30,000 new cases each day. The government said it is “mobilizing all resources” to deal with the Covid-19 surge, including bringing in oxygen from other countries to increase the supply.

But experts say Indonesia is now bearing the cost of not locking down early enough.

And the current numbers likely don’t capture the whole picture. More than 27% of tests come back positive, according to Johns Hopkins University figures, giving Indonesia one of the highest test positivity rates in the world. The numbers suggest that many cases still aren’t being caught.

A survey published last Saturday showed nearly half of Jakarta’s residents may have contracted Covid-19 — more than 12 times the number of cases officially recorded in the Indonesian capital at the time when the research was carried out.

“Without appropriate testing, many provinces are unable to isolate confirmed cases on time,” the World Health Organization said in its most recent situation report.

Just a common cold

Another major barrier to controlling Indonesia’s outbreak is the flood of misinformation.

For months, WhatsApp messages have spread fake news about ineffective Covid-19 treatments. Hoaxes about the vaccines have circulated on social media, making some people unwilling to take the shot for fear it could cause serious disease or death. And because of misinformation, many people in Indonesia still aren’t taking Covid-19 seriously, even as cases rise around them.

Amid all the noise, warnings about the severity of Covid-19 are being lost.

A few weeks ago, Karunia Sekar Kinanti, 32, noticed her two-month-old son Zhafran had a fever, but she assumed it was just a common cold.

Her mother had a flu and cough, but Kinanti didn’t think it was Covid because her mother still had a sense of smell. “Her symptoms didn’t seem to be Covid-19, so I was calm about responding to it,” she said. “Then Zhafran, me, and my other child got sick, too.”

Two weeks ago, as he became weaker and his breathing became more labored, she brought Zhafran to hospital, where scans showed Covid-19 had already damaged his right lung.

She remembers the doctor telling her to prepare for the worst. “You can be optimistic, but it all depends on God,” she remembers him saying.

On July 5, Kinanti’s mother died. Kinanti still doesn’t know whether her mother had Covid because she wasn’t tested. Kinanti didn’t go to her funeral — she was in hospital with her young son.

Aman B. Pulungan, the president of the Indonesian Pediatric Society, said it’s common for parents to assume their child doesn’t have Covid-19, in part because many people in Indonesia are unaware children can be infected.

Families do little to protect children from the virus, and even when they are infected, parents often think it’s a common cold. Schools were closed last year, and have been closed again as part of this latest lockdown, but Indonesian children are currently on summer holidays.

“We don’t protect our children. This is the problem,” he said.

The broader problem is continuing skepticism over Covid-19, according to an article published last month by Yatun Sastramidjaja, an associate fellow with the Regional Social and Cultural Studies Programme at the Yusof Ishak Institute in Singapore, and Amirul Adli Rosli, a research officer at the same institute.

“A more extreme type of commentary has been making its rounds on social media, questioning the legitimacy of the government’s pandemic response altogether, and even dismissing any official information about Covid-19,” they wrote.

Overwhelmed resources

When Kinanti and her baby Zhafran arrived at the hospital, all the intensive care unit beds were already full.

A front desk officer took pity on Zhafran and helped them get a room, and the next day, they were moved to an isolation room with other children infected with Covid-19. Zhafran was the youngest of them all, she said.

When Kinanti talked to CNN earlier this month, she said there were nine children in the hospital room with them, and many more were waiting for beds.

Indonesia’s crisis is now playing out in a similar way as India’s second wave, with a shortage of oxygen tanks and patients traipsing from hospital to hospital trying to find help. Sudirman Said, the secretary general of Indonesian Red Cross, said patients were traveling for hours to access vital medical care.

“Sick patients are just waiting for new deaths so they can even have a chance of making it inside a hospital,” Project HOPE’s Executive Director for Indonesia, Edhie Rahmat, said in a statement earlier this month, adding that many hospitals have built tents to care for patients outside the buildings. “The peak for the second Covid-19 wave in Indonesia has not been reached yet.”

The outbreak and the shortage of hospital beds makes those with underlying conditions even more vulnerable. According to Pulungan, from the Indonesian Pediatric Society, many children dying of Covid-19 have underlying health conditions.

That was the case for Tantien Hermawati’s baby Baswara Catra Wijaya, who was born with heart disease.

She believes he may have been infected with Covid-19 when he was in hospital in November last year having surgery for his condition. After he caught Covid-19, she could barely look at her baby’s face — it was obvious he was in pain.

He died on December 11, 2020, before he had even reached four months old. Hermawati believes she was lucky — at least she was able to attend his funeral.

She advises other parents to be more careful and cautious than she was, and stay at home to avoid exposing children to Covid.

“It’s really sad if our children get infected — our babies can’t tell us which part of their body are hurt, and we also don’t know it. So please just stay at home and obey the health protocol.”

The future

Indonesia’s main hope in addressing the spiraling crisis are vaccines, the country’s President Joko Widodo said Wednesday.

“Fair and equal access to vaccines must be guaranteed since we see there is still a wide gap in vaccine access throughout the country,” he said, according to Antara News.

Earlier this month, the White House announced it would send 3 million doses of Moderna vaccine to support Indonesia against the surge. On Tuesday more than 3 million doses of AstraZeneca’s Covid-19 vaccine arrived in Indonesia through the global COVAX program, the eighth such shipment to arrive in the country. Indonesia has received more than 14 million vaccines through the program, according to state media.

But for the millions already affected by Covid, those vaccines will come too late.

For Kinanti and her baby Zhafran, the situation is looking up. His doctor is more optimistic about his survival, but warns that Zhafran might always have diminished lung capacity.

She says she underestimated Covid, and thought it was impossible that it could affect her child: “I was late when I reached the hospital, and I really regret it.”

Suharyanto, the father of three, lives with the guilt of not knowing if he brought Covid-19 into their home. He works as a motorcycle taxi driver in Semarang City, in central Java province; he was always coming and going — but his wife stayed at home.

“The children are already carrying on as normal.  But me, I still cry on my own. I regret things but I just never imagined that this could happen,” he said. “I still can’t believe that she was gone that fast.”

Suharyanto wants people to understand that Covid is not fake news or a conspiracy — to him, it is painfully real.

“They’ve never had their family die from Covid,” he said.

The-CNN-Wire
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