CoronavirusINDONESIA Situation Disease Report 2019 19 (COVID -19) WorldWorld Health Health Coronavirus Disease 2019 (COVID-19) Coronavirus Disease 2019 (COVID-19) OrganizationOrganization

Situation Report - 21 Situation Report - 7 Indonesia

19 AugustData as2020 of 07 May 2020

HIGHLIGHTS • As of 19 August, the Government of Indonesia announced 144 945 confirmed cases of COVID-19, 6 346 deaths and 98 657 recovered cases from 484 districts across all 34 provinces1.

• WHO is providing technical assistance to the COVID-19 Task Force and the Indonesian Red Cross Society (PMI) for the national mask campaign (pages 16-17).

• WHO and partners continue to provide timely advice to the private sector about health protocols in the ‘new normal’. This week’s webinar highlighted the new guidelines for the hospitality and tourism industry (pages 22-23).

Figure 1: Geographic distribution of cumulative number of confirmed COVID-19 cases in Indonesia across the provinces reported between 13 to 19 August 2020. Source of data

Disclaimer: The number of cases reported daily is not equivalent to the number of persons who contracted COVID-19 on that day; reporting of laboratory-confirmed results may take up to one week from the time of testing.

1 https://infeksiemerging.kemkes.go.id/ 1 WHO Indonesia Situation Report - 21 who.int/indonesia

GENERAL UPDATES

• On 13 August, the Governor of , , announced that the large-scale social restrictions (PSBB) will continue in Jakarta until 27 August since the number of confirmed COVID-19 cases has continued to increase throughout the month. Jakarta has also over taken East as the province with the greatest number of cases in the country. Furthermore, during August, Jakarta has reported two of its highest single day tallies of confirmed cases since the pandemic began. The Governor stated that joint patrols involving city officials, soldiers and police will make sure the public comply with health protocols, particularly the use of face masks in public places, noting that violations to the simple medical advice remain rampant in the city2.

• A surge in confirmed COVID-19 cases in Jakarta has raised the hospital bed occupancy rate, with 70% of intensive care unit (ICU) beds and 66% of isolation beds occupied as of 14 August. Jakarta has designated more than 4 400 isolation beds and 483 ICU beds in 67 referral hospitals for COVID- 19 patients. The largest makeshift hospital in the country, established in Jakarta, can accommodate up to 2 000 patients and, as of 16 August, was occupied by 1 411 patients3.

• On 17 August, Indonesia celebrated its 75th Independence Day commemoration; the event largely taking place online due to concerns over COVID-19. President presided over the ceremony along with a handful of state officials and dignitaries at the Presidential Palace in Central Jakarta. The number of physical attendees was limited to 20 people to minimize the risk of COVID-19 transmission. Unlike past ceremonies, this year did not feature a complete line-up of the national flag-hoisting team, in compliance with the health protocols4.

2 https://jakartaglobe.id/news/jakarta-extends-restriction-after-coronavirus-resurgence 3 https://jakartaglobe.id/news/jakartas-icu-bed-occupancy-reaches-70-pct-as-coronavirus-cases-surge 4 https://www.thejakartapost.com/news/2020/08/17/indonesia-celebrates-75th-independence-day-with- subdued-virtual-ceremony-amid-pandemic.html 2 WHO Indonesia Situation Report - 21 who.int/indonesia

SURVEILLANCE

• On 19 August, 1 902 new and 144 945 cumulative confirmed COVID-19 cases were reported (Fig. 2). The average for the last seven days was 2 032 cases per day, compared to 1 978 per day for the previous seven days.

3000 160000

140000 2500 120000 2000 100000

1500 80000

Daily number 60000 1000 Cumulative number Cumulative 40000 500 20000

0 0 6-Jul 6-Jun 1-Apr 7-Apr 5-Aug 12-Jul 18-Jul 24-Jul 30-Jul 2-Mar 8-Mar 1-May 7-May 12-Jun 18-Jun 24-Jun 30-Jun 13-Apr 19-Apr 25-Apr 11-Aug 17-Aug 14-Mar 20-Mar 26-Mar 13-May 19-May 25-May 31-May Daily number of confirmed COVID-19 cases Cumulative number of confirmed COVID-19 cases

Figure 2: Daily and cumulative number of cases reported in Indonesia, as of 19 August 2020. Source of data

Disclaimer: The number of cases reported daily is not the number of persons who contracted COVID-19 on that day; reporting of laboratory-confirmed results may take up to one week from the time of testing. Therefore, caution must be taken in interpreting this figure and the epidemiological curve for further analysis.

• As of 19 August, most confirmed cases were in Java: DKI Jakarta followed by , , and . South is the only province outside Java that has one of the highest numbers of confirmed cases. Java contributed 58% of the total cases in Indonesia. The cumulative number of confirmed COVID-19 cases by province is shown in Figure 3.

3 WHO Indonesia Situation Report - 21 who.int/indonesia DKI Jakarta East Java Central Java West Java South North North Maluku Province Yogyakarta

0 5000 10000 15000 20000 25000 30000 35000 Cumulative number of confirmed COVID-19 cases

Figure 3: Cumulative number of confirmed COVID-19 cases by province in Indonesia, as of 19 August 2020. Source of data

Disclaimer: Data from DKI Jakarta include patients isolated or hospitalized in Wisma Atlet (RSDC: Rumah Sakit Darurat COVID-19), which is the biggest national makeshift hospital for COVID-19; some patients may not be residents of DKI Jakarta. The same may apply to other provinces.

4 WHO Indonesia Situation Report - 21 who.int/indonesia • As of 19 August, DKI Jakarta had the highest confirmed COVID-19 mortality per one million population, followed by , North Sulawesi, East Java, and South Sulawesi (Fig. 4).

DKI Jakarta South Kalimantan North Sulawesi East Java North Maluku South Sulawesi Gorontalo Central Kalimantan East Kalimantan West Nusa Tenggara South Sumatra Central Java Maluku Riau Islands Bengkulu Bali Papua Province West Sumatra Banten Yogyakarta West Papua Southeast Sulawesi Aceh West Sulawesi West Java North Kalimantan Central Sulawesi Riau Lampung Bangka Belitung Islands Jambi West Kalimantan East Nusa Tenggara 0 20 40 60 80 100 120 Death per one million population

Figure 4: Cumulative deaths per one million population by province in Indonesia, as of 19 August 2020. Source of data

Disclaimer: Based on data availability, only confirmed COVID-19 deaths have been included; however, as per the WHO definition, death resulting from a clinically compatible illness in a probable or confirmed COVID-19 case is a COVID-19-related death, unless there is a clear alternative cause of death that cannot be related to COVID-19 (e.g. trauma). There should be no period of complete recovery between the illness and death. 5 WHO Indonesia Situation Report - 21 who.int/indonesia • As of 19 August, the daily number of specimens and suspected cases tested were 26 078 and 14 940, respectively (Fig. 5). The weekly average number of specimens and suspected cases tested in the last seven days were 22 492 and 12 027, respectively. It is important to set the testing target to achieve the benchmark of suspected cases tested each day, in line with the fifth revision of the national guidelines for COVID-19 prevention and control. The guideline states the target as one suspected case tested per 1 000 population per week, adopted from WHO’s recommendation for comprehensive surveillance5. 35000

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0 4-Jul 8-Jul 2-Jun 6-Jun 1-Aug 5-Aug 9-Aug 12-Jul 16-Jul 20-Jul 24-Jul 28-Jul 1-May 5-May 9-May 10-Jun 14-Jun 18-Jun 22-Jun 26-Jun 30-Jun 13-Aug 17-Aug 13-May 17-May 21-May 25-May 29-May Number of specimens tested Number of suspected cases tested

Figure 5: The daily number of specimens and suspected COVID-19 cases tested in Indonesia, from 01 May to 19 August 2020. Source of data

Disclaimer: Due to the transition to a new data management application, there may have been reporting issues in timing. Therefore, on certain days the number of specimens tested is almost the same as the number of suspected cases tested, which might not have been the situation.

5 https://www.who.int/publications/i/item/public-health-criteria-to-adjust-public-health-and-social- measures-in-the-context-of-covid-19 6 WHO Indonesia Situation Report - 21 who.int/indonesia EPIDEMIOLOGICAL CRITERIA TO ASSESS COVID-19 TRANSMISSION

Table 1: Assessment of epidemiological criteria for six provinces in Java for the 3-week period from 27 July to 16 August.

Province Decline in the number of Decrease in the confirmed COVID-19 cases number of since the latest peak* confirmed and probable case deaths for the last 3 weeks**

DKI Jakarta Latest peak last week No West Java Latest peak last week Yes Central Java Latest peak last week No Yogyakarta Latest peak last week No East Java Less than 50% since latest peak No Banten Latest peak last week No

*date of latest peak differs for each province (see Figs. 6 to 11 for details) **decrease in deaths is calculated from 27 July to 16 August 2020 (see Fig. 13 for details)

Criterion 1: Decline of at least 50% over a 3-week period since the latest peak and continuous decline in the observed incidence of confirmed and probable cases

• None of the provinces in Java have shown a decline of at least 50% for three weeks since the latest peak (Figs. 6 to 11). Most provinces in Java experienced an increase in the number of confirmed COVID-19 cases in the last week.

7 WHO Indonesia Situation Report - 21 who.int/indonesia DKI Jakarta 4000 35000 3500 30000 3000 25000 2500 20000 2000 15000 1500 10000

Weekly number Weekly 1000 500 5000 Cumulativenumber 0 0

Number of confirmed COVID-19 cases Cumulative number of confirmed COVID-19 cases

Figure 6: Weekly and cumulative number of confirmed COVID-19 cases in DKI Jakarta, as of 16 August 2020. Source of data

West Java 1600 10000 1400 9000 8000 1200 7000 1000 6000 800 5000 600 4000 3000

Weekly number Weekly 400 2000 Cumulativenumber 200 1000 0 0

Number of confirmed COVID-19 cases Cumulative number of confirmed COVID-19 cases

Figure 7: Weekly and cumulative number of confirmed COVID-19 cases in West Java, as of 16 August 2020. Source of data

8 WHO Indonesia Situation Report - 21 who.int/indonesia Central Java 1600 14000 1400 12000 1200 10000 1000 8000 800 6000 600 4000

Weekly number Weekly 400 200 2000 Cumulativenumber 0 0

Number of confirmed COVID-19 cases Cumulative number of confirmed COVID-19 cases

Figure 8: Weekly and cumulative number of confirmed COVID-19 cases in Central Java, as of 16 August 2020. Source of data

Yogyakarta 250 1200

200 1000 800 150 600 100 400

Weekly number Weekly 50 200 Cumulativenumber 0 0

Number of confirmed COVID-19 cases Cumulative number of confirmed COVID-19 cases

Figure 9: Weekly and cumulative number of confirmed COVID-19 cases in Yogyakarta, as of 16 August 2020. Source of data

9 WHO Indonesia Situation Report - 21 who.int/indonesia East Java 3000 30000 2500 25000 2000 20000 1500 15000 1000 10000 Weekly number Weekly

500 5000 Cumulativenumber 0 0

Number of confirmed COVID-19 cases Cumulative number of confirmed COVID-19 cases

Figure 10: Weekly and cumulative number of confirmed COVID-19 cases in East Java, as of 16 August 2020. Source of data

Banten 250 2500

200 2000

150 1500

100 1000

Weekly number Weekly 50 500 Cumulativenumber

0 0

Number of confirmed COVID-19 cases Cumulative number of confirmed COVID-19 cases

Figure 11: Weekly and cumulative number of confirmed COVID-19 cases in Banten, as of 16 August 2020. Source of data

10 WHO Indonesia Situation Report - 21 who.int/indonesia Criterion 2: Less than 5% of samples positive for COVID-19, at least for the last 2 weeks, assuming that surveillance for suspected cases is comprehensive

• The percentage of positive samples can be interpreted only with comprehensive surveillance and testing of suspected cases, in the order of one per 1 000 population per week. DKI Jakarta has achieved this minimum case detection benchmark (Fig. 12).

5.00 30.0%

4.50 25.0% 4.00

3.50 20.0% 3.00

2.50 15.0%

2.00 rate Positivity 10.0% 1.50 Benchmark: One suspected case tested per 1000 population per week 1.00 5.0%

Suspected cases tested/1000 population/week cases tested/1000 Suspected Threshold positivity rate <5% 0.50

0.00 0.0% 1 2 3 1 2 3 1 2 3 Indonesia DKI Jakarta Indonesia without DKI Jakarta Weeks Suspected cases tested/1000 population/week Positivity rate

Figure 12: Positivity rate of cases, and suspected cases tested per 1 000 population per week: Week 1: 27/07/20 - 02/08/20; Week 2: 03/08/20 - 09/08/20; Week 3: 10/08/20 - 16/08/20

For surveillance purposes, positivity rate is calculated as the number of confirmed cases divided by the number of people tested for diagnosis. Source of data: Indonesia, DKI Jakarta

Note: Due to a limitation in data, other provinces could not be evaluated.

11 WHO Indonesia Situation Report - 21 who.int/indonesia Criterion 3: Decline in the number of deaths among confirmed and probable cases for the last 3 weeks

DKI Jakarta West Java 300 80 4 200 60 127 161 100 84 40 63 73 87 56 20 8 0 18 27/07/20 - 03/08/20 - 10/08/20 - 0 4 9 02/08/20 09/08/20 16/08/20 27/07/20 - 03/08/20 - 10/08/20 - 02/08/20 09/08/20 16/08/20 Other death with COVID-19 protocol Death-Confirmed-Case Death-Confirmed-Case Death-PDP Death-ODP

Central Java Yogyakarta 300 5 4 85 139 200 129 3 2 4 100 166 3 135 128 1 0 0 0 27/07/20 - 03/08/20 - 10/08/20 - 27/07/20 - 03/08/20 - 10/08/20 - 02/08/20 09/08/20 16/08/20 02/08/20 09/08/20 16/08/20 Death-Confirmed-Case Death-PDP Death-Confirmed-Case Death-Probable-Case

East Java Banten 250 10 200 99 8 98 2 150 6 5 100 4 141 146 7 50 135 2 3 2 0 0 27/07/20 - 03/08/20 - 10/08/20 - 27/07/20 - 03/08/20 - 10/08/20 - 02/08/20 09/08/20 16/08/20 02/08/20 09/08/20 16/08/20 Death-Confirmed-Case Death-Probable-Case Death-Confirmed-Case Death-PDP

12 WHO Indonesia Situation Report - 21 who.int/indonesia Figure 13: Deaths among confirmed COVID-19 cases, patients under investigation (PDP) and persons under observation (ODP) per week over the last three weeks from 27 July to 16 August 2020 in six provinces in Java. Source of data: DKI Jakarta, West Java, Central Java, East Java, Yogyakarta, Banten.

Disclaimer: The data are provisional. Since 20 July, DKI Jakarta and East Java are in the process of adopting case definitions based on the fifth revision of the national guidelines on COVID-19 prevention and control. There may be a discrepancy in the number of deaths of confirmed COVID-19 cases between national and provincial data sources.

• On 13 August, WHO, the Food and Agriculture Organization (FAO), and the United States Agency for International Development (USAID) – LINKAGE – convened a meeting to discuss measures to strengthen surveillance and contact tracing. Volunteers and field staff from various organizations will support activities at the subnational level. A refresher training on surveillance will take place next week, along with an orientation on the new contact tracing application with mobile and desktop versions: the mobile application will enable contact tracers to input information while the desktop version will compile and analyse the data.

HEALTH SYSTEM CRITERIA TO ASSESS COVID-19 TRANSMISSION

• The number of confirmed COVID-19 cases hospitalized in DKI Jakarta since the beginning of June had gradually decreased until 07 July; however, since 08 July, the number has been progressively increasing (Fig. 14). 3000 - 2500

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19 cases hospitalized 19 cases 500 Number of confirmed COVID of confirmed Number 0 1-Jun 8-Jun 15-Jun 22-Jun 29-Jun 6-Jul 13-Jul 20-Jul 27-Jul 3-Aug 10-Aug Figure 14: Number of confirmed COVID-19 cases hospitalized in DKI Jakarta from 01 June to 16 August 2020. Source of data

Disclaimer: Data from Wisma Atlet are not included. 13 WHO Indonesia Situation Report - 21 who.int/indonesia LABORATORY

• As reported by the government on 19 August, the number of suspected cases tested for COVID-19 with polymerase chain reaction (PCR) was 14 940 and the cumulative number of suspected cases tested was 1 096 294 (Fig. 15). 20000 1200000 18000 16000 1000000 14000 800000 12000 10000 600000 8000

Daily number 6000 400000 4000 200000 number Cumulative 2000 0 0 4-Jul 6-Jun 4-Apr 1-Aug 8-Aug 11-Jul 18-Jul 25-Jul 7-Mar 2-May 9-May 13-Jun 20-Jun 27-Jun 11-Apr 18-Apr 25-Apr 15-Aug 14-Mar 21-Mar 28-Mar 16-May 23-May 30-May Reporting date

Daily number of suspected COVID-19 cases tested with PCR Cumulative number of suspected COVID-19 cases tested with PCR

Figure 15: Daily and cumulative number of people tested with polymerase chain reaction (PCR) in Indonesia, as of 19 August 2020. Source of data

• On 12 and 14 August, the Intra-Action Review (IAR) met to discuss the laboratory response for COVID-19 and design short- and long-term plans for the laboratory response during the pandemic. Relevant stakeholders highlighted best practices and challenges identified.

Some best practices include:

i. Expanded laboratory network since the beginning of the pandemic (from 13 laboratories in March to 320 laboratories in August);

ii. Virtual as well as on-the-job training for laboratory technicians and volunteers;

iii. Mobile PCR laboratory in some provinces to enhance testing. 14 WHO Indonesia Situation Report - 21 who.int/indonesia

Some challenges include:

i. Lack of coordination between national and provincial laboratories;

ii. Delays in testing due to limited human resources, PCR reagents, extraction kits, viral transport media and consumables;

iii. Limited regional laboratories reporting their results in real time to the national laboratory;

iv. Limited participation in the external quality assurance (EQA); and some laboratories not meeting the EQA standards yet.

CASE MANAGEMENT

• As of 19 August, the proportion of people that recovered among the total confirmed COVID-19 cases was 68.1% (Fig. 16). As of the same date, there were 39 942 confirmed COVID-19 cases under care or in isolation6.

120000 80.0 70.0 100000 60.0 80000 50.0 60000 40.0 30.0 40000 Percentage (%) 20.0 Cummulative number Cummulative 20000 10.0 0 0.0 6-Jul 6-Jun 1-Apr 7-Apr 5-Aug 12-Jul 18-Jul 24-Jul 30-Jul 1-May 7-May 12-Jun 18-Jun 24-Jun 30-Jun 13-Apr 19-Apr 25-Apr 11-Aug 17-Aug 13-May 19-May 25-May 31-May Cumulative number of recovered cases Percentage recovery

Figure 16: Cumulative number of recovered cases and percentage recovery from COVID-19 in Indonesia, as of 19 August 2020. Source of data

6 https://covid19.go.id/ 15 WHO Indonesia Situation Report - 21 who.int/indonesia

PLANNING, RISK AND NEEDS ASSESSMENT • From 11 to 14 August, WHO supported an IAR for the COVID-19 response. Multiple sector stakeholders including, among others, the Ministry of Health (MoH), the National Board for Disaster Management (BNPB), the Secretariat of the Cabinet, selected Province Health Offices (PHOs), hospitals and the armed forces actively shared best practices, gaps and challenges and provided input to formulate recommendations to strengthen the national COVID-19 response. These recommendations will guide the review of the national and provincial response plans for COVID- 19. The core team of focal points for each pillar of the response plan will monitor the implementation of the IAR recommendations and the Directorate of Surveillance and Health Quarantine, MoH, in collaboration with BNPB, will coordinate periodic meetings to track progress. The results of the IAR will be published on the Partnership Platform and will be presented to the Directorate General of Disease Prevention and Control (International Health Regulations Focal Point for Indonesia) and the COVID-19 Task Force. Indonesia will also share the IAR outcomes with relevant stakeholders and regional and global communities.

RISK COMMUNICATION

• WHO is regularly translating and sharing important health messages on the website and social media platforms – Twitter and Instagram – and has recently published:

- Infographics: . One on staying safe during COVID-19 . One on staying healthy in the workplace . Three on substance abuse . Five on feeding young children . Eight on guidelines for management in the food sector, in collaboration with the Indonesia Global Compact Network (IGCN), the International Labour Organization (ILO) and the United Nations Development Programme (UNDP)

• On 14 and 16 August, the COVID-19 Task Force disseminated risk communication materials as part of the national mask campaign. WHO provided input, in line with the WHO advice on the use of masks in the 16 WHO Indonesia Situation Report - 21 who.int/indonesia context of COVID-19, to produce relevant information, education and communication (IEC) materials (Fig. 17). The Indonesian Red Cross Society (PMI) and MoH, as part of the Task Force, have developed a plan outlining campaign activities, starting from August. These were presented during the weekly Risk Communication and Community Engagement (RCCE) meeting on 14 August.

Figure 17: Information, education and communication material for the national mask campaign, August 2020.

17 WHO Indonesia Situation Report - 21 who.int/indonesia CONTINUITY OF ESSENTIAL HEALTH SERVICES

During the COVID-19 pandemic, the Subdirectorate of Hepatitis and Gastrointestinal Tract Infection Diseases, MoH, has conducted (i) ‘COVID-19 Impact Analysis on Hepatitis B and Hepatitis C Services’; and (ii) developed national guidance to mitigate potential disruptions to the delivery of hepatitis B and hepatitis C essential health services. The following are the highlights of MoH responses that are supported by WHO Indonesia:

Impact of COVID-19 on National Hepatitis Programme (NHP) in Indonesia7: i. The number of districts/cities conducting early detection of hepatitis B (Deteksi Dini Hepatitis B or DDHB) among pregnant women from January to April 2020 was significantly lower compared to the same period last year (Fig. 18).

400 363 364 368 368

300 276 263 214 200

100 85 Number of of districts/cities Number

0 Jan Feb Mar Apr 2019 2020

Figure 18: Number of districts/cities conducting early detection of hepatitis B, January to April 2019 and January to April 2020. Source of data: MoH analysis of COVID-19 impact to hepatitis B and hepatitis C services, 2020

ii. There was equally a decline in the total number of pregnant women who were tested for hepatitis B during the same period (Fig. 19). A more detailed and specific analysis comparing data from before and after the COVID-19 outbreak in Indonesia shows that the number of pregnant women tested

7 MoH analysis of COVID-19 impact to Hepatitis B and Hepatitis C services, 2020 18 WHO Indonesia Situation Report - 21 who.int/indonesia and screened for hepatitis B declined by more than half in March and April 2020 compared to January and February 2020.

250000 223664 207668 207035 205334 200000 158733 147672 150000 106140 tested 100000

50000 34100 Number of pregnant women women of Number pregnant 0 Jan Feb Mar Apr

2019 2020 Figure 19: Number of pregnant women tested for hepatitis B, January to April 2019 and January to April 2020. Source of data: MoH analysis of COVID-19 impact to hepatitis B and hepatitis C services, 2020

iii. The situation is similar for the number of infants (9-12 months old) (Fig. 20). 400 367 334 298 300 260 240 235

200 170 116 100 Number of infants screened of infants Number

0 Jan Feb Mar Apr 2019 2020 Figure 20: Number of infants (9 to 12 months old) screened for hepatitis B, January to April 2019 and January to April 2020. Source of data: MoH analysis of COVID-19 impact to hepatitis B and hepatitis C services, 2020

19 WHO Indonesia Situation Report - 21 who.int/indonesia iv. There was a decline of hepatitis C services at healthcare facilities as the number of facilities conducting hepatitis C early detection (Deteksi Dini Hepatitis C or DDHC) decreased by 61% on average in the period of January to April 2020 compared to January to April 2019 (Fig. 21). 300 239

200 157 145 142

91 100 71 61 41 Number of facilities

0 Jan Feb Mar Apr 2019 2020

Figure 21: Number of facilities that submitted hepatitis C early detection (DDHC) report, January to April 2019 and January to April 2020. Source of data: MoH analysis of COVID-19 impact to hepatitis B and hepatitis C services, 2020

v. There are two tests used for diagnosis of chronic hepatitis C infection, i.e. antibody test (anti-HCV), and antigen test (HCV RNA); both show a significant decline from January to April 2020 compared to 2019 (Fig. 22 and 23).

20000 15990 15954 15165 14530 15000 10803 10105 10000 7651

5000 1515 0 Numberof samples tested Jan Feb Mar Apr 2019 2020

Figure 22: Number of Anti-HCV samples tested, January to April 2019 and January to April 2020. Source of data: MoH analysis of COVID-19 impact to hepatitis B and hepatitis C services, 2020 20 WHO Indonesia Situation Report - 21 who.int/indonesia

800

580 600

402 396 423 400 366

200 132 120

Numberof samples tested 14 0 Jan Feb Mar Apr 2019 2020

Figure 23: Number of HCV RNA samples tested, January to April 2019 and January to April 2020. Source of data: MoH analysis of COVID-19 impact to hepatitis B and hepatitis C services, 2020

To mitigate the impact of COVID-19 and maintain essential hepatitis services, interventions are being made in the following areas8: i. Guidelines: MoH issued two circulars in April and June, in line with WHO guidance on ‘Maintaining essential health services’, covering guidance for health facilities, health workers regarding prevention of COVID-19 in hepatitis services, clinical management of hepatitis B and hepatitis C patients, and guidance for Province and District Health Offices to continue their roles in NHP.

ii. Diagnosis: Hepatitis B and C screening and confirmatory diagnosis are recommended to be conducted as usual in healthcare facilities, adhering to infection prevention and control (IPC) measures and maintaining physical distancing.

iii. Prevention: To prevent risk of COVID-19 transmission during the provision of hepatitis services, IPC protocols for COVID-19 have been put in place at the healthcare facilities for healthcare workers, patients and companions.

8 Director General of Disease Control and Prevention, MoH, Circular Letter No. HK.02.03/III/9204/2020, ‘Implementation of Hepatitis B and Hepatitis C Prevention and Control in New Normal Era’ 21 WHO Indonesia Situation Report - 21 who.int/indonesia Figure 24: A woman undergoes testing for hepatitis at a health facility. Routine health screening, including sexually transmitted diseases, should continue alongside the COVID-19 response. Credit: MoH

PARTNER COORDINATION

• WHO, IGCN, ILO and UNDP convened the third webinar of the ‘Business Unusual in the New Normal’ series on 19 August. The webinar discussed new protocols and guidelines for the hospitality and tourism industry with representatives of the private sector as the main stakeholders. Resource persons were available from WHO, ILO, the Ministry of Tourism and Creative Economy, the DKI Jakarta Provincial Government for Culture and Tourism, the Indonesia Tourism Development Corporation (ITDC) as well as the Indonesian Hotel and Restaurant Association (PHRI). WHO presented its guidance on the ‘Operational considerations for prevention of COVID-19 in the accommodation sector’. The webinar aimed to facilitate dialogue between UN agencies, governments, business associations, the private sector and workers regarding the needs, concerns and challenges for health and safety standards for businesses in the hospitality and tourism industry during the COVID-19 pandemic (Fig. 25).

22 WHO Indonesia Situation Report - 21 who.int/indonesia Figure 25: Poster of the webinar for hospitality and tourism industry in the ‘new normal’, 19 August 2020. Credit: Indonesia Global Compact Network (IGCN).

• Overall funding request for WHO operations and technical assistance is US$ 46 million (27 million for response and 19 million for recovery phase), based on estimated needs as of August 2020 (Fig. 26).

23 WHO Indonesia Situation Report - 21 who.int/indonesia

Figure 26: WHO funding situation for COVID-19 response, August 2020

Data presented in this situation report have been taken from publicly available data from the MoH (https://infeksiemerging.kemkes.go.id/), BNPB (http://covid19.go.id) and provincial websites. There may be differences in national and provincial data depending on the source used. All data are provisional and subject to change.

24 WHO Indonesia Situation Report - 21 who.int/indonesia A SNAPSHOT OF WHO COURSES AND INFORMATION MATERIAL

Online WHO COVID-19 courses: • Operational planning guidelines and COVID-19 • Clinical management of severe acute respiratory infections • Health and safety briefing for respiratory diseases – eProtect • Infection prevention and control • Emerging respiratory viruses, including COVID-19 • Design of severe acute respiratory infection treatment facility

WHO guidance: • Safe Eid-al-Adha practices in the context of COVID-19 • Doing things that matter • Considerations for school-related public health measures • Cleaning and disinfection of environmental surfaces • Guiding principles for immunization activities during the COVID-19 pandemic • Maintaining a safe and adequate blood supply during the COVID-19 pandemic

Infographics: • Breastfeeding and COVID-19 • Management at workplace • Take care in your workplace • Safe travel during COVID-19 • Tuberculosis and COVID-19 • Nutrition tips • ‘Be Active’

Questions and answers: • COVID-19 transmission • Contact tracing

Videos: • Stay healthy at home • How to protect yourself from COVID-19 • Take care in your workplace • Safe travel during COVID-19 • COVID-19 is a virus not bacteria • Health workers and stigma • Managing stress

For more information please feel free to contact: [email protected] WHO Indonesia Reports

25 WHO Indonesia Situation Report - 21 who.int/indonesia