Save lives, avoid recession

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Ninasapti Triaswati Teaching Staff Member of the University of Indonesia

IO – Announcement of 2657 new COVID-19 cases in Indonesia July 9, 2020, has broken the current record highs and completed a grim picture of the projections of the global economy and the Indonesian economy in 2020. The IMF, World Bank, and OECD have changed their worst projections about the decline of the world economy last month to around negative 4.9 percent to negative 7.6 percent for 2020. 

The Ministry of Finance hopes that the worst conditions in Indonesia’s economy in 2020 will be around -0.4 percent. This figure might be achieved if the Indonesian people successfully deal with the New Normal period in a healthy condition, namely, the occurrence of a consistent rate of decline in new COVID-19 cases. If growth in the number of new cases of COVID-19 in the regions increases, the local governments will re-apply social restrictions to reduce its rate of spread. As a result, national economic recovery will be hampered. 

The first wave of COVID-19 attacks on the Indonesian population has not yet passed. The news about the new national record of COVID-19 cases in Indonesia on July 9, 2020, reveals that the rapid growth of new cases began to occur evenly in various provinces, with the most populous both in Java and outside Java. That new record number increased 43 percent from a record of 1853 new cases just the day before. What was different at that time was that the province of West Java had become a new center, with an additional 962 new cases, surpassing East Java with 517 new cases. The other three largest provinces with the newest cases were Jakarta 284, South Sulawesi 130, and North Sulawesi 126. 

The provinces of East Java and Jakarta have become examples of cases when Large Scale Social Restrictions (PSBB) had been relaxed but that was not yet accompanied by community compliance to enforce discipline in maintaining distance. As a result, the number of COVID-19 new cases continued to surge. 

The Surabaya City Mayor’s apology to doctors at Dr. Soetomo Hospital has provided a tragic picture of the limitations of health facilities due to opening the economy too fast. Although the Surabaya City Government tried hard to make the community aware of the danger of gathering, distributing masks and closing some of Surabaya’s main roads, the spread of COVID-19 has already been too fast. 

Jakarta has also experienced a surge of new cases consistently since the adoption of the transition period after the PSBB was relaxed. On July 12, 2020, new cases in Jakarta reached a new record of 404. This happened after Jakarta carried out a strategy of actively pursuing cases through a PCR test in a densely populated area prone to the spread of COVID-19. Jakarta DKI has a high PCR test capacity but is very open in terms of the area so it is difficult to monitor population movements; thus, new COVID-19 cases are still growing rapidly. 

To make the sloping curve in Indonesia even more difficult, there is the rapid growth of new cases. Effective policy changes need to be made so that the curve can quickly turn down to avoid a recession. 

The first policy is to actively pursue the case through effective testing and tracing to uncover COVID-19, which is to focus on conducting PCR review and not prioritizing or requiring rapid tests before PCR. Testing procedures currently in force start with a rapid test through a blood test; if reactive, then a PCR swab test is done. Results of the rapid test do not prove whether someone has the COVID-19 virus, though. 

As a result of prioritizing the rapid test, there are two potential large losses for the safety of people’s lives. The first potential loss: the risk of increased transmission and death through asymptomatic people. This can occur due to people doing rapid tests, but the results are “not reactive”, even though one may be in the early stages of COVID-19. As a result, a person who is truly asymptomatic can transmit COVID-19 to the wider community, because he does not realize he is infected. Hence, the number of asymptomatic people will grow rapidly. 

The second potential loss: in terms of funds, everyone seems to feel obliged to do a rapid test first, then a PCR review test, while in fact it should be faster and more economical if you do just one test: the PCR test. If the government finances the rapid test, then there is an additional expenditure to buy the rapid test kit, which should not need to be done if the focus is on conducting a broad PCR test only. 

The second policy, the government’s focus on health policy to overcome implementation constraints, namely, providing an adequate number of PCR test materials and laboratory personnel to be able to immediately obtain the PCR test results. Besides, it is necessary to oversee the movement of population between regions. 

The ability to carry out PCR tests varies between regions in Indonesia. West Sumatra Province is an example of a province that explicitly focused on carrying out a broad PCR test to break the COVID-19 growth rate. This province is proven to have adequate health facilities and can monitor the movement of people between regions to/from the province. At present the number of new cases in West Sumatra has dropped dramatically, the data of July 13, 2020, show no new cases (zero) in this province. 

On the other hand, some groups benefit from the rapid test business. With a cost of around IDR 45,000 (the estimated price of a rapid test is only 3 US dollars), the government decreed the price for the rapid test should be IDR 150,000. But there is no sanction from the government if the hospital sets prices above the government’s direction. Entrepreneurs who have imported these rapid tests and hospitals that conduct rapid tests at high prices will benefit greatly from the examination procedures that do rapid tests first and then PCR tests later. 

On the other hand, the cost of people’s lives and health workers who have died due to asymptomatic distribution are “invaluable” compared to the economic benefits of rapid test business groups. Besides, the rapid test may cause asymptomatic expansion: the number of new cases will grow even though Indonesia’s health facilities are very limited and out of balance between regions, both in quantity and quality. This will cause local governments to be forced to close the economy again and can result in a prolonged recession. 

Saving lives and avoiding an economic recession in Indonesia will very much depend on the ability of central and regional governments to coordinate and synergize to focus on allocating funds for proper testing and tracing, namely, the expansion of PCR tests while making people aware of the discipline to maintain physical distance, as well as maintaining cleanliness and health. 

We all hope that together Indonesia can reduce the spread of COVID-19. If the people are healthy, then economic activity can begin to expand, employment will be able to grow again, thus increasing economic productivity. We hope that the Indonesian people will be able to avoid the threat of a recession.