Report in August 2021

handy Koesoemo Wardhana, Muhammad Thohawi Elziyad Purnama, Adiana Mutamsari Witaningrum
Airlangga University, Surabaya, Indonesia

Indonesia is one of the new epicentres of Covid-19 cases in Southeast Asia. After passing the 1st wave in January-February 2021, the latest facts revealed that Indonesia got 2nd wave in July 2021. Based on data from the Indonesia Covid-19 Task Force Team as of August 26, 2021, there were 4,043,736 confirmed cases, 243,588 (6%) active cases, 130,182 (3.2%) death cases and 3,669,966 (90.8%) cases recovered. In particular, on August 26, 2021, the increase in cases was recorded at 16,899 daily cases, 30,099 recovered and 889 cases died. It was even recorded that on July 15th, 2021, it reached the highest daily cases of 56,757 confirmed cases. Bed Occupancy Rate (BOR) facilities in hospitals has been recorded to exceed 90% and sometimes even overcapacity but currently it has decrease to 30%.

The delta variant has been shown to cause sporadic morbidity rate but spread rapidly on the Java and Bali islands. What's more, the lax community participation in implementing health protocols and the low level of vaccination at that time led to that situation. The high mobility is also a big trigger factor, especially in May-June 2021, which had religious holidays. The government's countermeasure against the emergence of 2nd wave is to apply a partial lockdown or Pemberlakuan Pembatasan Kegiatan Masyarakat (PPKM) (in Bahasa) which has been implemented since July 3, 2021, and then continued to be evaluated every week, and until now continues to be extended until August 30, 2021. PPKM policy separate essential and non-essential sectors.

The reaction of the ordinary citizen to the lockdown was that many people protested because they feel that their mobility and work will be limited, but there is no frenzy buying, because essential sector stores are still open and the supplies of household goods are still safe. People only buy more of a few products that are considered to increase immunity, such as sterile milk.

The essential sectors that are permitted to operate only until 8:00 pm includes health services, logistics, distribution of goods, basic needs, finance and energy resources. Meanwhile, non-essential, non-critical sectors and shopping centre are temporarily not operating. In this case, the number of human resources in the essential and non-essential sectors are required to work from home and only 25% of the workers were allowed to work from the office. Restrictions placed on restaurants includes only allowing to serve customers a maximum of 20 minutes in a room with alternate social distancing. Strict supervision is carried out by the Covid-19 task force at the regional level to regulate health protocols and community participation. Violators of the PPKM will be fined with imprisonment for a maximum of 1 year and/or a fine of a maximum of Rp. 100 million.

The government's policy of assistance to overcome Covid-19 and national economic recovery continues to be carried out by allocating a budget with details for the Health sector of Rp. 172.84 trillion, Social Protection of Rp. 148.27 trillion, priority programs and education of Rp. 127.85 trillion, UMKM (Usaha Mikro Kecil dan Menengah)(in Bahasa) and Corporate Support Rp 193.74 trillion, and business incentives Rp 56.73 trillion. The Test and Tracing program is also carried out as a condition of travel and attendance at the office. The use of rapid antigen test is the first choice to fulfil the test program. PCR is the second option if the results are positive on the rapid test and as a valid reference for the tracing program. Currently, the cost of PCR in Indonesia is a maximum of IDR 500,000. Since it is relatively expensive, many people chose the rapid antigen test option.

Currently, the government continues to aggressively implement a vaccination program to pursue herd immunity. Sinovac, Astrazeneca, Moderna, and Pfizer vaccines are routinely imported in large doses to meet the dose distribution in the community. Vaccinations are provided free of charge to increase public participation and willingness to receive vaccines. Currently, out of 208,265,720 total target people, as many as 59,381,203 (28.51%) have received vaccine 1st dose and 33,344,151 (16.01%) received vaccine 2nd dose. Health workers and public officials, numbering 1,468,764 and 17,327,167, respectively, received priority for the vaccination. This is followed by geriatrics and the general public which respectively includes 21,553,118 and 141,211,181 recipients. Even though they have received up to 2nd dose of the vaccine, all recipients are still required to wear masks and comply with health protocols during outdoor activities.

Traditional medicine being used against the Covid-19 includes Lianhua Qingwen Capsules from China without Ephedra for decreasing the symptoms and jamu or empon-empon, traditional drink or ingredients from Indonesia to increase the immunity. Lianhua Qingwen Capsules from China without Ephedra composition is approved by BPOM (Indonesia FDA) but it is different with Lianhua Qingwen Capsules with Ephedra composition, which doesn’t have the same permit.

Based on our friends and family experience, the drugs which are approved and given are Actemra, Azithromycin, Favipiravir, Remdesivir, Isprinol and the hospital always use Covalent plasma therapy for covid 19 patients.

The use of Ivermectin is still being debated because the government (minister) agrees to produce and distribute Ivermectin for Covid 19 therapy to the hospital but BPOM (Indonesia FDA) did not issue the permit for its use. However, in the hospital, some doctors recommended the use of Ivermectin for therapy.

The Covid-19 pandemic still seems to have a big impact on the education sector. All lecture activities are carried out online and for practical it can be done in a hybrid manner by requiring lecturers to demonstrate directly from the laboratory while students follow through live streaming videos. Some practical media have switched to using virtual reality and special software to demonstrate in silico. The decrease in the number of students was also seen because of the economic downturn, resulting in so many of them being unable to continue their education.

The good effects that resulted from this pandemic is that some new technologies and innovations were created to solve this covid 19 pandemic, we can gather with family at home, the quality of air will improve due to less pollutant, we can do all jobs from home and we are aware about our health. The bad effects are that many meetings can’t be scheduled well, we can join 2-3 meeting in same time, excessive watching of the laptop screen can impair our vision and strain our eyes, produce fatigue and is bad for our health. At the workplace, students can’t study and do practical well because they are different with offline class. Full knowledge cannot be maximally transferred the students. Many citizens lost their jobs because of the pandemic and it will affect the economy of our country

Universitas Airlangga makes some inventions like RAISA robot for hospitals to service covid 19 patients (in collaboration with ITS), Rapid Diagnostics Test IgG/IgM COVID-19 (in collaboration with UGM and PT. Hepatika Mataram) and covid 19 vaccines. The head researcher of the vaccine is Prof. Fedik Abdul Rantam and the name is Merah Putih vaccines (in collaboration with PT. Biotis Pharmaceutical). Hopefully this inactivated vaccine will be ready in 2022.