Coronavirus Disease 2019 (COVID-19) World Health

Coronavirus Disease 2019 (COVID-19) World Health CoronavirusCoronavirus Disease Disease 2019 2019 (COVID (COVID-19) -19) World Health OrganizationOrganization Situation Report - 51 Situation Report - 7 Indonesia Indonesia

14 AprilData 2021 as of 07 May 2020

HIGHLIGHTS

• As of 14 April, the Government of Indonesia reported 1 583 182 (5656 new) confirmed cases of COVID-19, 42 906 (124 new) deaths and 1 431 892 recovered cases from 510 districts across all 34 provinces.1

• To support the laboratory cold chain system in Indonesia, WHO handed over 1000 cold boxes worth US$ 313 000 to the Ministry of Health and the National Agency of Drug and Food Control, on 3 April (page 16).

• WHO supported the Ministry of Health and the National Working Group on Infection Prevention and Control (IPC) to conduct a virtual national training of trainers on IPC for health facilities in Indonesia, from 6 to 9 April (page 17).

Fig. 1. Geographic distribution of cumulative number of confirmed COVID-19 cases in Indonesia across

the provinces reported from 8 to 14 April 2021. 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://covid19.go.id/peta-sebaran-covid19 1 WHO Indonesia Situation Report - 51 who.int/indonesia GENERAL UPDATES

• As part of its strategy to accelerate COVID-19 vaccination of older people, the Ministry of Health (MoH) will open more vaccination centres across Indonesia to improve access and boost the vaccination coverage of this target group. As of 11 April, MoH reported that the vaccination coverage of older people is still considerably lower than that of other priority target groups.2 On 12 April, the DKI Jakarta Provincial Administration announced that it is preparing an offline registration system through the neighbourhood units (Rukun Tetangga (RT)) for older people, considering that not all can access the online registration platform. Assistance to register for vaccination will also be provided to older people who do not have the national ID card (Kartu Tanda Penduduk (KTP)) from DKI Jakarta3.

• The Ministry of Religious Affairs issued a Circular Letter on 8 April as a guideline for Ramadan and Eid al-Fitr worships in 2021. The circular letter stated that mosques and other places of worship are allowed to conduct prayers and other religious activities with maximum 50% capacity. This is to facilitate proper physical distancing while strictly complying to health protocols. However, no such activities are permitted in areas that are considered as high-risk zones by MoH. The Ministry of Religious Affairs urged Muslim communities living in high-risk areas to worship at home during the month of Ramadan to prevent COVID-19 transmission.4

• On World Health Day, 7 April 2021, WHO called for action to eliminate health inequities, as part of a year-long global campaign to bring people together to build a fairer, healthier world. The campaign highlights WHO’s constitutional principle that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being. The COVID-19 pandemic has hit all countries hard, but its impact has been harshest on those communities which were already vulnerable, which are more exposed to the disease, and less likely to have access to quality healthcare services. Therefore, WHO called on leaders to ensure that communities are at the forefront in decision-making processes as the world moves forward to a new future. At the same time, WHO urged leaders to monitor health inequities and to ensure that all people are able to access quality health services depending on their needs and values within their communities.5

2 https://www.antaranews.com/berita/2097250/kemenkes-buka-sentra-vaksinasi-percepat-vaksin-lansia-di-bulan- april#mobile-nav 3 https://en.tempo.co/read/1451719/jakarta-preps-covid-19-vaccination-offline-registration-system-for-elderly 4 https://en.antaranews.com/news/172274/people-in-orange-red-zones-urged-to-worship-at-home 5 https://www.who.int/indonesia/news/campaign/world-health-day-2021 2 WHO Indonesia Situation Report - 51 who.int/indonesia SURVEILLANCE

• On 14 April, 5656 new and 1 583 182 cumulative confirmed COVID-19 cases were reported nationwide (Fig. 2). The average for the last seven days from 8 to 14 April was 5115 cases per day, compared to 5095 cases per day reported in the previous week.

16000 1800000 14000 1600000 12000 1400000 1200000 10000 1000000 8000 800000 6000

600000 Daily numberDaily 4000 400000 number Cumulative 2000 200000

0 0

2-Jan

9-Oct

5-Apr

5-Sep 5-Feb

2-Aug

16-Jul

2-Mar

9-May

19-Jan

12-Jun 29-Jun

26-Oct

22-Apr 14-Apr

22-Sep 22-Feb

16-Dec

19-Aug

12-Nov 29-Nov

19-Mar 11-Mar 28-Mar 26-May

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

Fig. 2. Daily and cumulative number of cases reported in Indonesia, as of 14 April 2021. Source of data

Disclaimer: The number of cases reported daily is not the number of persons who contracted COVID-19 on that day and might be influenced by the number of people tested on that day (see Fig. 17); 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, either at the national or subnational level.

3 WHO Indonesia Situation Report - 51 who.int/indonesia • During the week of 5 to 11 April, the provinces of Aceh, South Sulawesi and Bengkulu experienced an increase in the number of weekly cases of more than 50% compared to the previous week (Fig. 3). It is critical to investigate reasons for the increase in the new confirmed cases to guide decisions on response activities and inform the adjustment of public health and social measures (PHSM).6

Fig. 3. Percentage change of weekly number of confirmed cases by province during 5 to 11 April 2021 compared to the previous week. Source of data

Disclaimer: The number of weekly confirmed cases is calculated taking into consideration the daily number of reported cases. Caution should be exercised when interpreting this figure due to data limitations reported by MoH.

6 It is also important to conduct further investigation if there is a substantial decrease in new cases, especially in provinces with 50% or more decline. Other indicators, such as testing and contact tracing, may help elucidate the reasons behind a drop in new cases. 4 WHO Indonesia Situation Report - 51 who.int/indonesia

• During the week of 5 to 11 April, the incidence7 of COVID-19 in Indonesia was 13.1 per 100 000 population, compared to 13.7 per 100 000 in the previous week (Fig. 4).

CT2 (20 - <50) 25

15 Case Case incidence CT1 (<20) 10

11/05 - 17/05 - 11/05 13/09 - 07/09 10/01 - 04/01 14/03 - 08/03 13/04 - 13/04 19/04 - 20/04 26/04 - 27/04 03/05 - 04/05 10/05 - 18/05 24/05 - 25/05 31/05 - 01/06 07/06 - 08/06 14/06 - 15/06 21/06 - 22/06 28/06 - 29/06 05/07 - 06/07 12/07 - 13/07 19/07 - 20/07 26/07 - 27/07 02/08 - 03/08 09/08 - 10/08 16/08 - 17/08 23/08 - 24/08 30/08 - 31/08 06/09 - 14/09 20/09 - 21/09 27/09 - 28/09 04/10 - 05/10 11/10 - 12/10 18/10 - 19/10 25/10 - 26/10 01/11 - 02/11 08/11 - 09/11 15/11 - 16/11 22/11 - 23/11 29/11 - 30/11 06/12 - 07/12 13/12 - 14/12 20/12 - 21/12 27/12 - 28/12 03/01 - 11/01 17/01 - 18/01 24/01 - 25/01 31/01 - 01/02 07/02 - 08/02 14/02 - 15/02 21/02 - 22/02 28/02 - 01/03 07/03 - 15/03 21/03 - 22/03 28/03 - 29/03 04/04 - 05/04 11/04 Fig. 4. Incidence of COVID-19 per 100 000 population per week averaged over a two-week period reported in Indonesia from 13 April 2020 (when Indonesia first reported community transmission in the country) to 11 April 2021, classified by level of community transmission (CT): CT1: low incidence; CT2: moderate incidence; CT3: high incidence; CT4: very high incidence. Source of data

Disclaimer: There are seven categories for transmission classification: (1) no (active) cases; (2) imported/sporadic cases; (3) cluster of cases; (4) community transmission 1 (CT1); (5) community transmission 2 (CT2); (6) community transmission 3 (CT3); and (7) community transmission 4 (CT4). Caution should be exercised when interpreting this indicator due to limitations listed in the WHO interim guidance. Other limitations include data incompleteness and data quality issues reported by MoH. Other epidemiological indicators also need to be evaluated to decide on the level of community transmission. This disclaimer applies to indicators at national (Fig. 4) and subnational levels (Figs. 5 to 11).

7 Weekly incidence of COVID-19 is calculated as the number of new cases per 100 000 population per week averaged over a two-week period. Source of population data 5 WHO Indonesia Situation Report - 51 who.int/indonesia

• During the week of 5 to 11 April, the incidence of COVID-19 per 100 000 population was 65.9 in DKI Jakarta, which corresponds to community transmission level 3 (Fig. 5). Based on WHO interim guidance, community transmission level 3 means that there is a high risk of COVID-19 infection for the general population and that a high incidence of locally acquired, widely dispersed cases was detected in the past 14 days.

DKI Jakarta South Kalimantan Bangka Belitung Islands DI Yogyakarta East Kalimantan Banten Bali Central Kalimantan North Kalimantan Riau West Papua West Sumatra West Java Papua Bengkulu Riau Islands Central Java Jambi Central Sulawesi South Sumatra East Nusa Tenggara South Sulawesi Gorontalo West Kalimantan East Java West Nusa Tenggara Lampung North Sumatra Maluku North Maluku North Sulawesi Aceh Southeast Sulawesi West Sulawesi

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 Weekly case incidence

CT 1 (<20) CT 2 (20-<50) CT 3 (50 - <150) CT 4 (150+)

Fig. 5. Incidence of COVID-19 per 100 000 population per week averaged over a two-week period by province in Indonesia during 5 to 11 April 2021, classified by level of community transmission (CT): CT1: low incidence; CT2: moderate incidence; CT3: high incidence; CT4: very high incidence. Source of data

6 WHO Indonesia Situation Report - 51 who.int/indonesia • The weekly incidence of COVID-19 decreased in all provinces in Java Island except Banten during the week of 5 to 11 April compared to the previous week (Fig. 6 to 11).

DKI Jakarta 240 CT4 (150+) 200

160

120 CT3 (50 - <150)

Case Case incidence 80

40 CT2 (20 - <50) CT1 (<20)

15/06 - 21/06 - 15/06 13/04 - 13/04 19/04 - 20/04 26/04 - 27/04 03/05 - 04/05 10/05 - 11/05 17/05 - 18/05 24/05 - 25/05 31/05 - 01/06 07/06 - 08/06 14/06 - 22/06 28/06 - 29/06 05/07 - 06/07 12/07 - 13/07 19/07 - 20/07 26/07 - 27/07 02/08 - 03/08 09/08 - 10/08 16/08 - 17/08 23/08 - 24/08 30/08 - 31/08 06/09 - 07/09 13/09 - 14/09 20/09 - 21/09 27/09 - 28/09 04/10 - 05/10 11/10 - 12/10 18/10 - 19/10 25/10 - 26/10 01/11 - 02/11 08/11 - 09/11 15/11 - 16/11 22/11 - 23/11 29/11 - 30/11 06/12 - 07/12 13/12 - 14/12 20/12 - 21/12 27/12 - 28/12 03/01 - 04/01 10/01 - 11/01 17/01 - 18/01 24/01 - 25/01 31/01 - 01/02 07/02 - 08/02 14/02 - 15/02 21/02 - 22/02 28/02 - 01/03 07/03 - 08/03 14/03 - 15/03 21/03 - 22/03 28/03 - 29/03 04/04 - 05/04 11/04 Fig. 6. Incidence of COVID-19 per 100 000 population per week averaged over a two-week period in DKI Jakarta, from 13 April 2020 to 11 April 2021, classified by level of community transmission (CT): CT1: low incidence; CT2: moderate incidence; CT3: high incidence; CT4: very high incidence. Source of data

West Java 45 CT 2 (20 - <50) 40 35

30 25 20

Case Case incidence 15 10 CT 1 (<20) 5

15/06 - 21/06 - 15/06 15/11 - 09/11 14/03 - 08/03 11/04 - 05/04 13/04 - 13/04 19/04 - 20/04 26/04 - 27/04 03/05 - 04/05 10/05 - 11/05 17/05 - 18/05 24/05 - 25/05 31/05 - 01/06 07/06 - 08/06 14/06 - 22/06 28/06 - 29/06 05/07 - 06/07 12/07 - 13/07 19/07 - 20/07 26/07 - 27/07 02/08 - 03/08 09/08 - 10/08 16/08 - 17/08 23/08 - 24/08 30/08 - 31/08 06/09 - 07/09 13/09 - 14/09 20/09 - 21/09 27/09 - 28/09 04/10 - 05/10 11/10 - 12/10 18/10 - 19/10 25/10 - 26/10 01/11 - 02/11 08/11 - 16/11 22/11 - 23/11 29/11 - 30/11 06/12 - 07/12 13/12 - 14/12 20/12 - 21/12 27/12 - 28/12 03/01 - 04/01 10/01 - 11/01 17/01 - 18/01 24/01 - 25/01 31/01 - 01/02 07/02 - 08/02 14/02 - 15/02 21/02 - 22/02 28/02 - 01/03 07/03 - 15/03 21/03 - 22/03 28/03 - 29/03 04/04 Fig. 7. Incidence of COVID-19 per 100 000 population per week averaged over a two-week period in West Java, from 13 April 2020 to 11 April 2021, classified by level of community transmission (CT): CT1: low incidence; CT2: moderate incidence; CT3: high incidence; CT4: very high incidence. Source of data

7 WHO Indonesia Situation Report - 51 who.int/indonesiaFig. 6. Incidence of COVID-19 per 100 000 population per week averaged over a two-week period in West Java, from 13 April 2020 to 24 January 2021, classified by level of community transmission (CT): CT1: low incidence; CT2: moderate incidence; CT3: high incidence; CT4: very high incidence.

Central Java 40 35 CT 2 (20 - <50) 30 25 20

15 Case Case incidence 10 CT 1 (<20) 5

11/05 - 17/05 - 11/05 13/09 - 07/09 11/10 - 05/10 07/02 - 01/02 13/04 - 13/04 19/04 - 20/04 26/04 - 27/04 03/05 - 04/05 10/05 - 18/05 24/05 - 25/05 31/05 - 01/06 07/06 - 08/06 14/06 - 15/06 21/06 - 22/06 28/06 - 29/06 05/07 - 06/07 12/07 - 13/07 19/07 - 20/07 26/07 - 27/07 02/08 - 03/08 09/08 - 10/08 16/08 - 17/08 23/08 - 24/08 30/08 - 31/08 06/09 - 14/09 20/09 - 21/09 27/09 - 28/09 04/10 - 12/10 18/10 - 19/10 25/10 - 26/10 01/11 - 02/11 08/11 - 09/11 15/11 - 16/11 22/11 - 23/11 29/11 - 30/11 06/12 - 07/12 13/12 - 14/12 20/12 - 21/12 27/12 - 28/12 03/01 - 04/01 10/01 - 11/01 17/01 - 18/01 24/01 - 25/01 31/01 - 08/02 14/02 - 15/02 21/02 - 22/02 28/02 - 01/03 07/03 - 08/03 14/03 - 15/03 21/03 - 22/03 28/03 - 29/03 04/04 - 05/04 11/04

Fig. 8. Incidence of COVID-19 per 100 000 population per week averaged over a two-week period in Central Java, from 13 April 2020 to 11 April 2021, classified by level of community transmission (CT): CT1: low incidence; CT2: moderate incidence; CT3: high incidence; CT4: very high incidence. Source of data

DI Yogyakarta

70 CT 3 (50 - <150) 60

40 CT 2 (20 - <50) 30

Case Case incidence 20

10 CT 1 (<20)

11/05 - 17/05 - 11/05 14/06 - 08/06 11/10 - 05/10 07/03 - 01/03 13/04 - 13/04 19/04 - 20/04 26/04 - 27/04 03/05 - 04/05 10/05 - 18/05 24/05 - 25/05 31/05 - 01/06 07/06 - 15/06 21/06 - 22/06 28/06 - 29/06 05/07 - 06/07 12/07 - 13/07 19/07 - 20/07 26/07 - 27/07 02/08 - 03/08 09/08 - 10/08 16/08 - 17/08 23/08 - 24/08 30/08 - 31/08 06/09 - 07/09 13/09 - 14/09 20/09 - 21/09 27/09 - 28/09 04/10 - 12/10 18/10 - 19/10 25/10 - 26/10 01/11 - 02/11 08/11 - 09/11 15/11 - 16/11 22/11 - 23/11 29/11 - 30/11 06/12 - 07/12 13/12 - 14/12 20/12 - 21/12 27/12 - 28/12 03/01 - 04/01 10/01 - 11/01 17/01 - 18/01 24/01 - 25/01 31/01 - 01/02 07/02 - 08/02 14/02 - 15/02 21/02 - 22/02 28/02 - 08/03 14/03 - 15/03 21/03 - 22/03 28/03 - 29/03 04/04 - 05/04 11/04 Fig. 9. Incidence of COVID-19 per 100 000 population per week averaged over a two-week period in DI Yogyakarta, from 13 April 2020 to 11 April 2021, classified by level of community transmission (CT): CT1: low incidence; CT2: moderate incidence; CT3: high incidence; CT4: very high incidence. Source of data

8 WHO Indonesia Situation Report - 51 who.int/indonesia

East Java 20 18 16 14 12 10 CT 1 (<20) 8

Case Case incidence 6 4 2

03/08 - 09/08 - 03/08 06/12 - 30/11 03/01 - 28/12 13/04 - 13/04 19/04 - 20/04 26/04 - 27/04 03/05 - 04/05 10/05 - 11/05 17/05 - 18/05 24/05 - 25/05 31/05 - 01/06 07/06 - 08/06 14/06 - 15/06 21/06 - 22/06 28/06 - 29/06 05/07 - 06/07 12/07 - 13/07 19/07 - 20/07 26/07 - 27/07 02/08 - 10/08 16/08 - 17/08 23/08 - 24/08 30/08 - 31/08 06/09 - 07/09 13/09 - 14/09 20/09 - 21/09 27/09 - 28/09 04/10 - 05/10 11/10 - 12/10 18/10 - 19/10 25/10 - 26/10 01/11 - 02/11 08/11 - 09/11 15/11 - 16/11 22/11 - 23/11 29/11 - 07/12 13/12 - 14/12 20/12 - 21/12 27/12 - 04/01 10/01 - 11/01 17/01 - 18/01 24/01 - 25/01 31/01 - 01/02 07/02 - 08/02 14/02 - 15/02 21/02 - 22/02 28/02 - 01/03 07/03 - 08/03 14/03 - 15/03 21/03 - 22/03 28/03 - 29/03 04/04 - 05/04 11/04

Fig. 10. Incidence of COVID-19 per 100 000 population per week averaged over a two-week period in East Java, from 13 April 2020 to 11 April 2021, classified by level of community transmission (CT): CT1: low incidence; CT2: moderate incidence; CT3: high incidence; CT4: very high incidence. Source of data

Banten

20 CT 1 (<20) Case Case incidence 10

27/07 - 02/08 - 27/07 29/11 - 23/11 27/12 - 21/12 13/04 - 13/04 19/04 - 20/04 26/04 - 27/04 03/05 - 04/05 10/05 - 11/05 17/05 - 18/05 24/05 - 25/05 31/05 - 01/06 07/06 - 08/06 14/06 - 15/06 21/06 - 22/06 28/06 - 29/06 05/07 - 06/07 12/07 - 13/07 19/07 - 20/07 26/07 - 03/08 09/08 - 10/08 16/08 - 17/08 23/08 - 24/08 30/08 - 31/08 06/09 - 07/09 13/09 - 14/09 20/09 - 21/09 27/09 - 28/09 04/10 - 05/10 11/10 - 12/10 18/10 - 19/10 25/10 - 26/10 01/11 - 02/11 08/11 - 09/11 15/11 - 16/11 22/11 - 30/11 06/12 - 07/12 13/12 - 14/12 20/12 - 28/12 03/01 - 04/01 10/01 - 11/01 17/01 - 18/01 24/01 - 25/01 31/01 - 01/02 07/02 - 08/02 14/02 - 15/02 21/02 - 22/02 28/02 - 01/03 07/03 - 08/03 14/03 - 15/03 21/03 - 22/03 28/03 - 29/03 04/04 - 05/04 11/04 Fig. 11. Incidence of COVID-19 per 100 000 population per week averaged over a two-week period in Banten, from 13 April 2020 to 11 April 2021, classified by level of community transmission (CT): CT1: low incidence; CT2: moderate incidence; CT3: high incidence; CT4: very high incidence. Source of data

9 WHO Indonesia Situation Report - 51 who.int/indonesia

• Test positivity proportion nationwide increased sharply after 23 November and reached a peak of 30.5% in mid-February. Subsequently, the positivity proportion declined and stood at 11.8% on 11 April (Fig. 12). However, the percentage of positive samples can be interpreted reliably only with comprehensive surveillance and testing in the order of one person tested per 1000 population per week. This minimum case detection benchmark was achieved in DKI Jakarta, DI Yogyakarta, and Banten for the last three weeks, but none of these provinces had a test positivity proportion of less than 5% (Fig. 13).

40%

35% CT 4 (20%+) 30%

25%

20%

CT 3 (5% - <20%)

15% Positivity Positivity proportion(%)

10%

5% CT 2 (2% - <5%) CT 1 (<2%) 0% 1-May 1-Jun 1-Jul 1-Aug 1-Sep 1-Oct 1-Nov 1-Dec 1-Jan 1-Feb 1-Mar 1-Apr

Fig. 12. Test positivity proportion averaged over a two-week period at the national level in Indonesia, as of 11 April 2021, classified by level of community transmission (CT): CT1: low incidence; CT2: moderate incidence; CT3: high incidence; CT4: very high incidence. Source of data Disclaimer: Caution should be exercised when interpreting this indicator due to limitations listed in the WHO interim guidance. Other epidemiological indicators also need to be evaluated to determine the level of community transmission.

10 WHO Indonesia Situation Report - 51 who.int/indonesia 8.00 55.0% 50.0% 7.00 45.0% 6.00 40.0% 5.00 35.0% 30.0% 4.00 25.0% 3.00 20.0% 2.00 15.0%

10.0% Positivity proportion(%) 1.00 5.0%

People People tested/1000 population/week - 0.0% 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 Indonesia DKI West Central DI Yogyakarta East Banten Jakarta Java Java Java

People tested/1000 population/week Test positivity proportion 8.00 55.0% 50.0% 7.00 45.0% 6.00 40.0% 5.00 35.0% 30.0% 4.00 25.0% 3.00 20.0% 2.00 15.0%

10.0% Positivity proportion(%) 1.00 5.0%

People People tested/1000 population/week - 0.0% 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 Indonesia West East West Riau Central South Southeast Sumatra Kalimantan Papua Kalimantan Sumatra Sulawesi

People tested/1000 population/week Test positivity proportion

Fig. 13. Test positivity proportion and people tested per 1000 population per week at the national level and in select provinces.

Week 1: 22/03/21 to 28/03/21; Week 2: 29/03/21 to 04/01/21; Week 3: 05/04/21 to 11/04/21 Benchmark: one person tested per 1000 population per week Threshold test positivity proportion: <5% Source of data: Indonesia, DKI Jakarta, West Java, Central Java, DI Yogyakarta, East Java, Banten, West Sumatra, East Kalimantan, West Papua, Riau, Central Kalimantan, South Sumatra, Southeast Sulawesi

Note: Due to a limitation in data, other provinces could not be evaluated. For surveillance purposes, test positivity proportion is calculated as the number of confirmed cases divided by the number of people tested for diagnosis.

11 WHO Indonesia Situation Report - 51 who.int/indonesia

• During the week of 5 to 11 April, Banten had the highest weekly number of confirmed COVID-19 deaths per 100 000 population, followed by East Kalimantan, Bali, DI Yogyakarta, and Bangka Belitung Islands (Fig. 14).

Banten East Kalimantan Bali DI Yogyakarta Bangka Belitung Islands North Kalimantan DKI Jakarta South Kalimantan East Java Riau West Papua Central Java Central Kalimantan West Java Gorontalo West Sumatra South Sumatra Central Sulawesi Lampung East Nusa Tenggara West Nusa Tenggara Bengkulu Riau Islands West Sulawesi North Sumatra Papua Aceh Jambi Maluku North Sulawesi South Sulawesi Southeast Sulawesi North Maluku West Kalimantan 0.0 0.5 1.0 1.5 2.0 Weekly number of confirmed COVID-19 deaths per 100 000 population

CT 1 (<1) CT 2 (1 - <2) CT 3 (2 - <5) CT 4 (5+)

Fig. 14. Number of confirmed COVID-19 deaths per 100 000 population per week averaged over a two-week period by province in Indonesia during 5 to 11 April 2021, classified by level of community transmission (CT): CT1: low incidence; CT2: moderate incidence; CT3: high incidence; CT4: very high incidence. Source of data

Disclaimer: Based on data availability, only confirmed COVID-19 deaths have been included. As per WHO definition, however, 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. 12 WHO Indonesia Situation Report - 51 who.int/indonesia

• During the week of 5 to 11 April, the number of confirmed COVID-19 deaths was 0.39 per 100 000 population8, compared to 0.36 per 100 000 in the previous week (Fig. 15).

0.8

0.7

0.6

0.5

0.4

0.3

0.2

Deaths Deaths per 000 100 population 0.1

0.0

23/11 - 29/1123/11- 17/0111/01- 07/0301/03- 13/0419/04- 20/0426/04- 27/0403/05- 04/0510/05- 11/0517/05- 18/0524/05- 25/0531/05- 01/0607/06- 08/0614/06- 15/0621/06- 22/0628/06- 29/0605/07- 06/0712/07- 13/0719/07- 20/0726/07- 27/0702/08- 03/0809/08- 10/0816/08- 17/0823/08- 24/0830/08- 31/0806/09- 07/0913/09- 14/0920/09- 21/0927/09- 28/0904/10- 05/1011/10- 12/1018/10- 19/1025/10- 26/1001/11- 02/1108/11- 09/1115/11- 16/1122/11- 30/1106/12- 07/1213/12- 14/1220/12- 21/1227/12- 28/1203/01- 04/0110/01- 18/0124/01- 25/0131/01- 01/0207/02- 08/0214/02- 15/0221/02- 22/0228/02- 08/0314/03- 15/0321/03- 22/0328/03- 29/0304/04- 05/0411/04-

Fig. 15. Number of confirmed COVID-19 deaths per 100 000 population per week averaged over a two-week period in Indonesia, as of 11 April 2021. Source of data

Disclaimer: Based on data availability, only confirmed COVID-19 deaths have been included. As per WHO definition, however, 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. Evaluation of the level of community transmission could not be conducted due to data limitations.

• Out of six provinces in Java, DKI Jakarta, Central Java and Banten showed a consecutive decline over the last three weeks in the number of deaths in confirmed and probable cases (Fig. 16).

8 Weekly mortality of COVID-19 is calculated as the number of COVID-19 deaths per 100 000 population per week averaged over a two-week period. Source of population data 13 WHO Indonesia Situation Report - 51 who.int/indonesia DKI Jakarta 300 West Java 300 250 45 200 142 200 150 59 17 7 100 122 100 218 144 123 90 50 109 56 0 0 21/03/2021 - 29/03/2021 - 05/04/2021 - 21/03/2021 - 29/03/2021 - 05/04/2021 - 28/03/2021 04/04/2021 11/04/2021 28/03/2021 04/04/2021 11/04/2021

Deaths in confirmed cases Deaths in probable cases Deaths in confirmed cases Deaths in probable cases

300 Central Java 38 DI Yogyakarta 36 200 34 287 32 37 100 233 220 30 32 33

0 28 21/03/2021 - 29/03/2021 - 05/04/2021 - 21/03/2021 - 29/03/2021 - 05/04/2021 - 28/03/2021 04/04/2021 11/04/2021 28/03/2021 04/04/2021 11/04/2021

Deaths in confirmed cases Deaths in confirmed cases

Banten 250 East Java 30 200 25 2 2 13 13 150 20 15 100 186 186 24 160 10 19 50 5 12 0 0 21/03/2021 - 29/03/2021 - 05/04/2021 - 21/03/2021 - 29/03/2021 - 05/04/2021 - 28/03/2021 04/04/2021 11/04/2021 28/03/2021 04/04/2021 11/04/2021 Deaths in confirmed cases Deaths in probable cases Deaths in confirmed cases Deaths in probable cases

Fig. 16. Deaths among confirmed COVID-19 cases and probable cases per week over three weeks between 21 March to 11 April 2021 in Java. Source of data: DKI Jakarta, West Java, Central Java, DI Yogyakarta, East Java, Banten

Disclaimer: The data are provisional. There may be a discrepancy in the number of deaths in confirmed COVID-19 cases between national and provincial data sources.

14 WHO Indonesia Situation Report - 51 who.int/indonesia HEALTH OPERATIONS

• As reported on 14 April, the daily number of people tested for COVID-19 was 44 286 and the cumulative number of people tested was 9 104 944 (Fig. 17).

80000 10000000 70000 8000000 60000 50000 6000000 40000 30000 4000000

Daily numberDaily 20000 2000000 10000

0 0 number Cumulative

5-Jan

1-Oct

8-Apr

6-Feb

4-Dec

13-Jul 29-Jul

2-Nov

7-Mar

21-Jan

27-Jun 11-Jun

17-Oct

24-Apr 11-Apr

15-Sep 22-Feb

20-Dec

14-Aug 30-Aug

18-Nov

23-Mar 10-Mar 26-Mar

10-May 26-May Daily number of people tested Cumulative number of people tested

Fig. 17. Daily and cumulative number of people tested for COVID-19 in Indonesia, as of 14 April 2021. Source of data

• As of 14 April, the proportion of people recovered among the total confirmed COVID -19 cases was 90.4% and there were 108 384 active cases (Fig. 18).

200000 100.0 80.0 150000 60.0 100000

40.0 Number

50000 (%) Percentage 20.0

0 0.0

1-Apr

15-Jul 30-Jul

1-May

11-Jan 26-Jan

15-Jun 30-Jun

13-Oct 28-Oct

16-Apr 11-Apr

13-Sep 28-Sep 10-Feb 25-Feb

12-Dec 27-Dec

14-Aug 29-Aug

12-Nov 27-Nov

12-Mar 27-Mar

16-May 31-May Active cases Recovery percentage

Fig. 18. Number of active cases of COVID-19 and recovery percentage in Indonesia, as of 14 April 2021. Source of data

15 WHO Indonesia Situation Report - 51 who.int/indonesia

• The reported number of confirmed COVID-19 cases hospitalized in DKI Jakarta reached a peak of 9888 hospitalized cases on 12 February. The number of hospitalized cases has since decreased to 3321 on 11 April (Fig. 19).

12000 19 19 - 10000

8000

6000

4000

cases hospitalized cases 2000

Number of confirmed COVID ofconfirmed Number

8-Jan

8-Apr

7-Feb

9-Dec

1-Aug

9-Nov

9-Mar

18-Jan 28-Jan

10-Oct 20-Oct 30-Oct

10-Sep 20-Sep 30-Sep 17-Feb 27-Feb

19-Dec 29-Dec

11-Aug 21-Aug 31-Aug

19-Nov 29-Nov

19-Mar 29-Mar

Fig. 19. Number of confirmed COVID-19 cases hospitalized in DKI Jakarta from 1 August 2020 to 11 April 2021. Source of data

Disclaimer: Data from Wisma Atlet are not included.

LABORATORY

• On 3 April, WHO handed over 1000 cold boxes, with an estimated cost of US$ 313 000, to MoH and the National Agency of Drug and Food Control (Badan Pengawas Obat and Makanan (BPOM)). The cold boxes were distributed to the existing COVID-19 referral laboratories across the country and will maintain the condition of specimens prior to testing, especially during transportation to laboratories.

16 WHO Indonesia Situation Report - 51 who.int/indonesia

Figure 20. WHO handed over 1000 cold boxes worth US$ 313 000 to the Ministry of Health and the National Agency of Drug and Food Control (BPOM), on 3 April 2021. Credit: WHO

INFECTION PREVENTION AND CONTROL

• WHO supported the MoH Directorate of Referral Health Services and the National Working Group on Infection, Prevention and Control (IPC) to conduct a virtual ‘National Training of Trainers on IPC for Health Facilities in Indonesia’. The objective of the training was to improve the capacity and knowledge of IPC staff of health facilities to implement the eight core components of IPC9. The trainings were conducted in two batches, from 6 to 9 April 2021. Around 120 participants from referral hospitals (including medical doctors and nurses), National Working Group on IPC and MoH participated in the trainings. WHO highlighted that preventing harm to patients, health workers and visitors from potential infections in healthcare facilities is fundamental to achieve quality care, patient safety and health security as well as to reduce health care-associated infections (HAIs) and antimicrobial resistance (AMR). As an output of the training, it is expected that participants will be able to train or provide technical assistance on IPC to health facilities, in coordination with MoH, Provincial Health Offices (PHOs) and District Health Offices (DHOs).

9 According to the WHO Guidelines on Core Components of Infection Prevention and Control Programmes at the National and Acute Health Care Facility Level, the eight core components of IPC are: (i) IPC programmes, (ii) National and facility level IPC guidelines, (iii) IPC education and training, (iv) Health care-associated infection surveillance, (v) Multimodal strategies for implementing IPC activities, (vi) Monitoring and evaluation and feedback, (vii) Workload, staffing and bed occupancy at the facility level, and (viii) Built environment, materials and equipment for IPC at the facility level. 17 WHO Indonesia Situation Report - 51 who.int/indonesia

Figure 21. WHO presented ‘IPC Core Component 2: Guidelines’ during the virtual ‘National Training of Trainers on IPC for Health Facilities in Indonesia’, organized by WHO from 6 to 9 April 2021. Credit: WHO

RISK COMMUNICATION

• WHO continues to translate important courses designed for key partners and frontline responders into Indonesian, also available on the OpenWHO platform. As of 12 April, 27 098 participants have enrolled in the eight OpenWHO courses available in Indonesian.

Table 1. Number of participants enrolled in the OpenWHO courses that have been translated into Indonesian, as of 12 April 2021.

No. OpenWHO courses Number of participants enrolled Infection Prevention and Control (IPC) for 1. 8185 COVID-19 virus 2. ePROTECT Respiratory Infections 6662 COVID-19: Operational Planning Guidelines 3. and COVID-19 Partners Platform to support 3803

country preparedness and response Introduction to COVID-19: methods for 4. 3410 detection, prevention, response and control COVID-19 vaccination training for health 5. 1348 workers

18 WHO Indonesia Situation Report - 51 who.int/indonesia WHO Clinical Care Severe Acute Respiratory 6. 1293 Infection Training Severe Acute Respiratory Infection (SARI) 7. 1267 Treatment Facility Design Long-term care facilities in the context of 8. 1130 COVID-19

VACCINATION

• As of 12 April, 15 602 574 vaccine doses have been administered to health workers, essential public service workers and older people (above 60 years old) in the national COVID-19 vaccination campaign; 10 280 073 people have received the first dose and 5 322 501 people have received the second dose (Fig. 22).

18000000 16000000 14000000 12000000 10000000 8000000 6000000 4000000 Number vaccinated 2000000

6-Apr 2-Apr 4-Apr 8-Apr

9-Feb 1-Feb 3-Feb 5-Feb 7-Feb

9-Mar 1-Mar 3-Mar 5-Mar 7-Mar

26-Jan 22-Jan 24-Jan 28-Jan 30-Jan

10-Apr 12-Apr

23-Feb 11-Feb 13-Feb 15-Feb 17-Feb 19-Feb 21-Feb 25-Feb 27-Feb

23-Mar 11-Mar 13-Mar 15-Mar 17-Mar 19-Mar 21-Mar 25-Mar 27-Mar 29-Mar 31-Mar

Cumulative 1st dose vaccination Cumulative 2nd dose vaccination

Fig. 22. Cumulative number of vaccine doses administered in Indonesia, from 22 January to 12 April 2021. Source of data

Disclaimer: COVID-19 vaccination started on 13 January. Published data from MoH is available starting from 22 January.

• As of 12 April, the number of health workers who have received the second dose of the COVID-19 vaccine (fully vaccinated) was 1 314 396 (89.5% of the target population of 1 468 764). The number of essential public service workers who have received the first dose of the vaccine was 6 735 239 (38.9% of the targeted 17 327 169); 3 336 070 (19.2% of the target population) have received the second dose of the vaccine. The number of older people who have received the first dose of the vaccine was 2 088 158 (9.7% of the targeted 21 553 118); 672 035 (3.1% of the target population) have received the second dose (Fig. 23).

19 WHO Indonesia Situation Report - 51 who.int/indonesia

Essential public service 6735239 workers 3336070

1455949 Health workers 1314396

2088158 Older people 1st dose 672035 2nd dose

0 1000000 2000000 3000000 4000000 5000000 6000000 7000000

Number of people who have received COVID-19 vaccine Fig. 23. Cumulative number of people who have received COVID-19 vaccine in Indonesia, as of 12 April 2021. Source of data

Disclaimer: COVID-19 vaccination started with health workers on 13 January. The second stage of COVID-19 vaccination started on 17 February, targeting essential public service workers and older people (above 60 years old). Published data from MoH is available starting from 22 January.

• As of 11 April, Bali had the highest coverage of the first dose vaccination administered to health workers, essential public service workers and older people

amongst all provinces, followed by DKI Jakarta, DI Yogyakarta, Riau Islands and East Java. As of the same day, DKI Jakarta had the highest coverage of the second dose vaccination administered to the same priority target groups, followed by DI Yogyakarta, Bali, East Java and Bangka Belitung Islands (Fig. 24).

100% 90% 80% 70% 60% 1st dose 2nd dose 50% 40% 30% 20%

Vaccinationcoverage 10%

Bali

Riau

Aceh

Jambi

Papua

Banten

Maluku

EastJava

Lampung

Bengkulu

West Java West

Gorontalo

Riau Island Riau

DKI Jakarta DKI

West Papua West

Central Java Central

DI Yogyakarta DI

NorthMaluku

West Sulawesi West

Bangka Belitug Bangka

South Sulawesi South

NorthSulawesi

West SumateraWest

EastKalimantan

South Sumatera South

NorthSumatera

Central Sulawesi Central

West Kalimantan West

South Kalimantan South

NorthKalimantan

Central Kalimantan Central

SoutheastSulawesi

East Nusa Tenggara EastNusa West NusaTenggara West

Fig. 24. COVID-19 vaccination coverage of health workers, essential public service workers and older people by province in Indonesia, as of 11 April 2021. Source of data

20 WHO Indonesia Situation Report - 51 who.int/indonesia

PARTNER COORDINATION

• The overall funding request for WHO operations and technical assistance is US$ 46 million (US$ 27 million for response and US$ 19 million for recovery phase), based on estimated needs as of April 2021 (Fig. 25).

Fig. 25. WHO funding situation for COVID-19 response, April 2021.

Data presented in this situation report have been taken from publicly available data from the MoH (https://infeksiemerging.kemkes.go.id/), COVID-19 Mitigation and National Economic Recovery Team (KPCPEN) (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.

21 WHO Indonesia Situation Report - 51 who.int/indonesia RECENT AND UPCOMING WHO RESOURCE MATERIALS

Table 2: Title and details of recent WHO resource materials Source: https://www.who.int/

Title Details Reducing public To reduce the public health risks associated with the sale of health risks live wild animals for food in traditional food markets, WHO, the associated with the World Organization of Animal Health (OIE) and United Nations sale of live wild Environment Programme (UNEP) have issued guidance on animals of actions that national governments should consider adopting mammalian species urgently with the aim of making traditional markets safer and in traditional food recognizing their central role in providing food and livelihoods markets (interim for large populations. In particular, WHO, OIE and UNEP call guidance), on national authorities to suspend the trade in live caught wild 12 April 2021 animals of mammalian species for food or breeding purposes and close sections of food markets selling such product as an emergency measure.

Episode 33 of WHO Head of Clinical Care Dr Janet Diaz explains and Science in 5, WHO’s answers questions around medical oxygen as an essential series of medicine in the treatment of COVID-19. conversations in science, 9 April 2021

Safe Ramadan This document is an update to the document of the same title practices in the that was published by WHO on 15 April 2020. Updates reflect context of COVID-19 the latest guidance on COVID-19 published by WHO since (interim guidance), then, with focus on areas of transmission of SARS-CoV-2, 7 April 2021 critical preparedness, PHSM/precautionary measures, ventilation, high-risk and vulnerable groups, vaccination and the use of masks. The advice included in this publication has been tailored to the Ramadan context.

Data for action: This guidebook and the associated surveys and qualitative achieving high interview guides were developed by a multi-disciplinary group uptake of COVID-19 of global experts and partners as a branch of an existing expert vaccines (interim group developing similar tools to measure behavioural and guidance), social drivers (BeSD) of childhood vaccination. These tools for 1 April 2021 COVID-19 vaccination are grounded in the overall BeSD group expertise and existing research on vaccine uptake. This guidebook will enable programmes to design, target and evaluate interventions to achieve greater impact with more efficiency and to examine and understand trends over time.

22 WHO Indonesia Situation Report - 51 who.int/indonesia A SNAPSHOT OF WHO COURSES AND INFORMATION MATERIAL

Online WHO COVID-19 courses: • COVID-19 vaccination training for health workers • Standard precautions: Environmental cleaning and disinfection • Management of COVID-19 in long-term care facilities • Operational planning guidelines and COVID-19 • Clinical management of severe acute respiratory infections • Health and safety briefing for respiratory diseases – eProtect

WHO guidance: • WHO COVID-19 infection prevention and control (IPC) pillar - achievements. February 2020 - January 2021 (meeting report draft) • Therapeutics and COVID-19: living guideline

Infographics: • Contact tracing • COVID-19 new variants • COVID-19 vaccines and vaccination • The truth about COVID-19 vaccines • Quarantine and self-monitoring • COVID-19 tests

Questions and answers: • COVID-19: Vaccines • COVID-19: Vaccine research and development • COVID-19: Vaccine access and allocation • How are vaccines developed?

Videos: • Science in 5: Evolution of the SARS-CoV-2 virus • Time to abide (1-10) • Hand sanitizer routine • COVID-19 virus variants

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

23 WHO Indonesia Situation Report - 51 who.int/indonesia