The Economist - USA (2021-07-17)

36 Asia TheEconomistJuly17th 2021

ThepandemicinSouth-EastAsia

The next covid catastrophe

T

riwahyonowastryingtokeepitto­

gether. It was rush hour on a weeknight

in late June in Yogyakarta, a city on the In­

donesian  island  of  Java,  but  the  streets

were almost empty. It had been like that for

a couple of weeks, since the number of co­

vid­19 cases in the city had begun to spike.

Mr Tri was speeding through the streets on

his motorbike, searching for a hospital that

would admit his 63­year­old mother, gasp­

ing for air in the makeshift ambulance be­

hind  him.  The  first  one  was  full.  The  sec­

ond  one  had  run  out  of  oxygen.  As  they

pulled up in front of the emergency ward of

yet  another  hospital,  four  medics  in  pro­

tective  gear  rushed  out  to  meet  them.  Mr

Tri hoped for a “miracle”, but by then it was

too  late.  He  chokes  back  tears  remember­

ing how his fear of catching the virus pre­

vented him from holding his mother in her

last moments. 

South­East  Asia  is  swimming  in  co­

vid­19. For much of the past year, it had far

fewer cases than Europe and North Ameri­

ca.  But  low  rates  of  vaccination,  limited

testing and the arrival of new, more trans­

missible variants mean the disease is surg­

ing  through  the  region.  Cambodia,  Myan­

mar, Thailand and Vietnam are posting re­

cord  numbers  of  new  cases  each  day.  Ma­

laysia  has  the  highest  caseload  in  the

region relative to population. 

But  in  absolute  terms,  Indonesia  has

the  most  new  cases  in  Asia.  It  surpassed

other  hotspots  like  India  and,  for  a  time,

even  Brazil.  The  daily  number  of  new  in­

fections has grown by a factor of ten in the

past month, exceeding 54,000 on July 14th.

And because testing is patchy, the virus is

likely  to  be  much  more  widespread  than

these  figures  suggest.  The  proportion  of

tests that come back positive—a whopping

26%—suggests that the disease is running

rampant. 

Indonesia’s  health­care  system  is

drowning.  Over  the  past  five  weeks,  the

number of hospital patients has more than

trebled  to  around  81,000.  Nearly  three­

quarters  of  hospital  beds  are  now  occu­

pied, according to the Indonesian Hospital

Association.  On  the  island  of  Java,  where

most  Indonesians  live  and  most  cases  are

found, only a few hospitals are still admit­

ting patients. On July 5th the health minis­

ter  said:  “Hospitals  are  full.”  Oxygen  sup­

plies  are  running  dangerously  low.  Be­

cause  of  the  shortage  of  medical  supplies

and  equipment,  doctors  report  being

forced  to  choose  which  patients  will  live

and which will die. 

On  July  5th  the  health  minister  urged

those with mild symptoms to refrain from

going  to  hospital.  Many  Indonesians  are

taking his advice. Some who stay at home

are  dying.  LaporCovid­19,  an  ngowhich

collects data on the pandemic, has record­

ed 451 instances of infected people perish­

ing  while  self­isolating  or  looking  for  a

hospital.  The  true  number  is  likely  to  be

much higher. There has been a steep rise in

deaths  since  June,  says  the  un’s  World

Health Organisation. 

The  rapid  spike  in  cases  and  the  “col­

lapse” of the health­care system, as Pandu

Riono, an epidemiologist at the University

of Indonesia, puts it, have invited compari­

sonstoIndia,anotherbigcountrywitha

weakhealthsystem.ButIndonesiaiseven

morepoorlyequippedtodealwithsucha

crisis.It hasjust four doctorsforevery

10,000people—lessthanhalfIndia’sratio.

Deathsfromcovid­19relativeto popula­

tionarehighernowinIndonesiathanthey

wereinIndiaattheheightoftheoutbreak

there,atleastaccordingtotheofficialdata.

Severalfactorshaveexacerbatedthelat­

estoutbreak.Thegovernmentneverim­

poseda fulllockdown,forfearofparalys­

ingtheeconomyandimpoverishingthe

country’s millions of informal workers,

whocannottoilfromhome.Therestric­

tionsthatitdidimposewerepoorlyen­

forced.DuringEid,a recentMuslimholi­

day,1.5mpeopleintentoncelebratingin

theirhomevillagesflouteda travelban—

anexampleof“herdstupidity”,asDrPandu

putsit.Thetravellersbroughttheperni­

ciousDeltavariantwiththemfromthecit­

iestothecountryside.Itnowaccountsfor

some90%ofcasesinthecountry.

Most Indonesians are not protected

againstthevirus.Just7%havebeendou­

ble­jabbed. The elderly are particularly

vulnerable.Thegovernment,whichatfirst

prioritised  vaccination  for  those  of  work­

ing  age,  did  not  begin  jabbing  the  elderly

for over a month after shots became avail­

able  in  mid­January.  This  was  a  mistake,

says  Dicky  Budiman  of  Griffith  University

in Australia.

Making matters worse is the shortage of

health  workers.  Although  97%  of  them

have been fully vaccinated, the vast major­

ity have received the shot from Sinovac, a

Chinese  firm,  which  is  less  effective  than

other  vaccines.  The  Indonesian  Hospital

Association  surveyed  big  state­run  hospi­

tals across Java’s main cities and found that

10%  of  their  staff  had  tested  positive.  La­

porCovid­19  found  that  131  vaccinated

health­care  workers  had  died  since  June,

50 of them in the first week of July. 

The  government  has  sprung  into  ac­

tion.  It  is  trying  to  accelerate  vaccination.

In early June it expanded eligibility for jabs

to  anyone  over  the  age  of  18.  In  July  it  an­

nounced  new  rules  to  slow  the  disease’s

advance. Houses of worship, malls and res­

taurants  on  Java  and  Bali,  another  island,

have  closed  their  doors  until  July  20th.

Non­essential  workers  on  those  islands

must  work  from  home.  Big  roads  in  some

cities  have  been  blocked  off.  On  July  10th,

in  a  sign  of  its  growing  concern,  the  gov­

ernment  announced  that  these  restric­

tions would also be imposed in 15 provin­

cial  capitals  outside  Java  and  Bali.  It  may

extend the curbs by six weeks. 

For Dr Pandu, the government’s efforts

are too little, too late. He thinks measures

to  suppress  the  virus  should  be  much

stricter. The governmentsays it will think

about further restrictions.That will be lit­

tle comfort to Mr Tri. n

S INGAPORE

A wave of the virus is engulfing Indonesia

Asian hotspots

Daily new confirmed cases of covid-19

Seven-day moving average, 2021, ’000

Source: Johns Hopkins University CSSE

40

30

20

10

0

Jan Feb Mar Apr May JulJun

Thailand

Indonesia

Malaysia

An ever more common sight