Situation Report 49

Home , Bio Farma, Java, Maluku (province), Sulawesi

Coronavirus Disease 2019 (COVID-19) World Health CoronavirusCoronavirus Disease Disease 2019 2019 (COVID (COVID-19) -19) World Health OrganizationOrganization Situation Report - 49 Situation Report - 7 Indonesia Indonesia

31 MarchData 2021as of 07 May 2020

HIGHLIGHTS

• As of 31 March, the Government of Indonesia reported 1 511 712 (5937 new) confirmed cases of COVID-19, 40 858 (104 new) deaths and 1 348 330 recovered cases from 510 districts across all 34 provinces.1

• WHO continues to support the National Institute of Health Research and Development to strengthen quality assurance systems in COVID-19 testing laboratories (page 16).

• WHO supported the Ministry of Health to review the implementation of the Indonesian Electronic Health Alert Card (eHAC) and conduct a refresher training on eHAC application in East Java (page 17).

Fig. 1. Geographic distribution of cumulative number of confirmed COVID-19 cases in Indonesia across the provinces reported from 25 to 31 March 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 - 49 who.int/indonesia GENERAL UPDATES

• State-owned pharmaceutical company, Bio Farma, announced that it had distributed 5000 vials of AstraZeneca COVID-19 vaccine to each province, namely DKI Jakarta, North Sulawesi and Riau Islands on 29 March. Previously, the company distributed 45 000 vials of the vaccine to East Java. Each vial consists of 10 doses. The spokesperson of Bio Farma said that the Ministry of Health (MoH) had instructed the company to distribute AstraZeneca COVID-19 vaccines to several provinces including Bali, DKI Jakarta, East Nusa Tenggara, North Sulawesi and Riau Islands. The company is awaiting further instructions from MoH on the distribution of the remaining vials.2

• On 27 March, the Minister of Health stated that Indonesia will ration its vaccine use in response to expected delays in the shipments of AstraZeneca COVID-19 vaccine from the COVAX Facility and a slowdown in the production of Sinovac vaccine manufactured by Bio Farma. Initially, Indonesia was expected to receive a shipment of 10 million doses of AstraZeneca vaccine in March and April. In addition, the Minister said that the country would only have around 7.6 million ready-to-use Sinovac vaccines manufactured by Bio Farma available in April 2021.3

• During a virtual press conference on 27 March, the Minister of Health said that COVID-19 vaccination for those aged 60 years and above has been rolled out slower than expected. He mentioned that the low vaccination rate in this priority group is due to several reasons, including vaccine hesitancy and limited mobility. To address this issue, MoH is considering several options to ensure easier access for older populations to receive their vaccination and boost national vaccination coverage.4

• On 26 March, the Coordinating Minister for Human Development and Cultural Affairs announced that the Government will ban the Eid al-Fitr tradition of mudik (returning to hometowns for Eid) in 2021. The ban is intended to prevent a spike in COVID-19 transmission and deaths after the holiday. Furthermore, he explained that the ban is effective for civil servants, military personnel, police and the general public. In addition, regulations specifying the mobility restrictions during the ban will be issued by related authorities after coordinating with the National COVID-19 Task Force.5

2 https://www.thejakartapost.com/paper/2021/03/25/following-mui-fatwa-astrazeneca-jabs-sent-to-regions.html 3 https://www.thejakartapost.com/paper/2021/03/28/indonesia-slows-down-vaccine-rollout-amid-delayed- supplies.html 4 https://nasional.kompas.com/read/2021/03/27/23254081/menkes-vaksinasi-covid-19-untuk-lansia-di-beberapa- provinsi-masih-rendah 5 https://www.thejakartapost.com/paper/2021/03/28/govt-to-ban-idul-fitri-exodus-again-this-year.html 2 WHO Indonesia Situation Report - 49 who.int/indonesia SURVEILLANCE

• On 31 March, 5937 new and 1 511 712 cumulative confirmed COVID-19 cases were reported nationwide (Fig. 2). The average for the last seven days from 25 to 31 March was 5037 per day, compared to 5596 cases per day reported in the previous week.

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Fig. 2. Daily and cumulative number of cases reported in Indonesia, as of 31 March 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 - 49 who.int/indonesia • During the week of 22 to 28 March, the provinces of Maluku, Riau Islands, Aceh, North Sulawesi and South Sumatra 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 new confirmed cases to guide decisions on response activities and inform the adjustment of public health and social measures (PHSM).6

Maluku Riau Islands Aceh North Sulawesi South Sumatra Central Sulawesi Jambi South Kalimantan Riau North Kalimantan West Sumatra Central Kalimantan Papua Gorontalo DI Yogyakarta North Sumatra Bengkulu East Java Bali Lampung Bangka Belitung Islands East Kalimantan West Nusa Tenggara DKI Jakarta West Java Central Java West Papua West Kalimantan Banten East Nusa Tenggara South Sulawesi North Maluku Southeast Sulawesi West Sulawesi -100% -50% 0% 50% 100% 150% Percentage change of weekly number of confirmed cases Fig. 3. Percentage change of weekly number of confirmed cases by province during 22 to 28 March 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 - 49 who.int/indonesia • During the week of 22 to 28 March, the incidence7 of COVID-19 in Indonesia was 14.4 per 100 000 population, compared to 15.2 per 100 000 in the previous week (Fig. 4).

CT2 (20 - <50) 25

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27/04 - 03/0527/04- 29/1123/11- 13/0419/04- 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- 26/1001/11- 09/1115/11- 07/1213/12- 21/1227/12- 04/0110/01- 18/0124/01- 01/0207/02- 15/0221/02- 01/0307/03- 15/0321/03-

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 28 March 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 - 49 who.int/indonesia

• During the week of 22 to 28 March, the incidence of COVID-19 per 100 000 population was 92.1 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 East Kalimantan North Kalimantan Bangka Belitung Islands DI Yogyakarta South Kalimantan Central Kalimantan Bali West Papua Banten West Java East Nusa Tenggara Papua Riau West Sumatra Central Java Central Sulawesi Gorontalo South Sulawesi West Kalimantan North Maluku Bengkulu East Java Riau Islands West Nusa Tenggara Jambi South Sumatra North Sumatra Maluku Lampung North Sulawesi Southeast Sulawesi West Sulawesi Aceh 0.0 50.0 100.0 150.0 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 22 to 28 March 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 - 49 who.int/indonesia • The weekly incidence of COVID-19 decreased in all provinces in Java Island except DI Yogyakarta and Banten during the week of 22 to 28 March compared to the previous week (Fig. 6 to 11).

DKI Jakarta 240

200 CT4 (150+)

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06/07 - 12/07 - 06/07 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 - 20/07 26/07 - 03/08 09/08 - 17/08 23/08 - 31/08 06/09 - 14/09 20/09 - 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 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 28 March 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)

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

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 28 March 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 - 49 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

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 - 14/09 20/09 - 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 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 28 March 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

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10 CT 1 (<20)

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 - 14/09 20/09 - 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 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 28 March 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 - 49 who.int/indonesia

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

Case Case incidence 6 4 2

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

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 28 March 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 18 16 14 12 10 CT 1 (<20) 8

Case Case incidence 6 4 2

27/04 - 03/0527/04- 09/0803/08- 15/1109/11- 13/0419/04- 11/0517/05- 25/0531/05- 08/0614/06- 22/0628/06- 06/0712/07- 20/0726/07- 17/0823/08- 31/0806/09- 14/0920/09- 28/0904/10- 12/1018/10- 26/1001/11- 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-

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 28 March 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 - 49 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 12.8% on 28 March (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).

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Fig. 12. Test positivity proportion averaged over a two-week period at the national level in Indonesia, as of 28 March 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 - 49 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%

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People tested/1000 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: 08/03/21 to 14/03/21; Week 2: 15/03/21 to 21/03/21; Week 3: 22/03/21 to 28/03/21 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 - 49 who.int/indonesia

• During the week of 22 to 28 March, DKI Jakarta had the highest weekly number of confirmed COVID-19 deaths per 100 000 population, followed by Bali, East Kalimantan, North Kalimantan, and Bangka Belitung Islands (Fig. 14).

DKI Jakarta Bali East Kalimantan North Kalimantan Bangka Belitung Islands DI Yogyakarta South Kalimantan East Java Central Java Central Sulawesi West Java Banten Lampung East Nusa Tenggara Riau West Papua Gorontalo Central Kalimantan North Maluku South Sumatra West Sumatra Riau Islands South Sulawesi Papua North Sumatra Maluku Bengkulu West Sulawesi Southeast Sulawesi West Nusa Tenggara Aceh Jambi North Sulawesi West Kalimantan 0.0 0.5 1.0 1.5 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 22 to 28 March 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 - 49 who.int/indonesia

• During the week of 22 to 28 March, the number of confirmed COVID-19 deaths was 0.38 per 100 000 population8, compared to 0.42 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 28 March 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, only DKI Jakarta 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 - 49 who.int/indonesia 400 DKI Jakarta 300 West Java 45 300 80 200 15 6 200 171 142 100 203 197 218 100 236 134 144 0 0 08/03/2021 - 15/03/2021 - 22/03/2021 - 08/03/2021 - 15/03/2021 - 22/03/2021 - 14/03/2021 21/03/2021 28/03/2021 14/03/2021 21/03/2021 28/03/2021

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300 Central Java 40 DI Yogyakarta

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250 East Java 50 Banten 200 9 40 19 1 13 150 30 1 2 100 176 197 20 38 160 31 50 10 24 0 0 08/03/2021 - 15/03/2021 - 22/03/2021 - 08/03/2021 - 15/03/2021 - 22/03/2021 - 14/03/2021 21/03/2021 28/03/2021 14/03/2021 21/03/2021 28/03/2021 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 8 to 28 March 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 - 49 who.int/indonesia HEALTH OPERATIONS

• As reported on 31 March, the daily number of people tested for COVID-19 was 45 714 and the cumulative number of people tested was 8 490 864 (Fig. 17).

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Fig. 17. Daily and cumulative number of people tested for COVID-19 in Indonesia, as of 31 March 2021. Source of data

• As of 31 March, the proportion of people recovered among the total confirmed COVID -19 cases was 89.2% and there were 122 524 active cases (Fig. 18).

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

15 WHO Indonesia Situation Report - 49 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 3830 on 28 March (Fig. 19).

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18-Mar 28-Mar Fig. 19. Number of confirmed COVID-19 cases hospitalized in DKI Jakarta from 1 July 2020 to 28 March 2021. Source of data

Disclaimer: Data from Wisma Atlet are not included.

LABORATORY

• WHO continues to support the National Institute of Health Research and Development (NIHRD) to strengthen quality assurance systems in COVID-19 testing laboratories (more information can be found in WHO Situation Report 34 (pages 14 to 16) and Situation Report 37 (page 16)). A total of 177 COVID-19 polymerase chain reaction (PCR) testing laboratories participated in the first phase of the External Quality Assessment (EQA), which was supported by the Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP), United States Agency for International Development (USAID) and WHO. The submission of EQA results was finalized on 15 March. From 24 to 26 March, WHO supported NIHRD to conduct supportive supervision visits to several laboratories identified based on the preliminary analysis of the EQA results. The visit was conducted to identify possible causes of problems in laboratory practices and to provide recommendations for corrective actions. Continuous supervision and technical assistance will be provided to underperforming laboratories to improve their quality management systems to reach the national standards.

16 WHO Indonesia Situation Report - 49 who.int/indonesia 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:

Videos: - Science in 5: Evolution of the SARS-CoV-2 virus

RISK AND NEEDS ASSESSMENT, AND PLANNING

• On 29 March, WHO supported MoH to conduct a training on contact tracing and use of selected indicators to guide the adjustment of PHSM for East Kalimantan. A total of 38 participants from the provincial health office (PHO) and district health offices (DHOs) participated in the training.

• On 27 March, WHO participated in a meeting organized by MoH to discuss a strategy and action plan to respond to the surge of COVID-19 cases in communities living around ground crossings between Papua province of Indonesia and Papua New Guinea. Several actions to improve and strengthen the response in Papua were recommended, including: (i) mobilizing resources to improve testing (including provision of PCR reagents and antigen-detecting rapid diagnostic tests (Ag-RDTs) and increasing human resources for laboratory testing); (ii) strengthening contact tracing activities by involving multiple stakeholders (including armed forces, Indonesian Red Cross Society, universities, and professional organizations); and (iii) accelerating vaccination to improve vaccine coverage. In addition, the meeting concluded that there is a need to increase hospital bed capacity in the province to be prepared for the surge of cases.

• On 25 March, WHO supported MoH to conduct a virtual session to review the implementation of the Electronic Health Alert Card (eHAC) in East Java and provide a refresher training on the eHAC application. The review found that not all districts in the province have access to the application to keep track of travellers. In addition, the number of travellers who have completed the eHAC remains relatively low. MoH will continue to improve the implementation of eHAC to support screening of travellers and contact tracing efforts.

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Fig. 20. A virtual meeting to review the implementation of the Electronic Health Alert Card (eHAC) in East Java, organized by the Ministry of Health on 25 March 2021. Credit: WHO/Endang Wulandari

VACCINATION

• As of 29 March, 10 766 490 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; 7 435 851 people have received the first dose and 3 330 639 people have received the second dose (Fig. 21). 12000000

10000000

8000000

6000000

4000000

Number vaccinated 2000000

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

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

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

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

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

Cumulative 1st dose vaccination Cumulative 2nd dose vaccination Fig. 21. Cumulative number of vaccine doses administered in Indonesia, from 22 January to 29 March 2021. Source of data

Disclaimer: COVID-19 vaccination started on 13 January. Published data from MoH is available starting from 22 January. 18 WHO Indonesia Situation Report - 49 who.int/indonesia

• As of 29 March, the number of health workers who have received the second dose of the COVID-19 vaccine (fully vaccinated) was 1 275 981 (86.9% 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 4 549 721 (26.3% of the targeted 17 327 169); and the number of older people who have received the first dose of the vaccine was 1 453 977 (6.8% of the targeted 21 553 118) (Fig. 22).

Essential public service 4549721 workers 1936112

1432153 Health workers 1275981

1st dose 1453977 Older people 2nd dose 118546

0 500000 1000000 1500000 2000000 2500000 3000000 3500000 4000000 4500000 5000000 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 29 March 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.

CONTINUITY OF ESSENTIAL HEALTH SERVICES

• To commemorate World Tuberculosis (TB) Day on 24 March, MoH organized a virtual event in collaboration with the Office of the Vice President and the Coordinating Ministry for Human Development and Cultural Affairs. Adapted from the global theme of World TB Day 2021 “The Clock is Ticking”, the theme of the national commemoration was “Every Second is Precious, Save the Nation from Tuberculosis”. The theme was intended to remind relevant stakeholders and the public that focusing on TB elimination efforts despite the COVID-19 pandemic still remains critical. During the event, the Vice President highlighted the importance of strengthening the national commitment and collective efforts in the fight against TB. The Director of the WHO Global TB Programme Dr Tereza Kasaeva attended the session and showed her appreciation for Indonesia’s efforts against TB during the pandemic. 19 WHO Indonesia Situation Report - 49 who.int/indonesia

Fig. 23. Infographics from the World Tuberculosis (TB) Day 2021 campaign with the global theme “The Clock is Ticking”, May 2021. Credit: WHO

• During a virtual event to commemorate World TB Day organized by WHO on 24 March, the Minister of Health delivered a speech reiterating Indonesia’s commitment towards TB elimination by 2030. Indonesia’s three main strategies to improve TB notification and treatment include: (i) advancing TB screening, diagnosis and treatment; (ii) ensuring the availability and continuity of essential TB services for all Indonesian citizens; and (iii) ameliorating a multisectoral collaboration in the fight against TB. In line with the joint movement to end TB which was declared by President Joko Widodo in 2020, Indonesia is aiming to reduce TB incidence to 219 per 100 000 population and TB mortality to 27 per 100 000 population by 2024.

• On 24 March, the National TB Programme launched a new application called “Dashboard TB Indonesia”. The application intends to provide a platform for health officers and stakeholders to easily and swiftly monitor the programmatic achievements based on relevant indicators that are aligned with the National TB Programme and Global TB Report indicators. The application is also accessible to the public and it serves to raise public awareness on TB in the country.

20 WHO Indonesia Situation Report - 49 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 March 2021 (Fig. 24)

Fig. 24. WHO funding situation for COVID-19 response, March 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 - 49 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 WHO-convened In May 2020, the World Health Assembly in resolution global study of WHA73.1 requested the Director-General of WHO to continue origins of SARS- to work closely with the World Organization for Animal Health CoV-2: China Part (OIE), the Food and Agricultural Organization of the United (joint report), Nations (FAO) and countries to identify the zoonotic source of 30 March 2021 SARS-CoV-2 and the route of introduction to the human population, including the possible role of intermediate hosts.

Operational This document provides practical guidance to Global Influenza considerations to Surveillance and Response System (GISRS) laboratories and expedite genomic other national laboratories to move beyond virus detection to sequencing genomic sequencing of SARS-CoV-2 PCR positive materials component of GISRS obtained from sentinel surveillance of influenza-like illness (ILI), surveillance of acute respiratory infection (ARI) and severe acute respiratory SARS-CoV-2, infection (SARI). 30 March 2021

Episode 31 of WHO Director of Immunization, Vaccines and Biologicals Dr Science in 5, WHO’s Katherine O’ Brien answers questions related to COVID-19 series of vaccines, variants and vaccine doses. conversations in science, 26 March 2021

COVID-19 new This draft report is a summary of presentations and panel variants: Knowledge discussions of the WHO ad hoc consultation to discuss the gaps and research development of a research and development agenda in (draft meeting response to the existing and emerging SARS-CoV-2 variants, report), 25 March organized on 12 January 2021. 2021 Evaluation of This document provides interim best practice guidance on how COVID-19 vaccine to assess COVID-19 vaccine effectiveness (VE) using effectiveness, observational study designs. It discusses critical considerations 17 March 2021 in the design, analysis and interpretation of COVID-19 VE evaluations. This interim guidance is targeted mainly to evaluations undertaken in low- and middle-income countries but most of the concepts also apply to VE evaluations in high-income settings.

22 WHO Indonesia Situation Report - 49 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: • Interim guidance for developing a Smart Vaccination Certificate • A guide to contracting for health services during the COVID-19 pandemic (conference copy) • Interim recommendations for the use of the Janssen Ad26.COV2.S (COVID-19) vaccine • Background document on the Janssen Ad26.COV2.S (COVID-19) vaccine

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: • Time to abide (1-10) • Hand sanitizer routine • COVID-19 virus variants • Science in 5: “I am vaccinated, what next?”

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

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