United Nations Secretary-General Antonio Gutierrez has declared the COVID-19 pandemic “the biggest threat to humanity since World War II” as the global total of COVID-19 cases approaches 2.3 million with more than 160,000 deaths.
Though Europe is now the epicenter of the pandemic, many countries in Asia continue to face major challenges. While China and Singapore, for example, have progressed in containment efforts, they are now concerned with a potential “second wave” linked to imported cases and an increase of local transmission. However, other countries including Indonesia, Malaysia and the Philippines are bracing for the worst of the pandemic. Indonesia now has over 6,000 cases with more than 500 deaths, the highest number of deaths in Southeast Asia. A projection by Bappenas suggests that the virus might cause hundreds of thousands of deaths.
What steps can Indonesia take to mitigate the situation and contain the growing pandemic? What can Indonesia learn from the experiences of other countries?
Other countries have shown that the highest priority should be given to efforts to delay the spread of the virus. The goal of “flattening the curve” is to spread cases out over a longer period of time to avoid a sudden, exponential surge in the number of cases. The strategy also gives the healthcare system time to prepare for a more robust and effective response, and not be overwhelmed as has happened in Italy and Iran. Underlying the goal to delay the spread are probably several key strategies, which are outlined below.
First, rapid, accurate and extensive testing of suspected cases is the first critical step in the confirmation of cases, isolation and quarantine and, most importantly, exhaustive contact tracing to confine cases to well-identified and closely monitored clusters. Testing has gained further importance with recent evidence emerging that asymptomatic individuals can spread the virus.
There is also an urgent need for more rapid diagnostic tests together with the standard nucleic-acid-based tests. The dual approach could result in more accurate data while the workings and accuracy of these tests should be made known to the public to avoid confusion and anxiety.
The highest priority should also be protecting frontline healthcare workers and providing care for severe cases to keep mortality low. The emphasis here is on speed of reaction – where there was a delay in the aforementioned measures, the situation can deteriorate rapidly as was seen in Europe, the United Kingdom and the United States. Arguably, in China mass surveillance of cases and contacts through big data analytics and artificial intelligence contributed to its success in containing the pandemic. Does Indonesia possess the same capacity to implement mass surveillance? This should perhaps be a top government priority.
More importantly, the government should ensure sufficient production and efficient distribution of personal protective equipment (PPE) for health workers to prevent deaths among them.
Second, more strict enforcement is needed for social distancing, including bans on large gatherings such as religious, community and events. Where feasible, work-from-home measures will also minimize the viral spread.
Third, limiting large-scale movement within the country is commendable. President Joko “Jokowi” Widodo has finally banned the traditional homecoming exodus (mudik) ahead of the Ramadan fasting month and Idul Fitri celebrations. Imposing curfews is among even less desirable measures. However, the success of such measures is dependent on a high level of social responsibility, awareness and solidarity among the population.
For example, Singapore’s and China’s economic and political systems allow for stringent measures (with fines and some with jail time), which in more democratic countries would be less acceptable. Singapore’s population, and also China’s, show an inherent degree of trust in the government to do what is urgent and necessary during the pandemic. As expressed by Vivian Balakrishnan, Singapore’s foreign minister, “Social capital of trust and compliance when the chips are down with an extreme situation is absolutely crucial.”
Fourth, transparent and effective risk communication to the public based on reliable and verified data is vital to build trust and confidence in government actions, including compliance with imposed restrictions. This includes strategies to deal with fake news and misinformation, which can sow panic and confusion. Indonesia’s police have already prosecuted those who spread such falsehoods.
Fifth, the efficacy of all the aforementioned measures is critically dependent on good and effective governance frameworks. Both Singapore and China had interministerial coordinating committees that worked closely with task forces overseeing key issues such as border control and surveillance, health and medical facilities, logistics and supplies, public communications, enforcement of social distancing measures, media liaison, etc. In China, similar structures were set up at all levels to ensure effective coordination and conformity with national policies, and to avoid contradictory measures at various administrative levels.
Finally, the pandemic serves as an acid test of every country’s quality of healthcare and governments must ensure that health systems are resilient, robust and prepared to respond to future pandemics. Patients with other serious illnesses should continue to receive quality care even during a pandemic when the health system faces a huge surge in cases requiring intensive care.
The pandemic also highlights the importance of regional solidarity as countries are closely linked and interdependent. Four of the world’s 10 busiest air routes, for example, are in ASEAN so these countries, which are all in “one hot zone”, should coordinate efforts, share information, provide technical assistance and help each other in fighting the pandemic.
As the virus has spread to virtually every country, international solidarity becomes even more important to promote trust, cooperation and collective action between countries, rich and poor alike. The central role of multilateral institutions like the World Health Organization and the World Bank in helping countries deal with the pandemic cannot be overstated.
Minister Balakrishnan succinctly summarized the need for a “tripod” of quality healthcare, standard of governance and social capital as foundations for effectively dealing with the pandemic. We are in uncharted territory as to what the future holds and continued vigilance is necessary at all levels. While the UN secretary-general may be correct in declaring the pandemic “the biggest threat to humanity since World War II”, at least during the war, the enemy was visible.