Coronavirus Disease 2019 (COVID-19) World Health CoronavirusCoronavirus Disease Disease 2019 2019 (COVID (COVID-19) -19) World Health OrganizationOrganization Situation Report - 53 Situation Report - 7 Indonesia Indonesia 28 AprilData 2021 as of 07 May 2020 HIGHLIGHTS • As of 28 April, the Government of Indonesia reported 1 657 035 (5241 new) confirmed cases of COVID-19, 45 116 (177 new) deaths and 1 511 417 recovered cases from 510 districts across all 34 provinces.1 • On 24 and 25 April, WHO supported the Ministry of Health in conducting a virtual training on contact tracing for volunteers from medical students (page 16). • WHO supported the Ministry of Health to conduct a waste management training for health workers and waste operators of Dr Mohammad Hoesin Hospital Palembang, from 19 to 22 April (page 18). Fig. 1. Geographic distribution of cumulative number of confirmed COVID-19 cases in Indonesia across the provinces reported from 22 to 28 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 - 53 who.int/indonesia GENERAL UPDATES • On 26 April, the Indonesian Child Protection Commission (Komisi Perlindungan Anak Indonesia (KPAI)) reported that COVID-19 clusters have emerged in several schools that have re-initiated face-to-face learning in West Sumatra. KPAI urged the Provincial Government and Education Office to re-evaluate the continuation of face-to-face learning in schools amid the increasing number of cases.2 • The DKI Jakarta Provincial Government requested the public to stay vigilant as COVID-19 transmission at workplaces still continues, evidenced by the increased number of office clusters observed throughout April. As of 25 April, the City Administration reported that the number of office clusters increased from 78 (157 confirmed cases) offices in the week of 5 to 11 April to 177 (426 cases) offices in the week of 12 to 18 April.3 • The Government of Indonesia has tightened travel restrictions to discourage people to return to their hometowns during Eid al-Fitr holidays and thus avert a surge of COVID-19 cases. Based on the Circular Letter issued by the Ministry of Transportation on 21 April, the restrictions will be in effect from 22 April to 5 May as well as from 18 to 24 May. During these periods, anyone traveling by plane, train and ship will be required to present a negative polymerase chain reaction (PCR) or antigen-RDT test result taken no later than 24 hours before departure.4 • The Minister of Health urged Indonesians to remain vigilant of the SARS-CoV-2 variant first identified in the United Kingdom (B.1.1.7). The Minister stated that this variant is now spreading in Indonesia. As of 26 April, Indonesia has reported ten confirmed COVID-19 cases of SARS-CoV-2 variant B.1.1.7. Five of the cases were reported in West Java, two in North Sumatra and one each in South Sumatra, South Kalimantan and East Kalimantan.5 2 https://nasional.kompas.com/read/2021/04/26/19591641/kpai-klaster-covid-19-sekolah-muncul-setelah-gelar- pembelajaran-tatap-muka?page=all#page2 3 https://en.tempo.co/read/1456440/covid-19-office-clusters-in-jakarta-increase 4 https://www.thejakartapost.com/paper/2021/04/22/covid-19-travel-restrictions-tightened-ahead-of-idul- fitri.html 5 https://go.kompas.com/read/2021/04/19/173846274/indonesias-health-minister-urges-vigilance-against-local- transmission-of-uk-covid 2 WHO Indonesia Situation Report - 53 who.int/indonesia SURVEILLANCE • On 28 April, 5241 new and 1 657 035 cumulative confirmed COVID-19 cases were reported nationwide (Fig. 2). The average for the last seven days from 22 to 28 April was 5209 cases per day, compared to 5341 cases per day reported in the previous week. 16000 1800000 14000 1600000 1400000 12000 1200000 10000 1000000 8000 800000 Daily numberDaily 6000 600000 Cumulative number Cumulative 4000 400000 2000 200000 0 0 1-Apr 30-Jul 15-Jul 2-Mar 1-May 11-Jan 26-Jan 15-Jun 30-Jun 13-Oct 28-Oct 16-Apr 11-Apr 26-Apr 13-Sep 28-Sep 10-Feb 25-Feb 12-Dec 27-Dec 14-Aug 29-Aug 12-Nov 27-Nov 17-Mar 12-Mar 27-Mar 16-May 31-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 28 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 - 53 who.int/indonesia • During the week from 19 to 25 April, the provinces of North Sulawesi (172%), West Sulawesi (124%), East Nusa Tenggara (83%), Aceh (73%) and West Sumatra (71%) 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). North Sulawesi West Sulawesi East Nusa Tenggara Aceh West Sumatra Riau Bangka Belitung Islands Bengkulu South Sumatra Southeast Sulawesi North Maluku Lampung Jambi Riau Islands North Sumatra East Java Central Kalimantan DI Yogyakarta East Kalimantan West Kalimantan DKI Jakarta West Java Bali North Kalimantan South Kalimantan Central Java Central Sulawesi Banten West Nusa Tenggara Papua West Papua South Sulawesi Maluku Gorontalo -100% -50% 0% 50% 100% 150% 200% Percentage change of weekly number of confirmed cases Fig. 3. Percentage change of weekly number of confirmed cases by province during 19 to 25 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. 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 - 53 who.int/indonesia • During the week from 19 to 25 April, the incidence6 of COVID-19 in Indonesia increased to 13.5 per 100 000 population, compared to 13.2 per 100 000 in the previous week (Fig. 4). 35 30 CT2 (20 - <50) 25 20 15 Case Case incidence CT1 (<20) 10 5 0 08/06 - 14/06 08/06 - 16/08 10/08 - 07/03 01/03 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 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 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 08/03 - 14/03 15/03 - 21/03 22/03 - 28/03 29/03 - 04/04 05/04 - 11/04 12/04 - 18/04 19/04 - 25/04 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 25 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 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). 6 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 - 53 who.int/indonesia • During the week from 19 to 25 April, the incidence of COVID-19 per 100 000 population was 60.0 in DKI Jakarta and 59.9 in Bangka Belitung Islands, which corresponds to community transmission level 3 (Fig.