Coronavirus Disease 2019 (COVID-19) World Health CoronavirusCoronavirus Disease Disease 2019 2019 (COVID (COVID-19) -19) World Health OrganizationOrganization Situation Report - 57 Situationn Report - 7 Indonesia Indonesia 2 JuneData 2021 as of 07 May 2020 HIGHLIGHTS • As of 2 June, the Government of Indonesia reported 1 831 773 (5246 new) confirmed cases of COVID-19, 50 908 (185 new) deaths and 1 680 501 recovered cases from 510 districts across all 34 provinces.1 • WHO supported the National Institute of Health Research and Development (NIHRD) to conduct supportive supervision to provincial hospital laboratories that conduct polymerase chain reaction testing for COVID-19 in West Nusa Tenggara (page 18). • WHO continues to support the Ministry of Health in conducting rapid response team training for Sulawesi region and presented ‘Rapid Risk Assessment of Acute Public Health Events’ during the session on 31 May (pages 19-20). Fig. 1. Geographic distribution of cumulative number of confirmed COVID-19 cases in Indonesia across the provinces reported from 27 May to 2 June 2021. Source of data Disclaimer: Data are not available for Papua 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 - 57 who.int/indonesia GENERAL UPDATES • Indonesia recorded a surge in the number of COVID-19 cases and clusters of COVID-19 infection, one week following the Eid al-Fitr holidays. The National COVID-19 Task Force (Satuan Tugas (Satgas)) reported that from 17 to 23 May, the weekly average number of confirmed cases increased by 36.1% compared to the previous week. As of the same week, Satgas also reported that the number of COVID-19 deaths increased by 13.8%. In addition, a low level of public compliance to health protocols was reported since the beginning of the second week of Ramadan, as many public places were crowded with visitors.3 • The Government of Indonesia resumed COVID-19 vaccination using the AstraZeneca COVID-19 vaccine from the CTMAV547 batch, which was temporarily suspended over safety concerns. The batch is comprised of 448 480 vaccine doses, which was part of the 3.8 million doses from the COVAX Facility that arrived in April. On 27 May, the Ministry of Health (MoH) announced that according to the findings from further tests conducted by the National Agency of Drug and Food Control (Badan Pengawas Obat dan Makanan (BPOM)), the vaccines from this batch are safe to be used. BPOM concluded that the batch meets the requirements in terms of quality during distribution and storage.4 • On 27 May, MoH announced that locally transmitted SARS-CoV-2 variants of concern (VoC) were detected in 19 cases across the country. These included the variants that were first identified in the United Kingdom (B.1.1.7 variant), South Africa (B.1.351) and India (B.1.617). These cases were found in North Sumatra, South Sumatra, DKI Jakarta, West Java, Bali, South Kalimantan and Central Kalimantan.5 • On 25 May, Bio Farma reported that 77 000 doses of COVID-19 vaccine from Sinopharm have been distributed for the ‘Gotong Royong’ private vaccination programme. Around 22 000 doses have been administered. As the initial stage, Indonesia received 500 000 doses of COVID-19 vaccine from Sinopharm in May. Bio Farma stated that another one million doses of the vaccine are scheduled to be sent to the country during the first week of June. In total, Indonesia will receive 15 million doses of vaccine from Sinopharm, which will be delivered in stages.6 3 https://www.thejakartapost.com/news/2021/05/29/post-idul-fitri-covid-19-surge-imminent-with-daily-case-rise- new-clusters.html 4 https://www.thejakartapost.com/paper/2021/05/28/government-resumes-use-of-astrazeneca-vaccines-after- clot-scare.html 5 https://go.kompas.com/read/2021/05/27/194016674/indonesia-detects-19-locally-transmitted-cases-of-mutant- covid-strains-deputy?page=all#page2 6 https://en.tempo.co/read/1465804/bio-farma-distributes-77000-doses-of-sinopharm-vaccine-for-private- vaccination 2 WHO Indonesia Situation Report - 57 who.int/indonesia SURVEILLANCE • On 2 June, 5246 new and 1 831 773 cumulative confirmed COVID-19 cases were reported nationwide (Fig. 2). The average for the last seven days from 27 May to 2 June was 5793 cases per day, compared to 5446 cases per day reported in the previous week. 16000 2000000 14000 1800000 1600000 12000 1400000 10000 1200000 8000 1000000 Daily numberDaily 6000 800000 600000 number Cumulative 4000 400000 2000 200000 0 0 6-Jul 2-Jan 4-Oct 7-Apr 2-Apr 7-Feb 24-Jul 9-Nov 2-Mar 8-May 20-Jan 18-Jun 22-Oct 20-Apr 25-Apr 16-Sep 25-Feb 15-Dec 11-Aug 29-Aug 27-Nov 20-Mar 15-Mar 31-May 13-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 2 June 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. 16); 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 - 57 who.int/indonesia • During the week of 24 to 30 May, the provinces that experienced an increase in the number of weekly cases of more than 50% compared to the previous week were West Nusa Tenggara (189%), Aceh (71%), Maluku (63%), Riau Islands (62%), Central Sulawesi (57%), Gorontalo (54%), Jambi (53%) and Central Java (51%) (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). West Nusa Tenggara Aceh Maluku Riau Islands Central Sulawesi Gorontalo Jambi Central Java Riau East Nusa Tenggara Banten South Sumatra Lampung South Kalimantan DKI Jakarta Bangka Belitung Islands Central Kalimantan Southeast Sulawesi DI Yogyakarta East Kalimantan West Kalimantan East Java North Maluku Bengkulu North Sumatra South Sulawesi West Java West Sumatra North Kalimantan Bali West Papua North Sulawesi West Sulawesi -100% -50% 0% 50% 100% 150% 200% 250% Percentage change of weekly number of confirmed cases Fig. 3. Percentage change of weekly number of confirmed cases by province during 24 to 30 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 - 57 who.int/indonesia • During the week of 24 to 30 May, the incidence7 of COVID-19 in Indonesia increased to 12.5 per 100 000 population, compared to 11.3 per 100 000 in the previous week (Fig. 4). 35 30 CT2 (20 - <50) 25 20 15 Case Case incidence 10 CT1 (<20) 5 0 22/06 - 28/0622/06 - 12/0706/07 - 13/0419/04 - 27/0403/05 - 11/0517/05 - 25/0531/05 - 08/0614/06 - 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 - 15/0321/03 - 29/0304/04 - 12/0418/04 - 26/0402/05 - 10/0516/05 - 24/0530/05 - 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 30 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 - 57 who.int/indonesia • During the week of 24 to 30 May, the incidence rates of COVID-19 per 100 000 population were 71.3 in Bangka Belitung Islands and 61.7 in Riau Islands; these rates correspond to community transmission level 3 (Fig.