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Coronavirus Disease 2019 (COVID-19) World Health CoronavirusCoronavirus Disease Disease 2019 2019 (COVID (COVID-19) -19) World Health OrganizationOrganization Situation Report - 56 Situationn Report - 7 Indonesia

26 MayData 2021 as of 07 May 2020

HIGHLIGHTS

• As of 26 May, the Government of Indonesia reported 1 791 221 (5034 new) confirmed cases of COVID-19, 49 771 (144 new) deaths and 1 645 263 recovered cases from 510 districts across all 34 provinces.1

• WHO supported the Ministry of Health to conduct contact tracing training for staff of community health centres (puskesmas) in East from 18 to 21 May (page 14).

• On 18 and 19 May, WHO organized a global consultative meeting on COVID-19 Intra-Action Review, which included experiences from Indonesia (page 17).

Fig. 1. Geographic distribution of cumulative number of confirmed COVID-19 cases in Indonesia across the provinces reported from 20 to 26 May 2021. Source of data

Disclaimer: Data are not available for province for this time period due to internet connectivity issues2. 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 2 https://www.cnnindonesia.com/nasional/20210519005740-20-644032/internet-mati-di-papua-ganggu-rekap- data-covid-19-vaksinasi 1 WHO Indonesia Situation Report - 56 who.int/indonesia GENERAL UPDATES

• On 23 May, the National COVID-19 Task Force (Satuan Tugas (Satgas)) announced that four provinces had seen an increase of over 50% in the hospital bed occupancy rate (BOR). As of 22 May, the provinces with the highest BOR were North (57.9%), West (57.6%), (52.8%) and (51.1%). In addition, Satgas reported that the hospital BOR in provinces such as DKI , , and DI Yogyakarta have also started increasing.3

• Indonesia is set to kick off the third phase of its national COVID-19 vaccination programme in June 2021. The third phase of the vaccination will mainly target vulnerable populations, including people with disabilities. On 20 May, the Ministry of Health (MoH) spokesperson for COVID-19 vaccination stated that the third phase of vaccination will prioritize around 250 000 persons with disabilities.4

• During a press conference on 20 May, the Minister of Education, Culture, Research and Technology reported that around 23% of 4.5 million teachers in Indonesia have received their COVID-19 vaccines. The Minister stated that the vaccination coverage is still relatively low due to the limited availability of vaccine stock. However, he stated that the government will continue to improve vaccination in order to reopen schools for the new term in July 2021.5

• On 20 May, the MoH spokesperson for COVID-19 vaccination stated that the distribution of only one out of the forty batches of AstraZeneca COVID-19 vaccine from the COVAX Facility has been suspended. She emphasized that the remaining batches are safe to be used. The CTMAV547 batch that was suspended for distribution, comprised of around 448 000 doses, was part of the 3.8 million doses that arrived in Indonesia in late April 2021. The National Agency of Drug and Food Control (Badan Pengawas Obat dan Makanan (BPOM)) is conducting further tests of the vaccines from this batch to ensure safety before rollout can resume.6

3 https://en.tempo.co/read/1465173/covid-19-task-force-sees-rise-in-hospital-bed-occupancy 4 https://en.tempo.co/read/1464389/covid-19-vaccination-for-people-with-disability-to-start-next-month 5 https://www.antaranews.com/berita/2166262/23-persen-guru-di-indonesia-sudah-divaksin-covid-19 6 https://jakartaglobe.id/special-updates/it-is-safe-rollout-for-39-astrazeneca-batches-continues-in-indonesia 2 WHO Indonesia Situation Report - 56 who.int/indonesia SURVEILLANCE

• On 26 May, 5034 new and 1 791 221 cumulative confirmed COVID-19 cases were reported nationwide (Fig. 2). The average for the last seven days from 20 to 26 May was 5446 cases per day, compared to 3557 cases per day reported in the previous week.

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12-Nov 27-Nov

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16-May 31-May 11-May 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 26 May 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 - 56 who.int/indonesia • During the week of 17 to 23 May, the provinces that experienced an increase in the number of weekly cases of more than 50% compared to the previous week were (575%), South (203%), (134%), (117%), North (113%), (112%), (95%), West Sumatra (88%), (73%), (68%) and (56%) (Fig. 3). It is critical to investigate reasons for the increase in new confirmed cases to guide response decisions and inform the adjustment of public health and social measures (PHSM).

North Kalimantan Aceh Gorontalo West Nusa Tenggara Bengkulu West Sumatra South Kalimantan Bangka Belitung Islands Central Kalimantan West Java DI Yogyakarta DKI Jakarta Central Java Riau Maluku -100% 0% 100% 200% 300% 400% 500% 600% 700% Percentage change of weekly number of confirmed cases

Fig. 3. Percentage change of weekly number of confirmed cases by province during 17 to 23 May 2021 compared to the previous week. Source of data

Disclaimer: Data are not available for Papua province for this time period due to internet connectivity issues2. The number of weekly confirmed cases is calculated taking into consideration the daily number of reported cases. It is important to conduct further investigation if there is a substantial change in new cases, especially in provinces with a change of 50% or more. Other factors, such as testing and contact tracing, may help elucidate the reasons behind substantial changes. Additional indicators, including case incidence and mortality, should be considered to guide adjustment of PHSM. 4 WH O Indonesia Situation Report - 56 who.int/indonesia

• During the week of 17 to 23 May, the incidence7 of COVID-19 in Indonesia decreased to 11.3 per 100 000 population, compared to 12.5 per 100 000 in the previous week (Fig. 4).

35

30

CT2 (20 - <50) 25

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28/09 - 04/1028/09- 13/0419/04- 27/0403/05- 11/0517/05- 25/0531/05- 08/0614/06- 22/0628/06- 06/0712/07- 20/0726/07- 03/0809/08- 17/0823/08- 31/0806/09- 14/0920/09- 12/1018/10- 26/1001/11- 09/1115/11- 23/1129/11- 07/1213/12- 21/1227/12- 04/0110/01- 18/0124/01- 01/0207/02- 15/0221/02- 01/0307/03- 15/0321/03- 29/0304/04- 12/0418/04- 26/0402/05- 10/0516/05-

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 23 May 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 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 - 56 who.int/indonesia

• During the week of 17 to 23 May, the incidence of COVID-19 per 100 000 population was 64.1 in Bangka Belitung Islands, 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 number of locally acquired, widely dispersed cases was detected in the past 14 days.

Bangka Belitung Islands Riau Islands Riau DKI Jakarta DI Yogyakarta West Sumatra Central Kalimantan East Kalimantan West Java West Kalimantan Bali Bengkulu Aceh Jambi North Kalimantan South Sumatra South Kalimantan Central Java West Papua East Nusa Tenggara Lampung Central Sulawesi North Sumatra East Java Banten West Nusa Tenggara Maluku South Sulawesi Gorontalo North Maluku North Sulawesi 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. Data are not available for Papua province for this time period due to internet connectivity issues2. Incidence of COVID-19 per 100 000 population per week averaged over a two-week period by province in Indonesia during 17 to 23 May 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 - 56 who.int/indonesia

• During the week of 17 to 23 May, the weekly incidence of COVID-19 increased in Central Java, compared to the incidence in the previous week (Figs. 6 to 11).

DKI Jakarta 240

200 CT4 (150+)

160

120 CT3 (50 - <150)

Case Case incidence 80

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

0

14/09 - 20/09 - 14/09 13/04 - 13/04 19/04 - 27/04 03/05 - 11/05 17/05 - 25/05 31/05 - 08/06 14/06 - 22/06 28/06 - 06/07 12/07 - 20/07 26/07 - 03/08 09/08 - 17/08 23/08 - 31/08 06/09 - 28/09 04/10 - 12/10 18/10 - 26/10 01/11 - 09/11 15/11 - 23/11 29/11 - 07/12 13/12 - 21/12 27/12 - 04/01 10/01 - 18/01 24/01 - 01/02 07/02 - 15/02 21/02 - 01/03 07/03 - 15/03 21/03 - 29/03 04/04 - 12/04 18/04 - 26/04 02/05 - 10/05 16/05 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 23 May 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 40 CT 2 (20 - <50) 35

30 25 20

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

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06/07 - 12/0706/07- 21/0315/03- 13/0419/04- 27/0403/05- 11/0517/05- 25/0531/05- 08/0614/06- 22/0628/06- 20/0726/07- 03/0809/08- 17/0823/08- 31/0806/09- 14/0920/09- 28/0904/10- 12/1018/10- 26/1001/11- 09/1115/11- 23/1129/11- 07/1213/12- 21/1227/12- 04/0110/01- 18/0124/01- 01/0207/02- 15/0221/02- 01/0307/03- 29/0304/04- 12/0418/04- 26/0402/05- 10/0516/05- 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 23 May 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 - 56 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 5 CT 1 (<20)

0

22/06 - 28/0622/06- 07/0301/03- 13/0419/04- 27/0403/05- 11/0517/05- 25/0531/05- 08/0614/06- 06/0712/07- 20/0726/07- 03/0809/08- 17/0823/08- 31/0806/09- 14/0920/09- 28/0904/10- 12/1018/10- 26/1001/11- 09/1115/11- 23/1129/11- 07/1213/12- 21/1227/12- 04/0110/01- 18/0124/01- 01/0207/02- 15/0221/02- 15/0321/03- 29/0304/04- 12/0418/04- 26/0402/05- 10/0516/05- 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 23 May 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

50

40 CT 2 (20 - <50) 30

Case Case incidence 20 10 CT 1 (<20)

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28/09 - 04/1028/09- 10/0104/01- 13/0419/04- 27/0403/05- 11/0517/05- 25/0531/05- 08/0614/06- 22/0628/06- 06/0712/07- 20/0726/07- 03/0809/08- 17/0823/08- 31/0806/09- 14/0920/09- 12/1018/10- 26/1001/11- 09/1115/11- 23/1129/11- 07/1213/12- 21/1227/12- 18/0124/01- 01/0207/02- 15/0221/02- 01/0307/03- 15/0321/03- 29/0304/04- 12/0418/04- 26/0402/05- 10/0516/05- 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 23 May 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 WH O Indonesia Situation Report - 56 who.int/indonesia

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

Case Case incidence 6 4 2

0

14/09 - 20/0914/09- 13/0419/04- 27/0403/05- 11/0517/05- 25/0531/05- 08/0614/06- 22/0628/06- 06/0712/07- 20/0726/07- 03/0809/08- 17/0823/08- 31/0806/09- 28/0904/10- 12/1018/10- 26/1001/11- 09/1115/11- 23/1129/11- 07/1213/12- 21/1227/12- 04/0110/01- 18/0124/01- 01/0207/02- 15/0221/02- 01/0307/03- 15/0321/03- 29/0304/04- 12/0418/04- 26/0402/05- 10/0516/05-

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 23 May 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

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30 CT 2 (20 - <50)

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Case incidence Case 10 CT 1 (<20)

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26/10 - 01/1126/10- 13/0419/04- 27/0403/05- 11/0517/05- 25/0531/05- 08/0614/06- 22/0628/06- 06/0712/07- 20/0726/07- 03/0809/08- 17/0823/08- 31/0806/09- 14/0920/09- 28/0904/10- 12/1018/10- 09/1115/11- 23/1129/11- 07/1213/12- 21/1227/12- 04/0110/01- 18/0124/01- 01/0207/02- 15/0221/02- 01/0307/03- 15/0321/03- 29/0304/04- 12/0418/04- 26/0402/05- 10/0516/05-

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 23 May 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 - 56 who.int/indonesia

• Nationwide test positivity proportion increased sharply after 23 November and reached a peak of 30.5% in mid-February. Subsequently, the positivity proportion declined and stood at 11.7% on 23 May, which is considered as CT3 (high incidence) (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 and DI Yogyakarta for the last three weeks. Nevertheless, these provinces still have a test positivity proportion of more than 5%, which means that transmission is still high in the community (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 1-May

Fig. 12. Test positivity proportion averaged over a two-week period at the national level in Indonesia, as of 23 May 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 - 56 who.int/indonesia

7.00 55.0% 50.0% 6.00 45.0% 5.00 40.0% 35.0% 4.00 30.0% 3.00 25.0% 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

7.00 55.0% 50.0% 6.00 45.0% 5.00 40.0% 35.0% 4.00 30.0% 3.00 25.0% 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: 03/05/21 to 09/05/21; Week 2: 10/05/21 to 16/05/21; Week 3: 17/05/21 to 23/05/21 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 - 56 who.int/indonesia

• During the week of 17 to 23 May, Riau had the highest weekly number of confirmed COVID-19 deaths per 100 000 population, followed by DI Yogyakarta, DKI Jakarta, Bali and Riau Islands (Fig. 14).

Riau DI Yogyakarta DKI Jakarta Bali Riau Islands Bangka Belitung Islands Central Java West Sumatra South Sumatra North Sulawesi Central Kalimantan Aceh East Kalimantan South Kalimantan Lampung East Java West Papua Jambi West Kalimantan Central Sulawesi East Nusa Tenggara West Java West Nusa Tenggara North Sumatra Maluku Banten Southeast Sulawesi Gorontalo North Kalimantan West Sulawesi Bengkulu South Sulawesi North Maluku 0.0 0.2 0.4 0.6 0.8 1.0 1.2 1.4 1.6 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 17 to 23 May 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: Data are not available for Papua province for this time period due to internet connectivity issues2. 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 - 56 who.int/indonesia

• At the national level, during the week of 17 to 23 May, the number of confirmed COVID-19 deaths was 0.43 per 100 000 population8, compared to 0.44 per 100 000 in the previous week (Fig. 15).

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Fig. 15. Number of confirmed COVID-19 deaths per 100 000 population per week averaged over a two-week period in Indonesia, as of 23 May 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.

• During the week of 17 to 23 May, the total number of weekly confirmed COVID-19 deaths in DKI Jakarta was 125, compared to 171 in the previous week (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 - 56 who.int/indonesia DKI Jakarta 350

300 19 19 deaths

- 250

200

150

100

50

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Weekly Weekly number confirmed of COVID

13/04 - 19/0413/04- 06/0931/08- 07/0301/03- 02/0308/03- 16/0322/03- 30/0305/04- 27/0403/05- 11/0517/05- 25/0531/05- 08/0614/06- 22/0628/06- 06/0712/07- 20/0726/07- 03/0809/08- 17/0823/08- 14/0920/09- 28/0904/10- 12/1018/10- 26/1001/11- 09/1115/11- 23/1129/11- 07/1213/12- 21/1227/12- 04/0110/01- 18/0124/01- 01/0207/02- 15/0221/02- 15/0321/03- 29/0304/04- 12/0418/04- 26/0402/05- 10/0516/05-

Fig. 16. Weekly number of confirmed COVID-19 deaths in DKI Jakarta, as of 23 May 2021.Source of data,

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.

• To further strengthen contact tracing activities, MoH collaborated with the Ministry of Education, Culture, Research and Technology to mobilize university students of health-related programmes to be contact tracers. As of 24 May, around 1000 students have been recruited and trained. These students will be deployed to support contact tracing activities in their respective provinces. The assignment will officially start on 1 June, for the duration of three months. Each tracer will be assigned to puskesmas by District Health Officers (DHOs) and will be given access to the ‘Silacak’ application.

• From 18 to 21 May, WHO supported MoH to conduct contact tracing training for staff of community health centres (puskesmas) in East Java. Participants were trained on how to use ‘Silacak’ application to support contact tracing activities. The training was divided into eight sessions and attended by more than 3600 participants from 296 puskesmas of 12 districts in East Java.

• On 20 May, MoH issued a new guideline for COVID-19 testing, tracing, quarantine and isolation. This guideline was updated based on the latest global updates and WHO recommendations on COVID-19.

14 WHO Indonesia Situation Report - 56 who.int/indonesia • Following the report of two COVID-19 variants of concern (VoC) (B.1.351 and B.1.1.7) that were detected in several confirmed COVID-19 cases in Bali, the Governor of Bali province issued a circular letter to district heads and city mayors on 17 May. The letter urged district and city administrators to strengthen testing to identify and isolate COVID-19 cases as soon as possible and to accelerate contact tracing for COVID-19, including the implementation of proper quarantine measures to reduce transmission and control the COVID-19 pandemic. It emphasized the importance of achieving a testing benchmark of 1 per 1000 population per week, at least 25 to 30 close contacts traced per case and performing entry and exit tests as part of quarantine procedure of the national guideline.

HEALTH OPERATIONS

• As reported on 26 May, the daily number of people tested for COVID-19 was 56 318 and the cumulative number of people tested was 10 938 373 (Fig. 17).

80000 12000000 70000 10000000 60000 8000000 50000 40000 6000000 30000

Daily numberDaily 4000000

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14-May 31-May 23-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 26 May 2021. Source of data

15 WHO Indonesia Situation Report - 56 who.int/indonesia • As of 26 May, the proportion of people recovered among the total confirmed COVID-19 cases was 91.9% and there were 96 187 active cases (Fig. 18). 200000 100.0 180000 90.0 160000 80.0 140000 70.0 120000 60.0 100000 50.0

Number 80000 40.0

60000 30.0 (%) Percentage 40000 20.0 20000 10.0

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12-Dec 27-Dec

14-Aug 29-Aug

12-Nov 27-Nov

12-Mar 27-Mar

16-May 31-May 11-May 26-May Active cases Recovery percentage Fig. 18. Number of active cases of COVID-19 and recovery percentage in Indonesia, as of 26 May 2021. Source of data

RISK COMMUNICATION

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

Infographics: - Celebrating Eid al-Fitr

16 WHO Indonesia Situation Report - 56 who.int/indonesia Fig. 19. WHO infographics on Celebrating Eid al-Fitr, May 2021.

RISK AND NEEDS ASSESSMENT, AND PLANNING

• On 18 and 19 May, WHO organized a global consultative meeting and session to share experiences on COVID-19 Intra-Action Review (IAR), attended by more than 60 participants from various Member States. During the session on 18 May, the MoH Coordinator of Emerging Infectious Diseases Programme Dr Endang Budi

Hastuti presented the Indonesia experience and lessons learned from IAR in the country. She highlighted the importance of IAR as a useful tool to bring together multiple sectors to review COVID-19 response to formulate recommendations to improve the overall response to the pandemic.

17 WHO Indonesia Situation Report - 56 who.int/indonesia

Fig. 20. Ministry of Health (MoH) presented the Indonesia experience and lessons learned from Intra-Action Review (IAR) during a WHO global consultative meeting and session to share experiences, on 18 and 19 May 2021. Credit: WHO/Endang Wulandari

• On 19 May, WHO participated in a meeting on health security, organized by MoH. The meeting was attended by more than 70 participants including representatives from Ministry of Foreign Affairs (MoFA), Ministry of Defence, professional organizations and representatives from the United States Centers for Disease Control and Prevention (US CDC). The main objective of the meeting was to discuss priority actions to improve health security in Indonesia. During the meeting, WHO emphasized the need to improve and monitor the implementation of the 13 International Health Regulations (IHR) core capacities9 as well as to mobilize all aspects of the society to improve the whole-of-society approach to pandemic preparedness and response. In addition, WHO highlighted the importance of taking into consideration lessons learned from the COVID-19 pandemic response to improve health security.

VACCINATION

• As of 24 May, 24 826 221 vaccine doses have been administered in the national COVID-19 vaccination campaign; 14 919 592 people have received the first dose and 9 906 629 people have received the second dose (Fig. 21).

9 The 13 International Health Regulations (IHR) core capacities are: (1) Legislation and financing, (2) IHR coordination and National IHR Focal Point functions, (3) Zoonotic events and the human-animal health interface, (4) Food safety, (5) Laboratory, (6) Surveillance, (7) Human resources, (8) National Health Emergency Framework, (9) Health service provision, (10) Risk communication, (11) Points of entry, (12) Chemical events and (13) Radiation emergencies. 18 WHO Indonesia Situation Report - 56 who.int/indonesia

30000000 25000000 20000000 15000000 10000000

5000000 Number vaccinated

0

4-Apr 8-Apr

3-Feb 7-Feb

3-Mar 7-Mar

2-May 6-May

22-Jan 26-Jan 30-Jan

12-Apr 16-Apr 20-Apr 24-Apr 28-Apr

11-Feb 15-Feb 19-Feb 23-Feb 27-Feb

11-Mar 15-Mar 19-Mar 23-Mar 27-Mar 31-Mar

10-May 14-May 18-May 22-May

Cumulative 1st dose vaccination Cumulative 2nd dose vaccination

Fig. 21. Cumulative number of vaccine doses administered in Indonesia, from 22 January to 24 May 2021. Source of data

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

• As of 24 May, the number of health workers who have received the second dose of the COVID-19 vaccine (fully vaccinated) was 1 378 328 (93.8% 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 10 358 645 (59.8% of the targeted 17 327 167); 6 490 766 (37.5% 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 3 037 155 (14.1% of the targeted 21 553 118); 2 036 828 (9.5% of the targeted population) have received the second dose (Fig. 22).

19 WHO Indonesia Situation Report - 56 who.int/indonesia Essential public service 10358645 workers 6490766

1509688 Health workers 1378328

3037155 1st dose Older people 2036828 2nd dose

0 2000000 4000000 6000000 8000000 10000000 12000000 Number of people who have received COVID-19 vaccine Fig. 22. Cumulative number of people who have received COVID-19 vaccine in Indonesia, as of 24 May 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 24 May, the highest coverage of the first dose vaccination administered to eligible target populations in the country was in Bali, followed by DKI Jakarta, DI Yogyakarta, Riau Islands and East Java. As of the same day, Bali had the highest coverage of the second dose vaccination administered, followed by DKI Jakarta, DI Yogyakarta, East Kalimantan and Bangka Belitung Islands (Fig. 23).

180% 160% 140% 120% 100% 80% 60% 40% 20%

Vaccination coverage (%) 0%

Bali

Riau

Aceh

Jambi

Papua

Banten

Maluku

EastJava

Lampung

Bengkulu

West Java West

Gorontalo

DKI Jakarta DKI

Riau Islands Riau

Central Java Central

West Papua West

DI Yogyakarta DI

NorthMaluku

West Sulawesi West

South Sulawesi South

NorthSulawesi

West SumateraWest

NorthSumatera

EastKalimantan

South Sumatera South

Central Sulawesi Central

West Kalimantan West

South Kalimantan South

NorthKalimantan

SoutheastSulawesi

Central Kalimantan Central

East Nusa Tenggara EastNusa

West NusaTenggara West Bangka Belitung Islands Belitung Bangka 1st dose coverage (%) 2nd dose coverage (%) Target Fig. 23. COVID-19 vaccination coverage among the eligible target populations by province in Indonesia, as of 24 May 2021. Source of data

Disclaimer: Vaccination coverage over 100% is due to differences in actual versus estimated target population.

20 WHO Indonesia Situation Report - 56 who.int/indonesia

• As of 24 May, the number of people vaccinated with at least one dose of the vaccine per 100 population nationwide was 5.5. As of the same day, Bali had the highest number of people vaccinated with at least one dose of the vaccine (26.1 per 100 population) amongst all provinces, followed by DKI Jakarta (21.7) (Fig. 24).

<5 5-<10 ≥10

Fig. 24. Number of people vaccinated with at least one dose of the vaccine per 100 population by province in Indonesia, as of 24 May 2021. Source of data

• As of 24 May, DKI Jakarta had the highest coverage of first and second dose vaccination to older people (Fig. 25). As of the same day, provinces with the highest number of unvaccinated older people were West Java, Central Java and East Java (Fig. 26).

100% 90% 80% 70% 60% 50% 40% 30% 20% Vaccination coverage (%) coverage Vaccination 10%

0%

Bali

Riau

Aceh

Jambi

Papua

Banten

Maluku

EastJava

Lampung

Bengkulu

West Java West

Gorontalo

DKI Jakarta DKI

Riau Islands Riau

Central Java Central

West Papua West

DI Yogyakarta DI

NorthMaluku

West Sulawesi West

South Sulawesi South

NorthSulawesi

West SumateraWest

NorthSumatera

EastKalimantan

South Sumatera South

Central Sulawesi Central

West Kalimantan West

South Kalimantan South

NorthKalimantan

SoutheastSulawesi

Central Kalimantan Central

East Nusa Tenggara EastNusa

West NusaTenggara West Bangka Belitung Islands Belitung Bangka 1st dose (coverage) 2nd dose (coverage) Target (coverage) Fig. 25. COVID-19 vaccination coverage of older people by province in Indonesia, as of 24 May 2021. Source of data 21 WH O Indonesia Situation Report - 56 who.int/indonesia

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

0 800,000 1,600,000 2,400,000 3,200,000 4,000,000 4,800,000 Unvaccinated Fig. 26. Number of unvaccinated older people (over 60 years of age) by province in Indonesia, as of 24 May 2021. Source of data

22 WHO Indonesia Situation Report - 56 who.int/indonesia

PARTNER COORDINATION

• On 25 May, WHO participated in the second townhall meeting for UN staff in Indonesia in 2021, which virtually connected over 600 colleagues from UN organizations across the country. The WHO Representative to Indonesia Dr Paranietharan provided updates on the COVID-19 epidemiological situation in the country, status of COVID-19 vaccines within WHO emergency use listing (EUL) evaluation process and SARS-CoV-2 VoC. He reiterated the importance of adhering to personal protective measures for COVID-19 and responded to questions.

• 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 May 2021 (Fig. 27).

Fig. 27. WHO funding situation for COVID-19 response, May 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.

23 WHO Indonesia Situation Report - 56 who.int/indonesia RECENT AND UPCOMING WHO RESOURCE MATERIALS

Table 1: Title and details of recent WHO resource materials Source: https://www.who.int/ Title Details Episode 39 of The WHO Technical Lead for COVID-19 Dr Maria Van Science in 5, WHO’s Kerkhove provides an update on SARS-CoV-2 virus variants. series of conversations in science, 19 May 2021 Preventing and This joint WHO/ILO policy brief provides a summary of the mitigating COVID-19 evidence for transmission of COVID-19 in general workplaces at work (policy brief), and an overview of WHO and ILO recommendations for 19 May 2021 prevention and mitigation of COVID-19 and for protecting health and safety at work in the context of the pandemic. This document is intended for public health and labour authorities, businesses, employers, workers and their representatives at the national, local and workplace levels to facilitate the implementation of public health and social measures for COVID-19 while maintaining productive employment and decent work during the pandemic. COVID-19 Vaccine This is an updated version of the COVID-19 Vaccine Introduction and Introduction and Deployment Costing tool (CVIC tool) that was Deployment Costing published on 20 February. The CVIC tool supports credible tool (CVIC tool), COVID-19 vaccination costing to facilitate a dialogue with 14 May 2021 stakeholders, while maintaining sensitivity to protect essential health services. Health worker The ‘Health Worker Communication for COVID-19 Vaccination communication for Flow Diagram’ supports health workers by outlining key steps COVID-19 and messages to communicate during a COVID-19 vaccination vaccination flow session. diagram, 13 May 2021 Programmatic To avoid a reversal of progress towards eliminating innovations to tuberculosis (TB), new knowledge and lessons from successful address challenges programmatic innovations are urgently needed to improve TB in tuberculosis prevention and care in the context of the pandemic. To support prevention and care evidence-based adaptation of TB services to the context during the COVID-19 created by the pandemic, WHO Global TB Programme pandemic, 13 May therefore established a compendium of resources on TB and 2021 COVID-19, which comprises a list of research projects on TB and COVID-19 in various countries reported to WHO by the investigators and an inventory of peer-reviewed or preprint

24 WHO Indonesia Situation Report - 56 who.int/indonesia manuscripts that describe the impact of the pandemic on epidemiological, clinical and laboratory perspectives of TB. Continuity of The ‘Continuity of essential health services: Facility essential health Assessment Tool’ can be used by countries to rapidly assess services: Facility the capacity of health facilities to maintain the provision of assessment tool essential health services during the COVID-19 pandemic. It (interim guidance), can help to alert the authorities and stakeholders about where 12 May 2021 service delivery and utilization may require modification and/or investment. This tool can be used in multiple types of health facilities. It can be used on a one-time basis to provide a rapid snapshot of current service capacity, or on a regular basis for tracking and monitoring the continuity of essential health services during the different phases of the pandemic. COVID-19 natural This scientific brief replaces the WHO Scientific Brief entitled immunity (scientific ‘Immunity passports in the context of COVID-19’, published on brief), 10 May 2021 24 April 2020. This update focuses on what is currently understood about SARS-CoV-2 immunity from natural infection. More information about considerations on vaccine certificates or ‘passports’ will be covered in an update of WHO interim guidance. Interim These WHO interim recommendations for use of the COVID-19 recommendations for vaccine BIBP were developed on the basis of advice issued by use of the inactivated the Strategic Advisory Group of Experts on Immunization COVID-19 vaccine (SAGE) and the evidence summary included in the BIBP developed by Background document on the inactivated COVID-19 vaccine China National BIBP developed by China National Biotec Group (CNBG) and Biotec Group GRADE and ETR tables. These interim recommendations refer (CNBG), Sinopharm to the inactivated COVID-19 vaccine (Vero cell) manufactured - Interim guidance, by the Beijing Institute of Biological Products Co., Ltd (BIBP), 7 May 2021 a subsidiary of the China National Biotec Group (CNBG).

25 WHO Indonesia Situation Report - 56 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: • COVID-19 home care bundle for healthcare workers • Estimating COVID-19 vaccine effectiveness against severe acute respiratory infections (SARI) hospitalizations associated with laboratory-confirmed SARS-CoV-2: an evaluation using the test-negative design • WHO Information Note: COVID-19 considerations for tuberculosis (TB) care

Infographics: • Self-isolation • How to make a fabric mask • Religious celebration • Contact tracing • COVID-19 new variants

Questions and answers: • COVID-19: Vaccines • COVID-19: Vaccine research and development • COVID-19: Vaccine access and allocation

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

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

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