The war on COVID-19 Why is Indonesia still struggling?

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(Photo: Aslam Iqbal/IO)

IO – The Covid-19 pandemic has degenerated from a public health tragedy into a political football. While its impact varies widely around the world, one thing is certain: it has become a very complex and serious problem, as countries scramble to find their way out of this unprecedented crisis. Any response by the authorities, as policy-makers, is immediately is thrown into the spotlight of public scrutiny. 

Several countries and governments appear capable of, responsive to and proactive in setting policies capable of mitigating the problem. They are decisive and swift, taking all necessary strategic steps in order to shield their nations and their people from the growing threat of the pandemic. In fact, it is not too much to expect a state to be able to prioritize life-saving health protocol for its citizens. 

However, we can also point to several countries that are woefully unprepared and have been reluctant to respond to the pandemic and deal with its impact. There are also those who trivialize the issue and are in denial, burying their heads in the sand, fearing the economic fallout. As a consequence, they ignore or take the pandemic lightly, for example by not involving scientists or health experts in policy-making. 

There are several indicators to measure the success or failure of a country in dealing with the pandemic, among them being leadership and the level of public trust. 

Leadership 

Strong and decisive leadership is essential if a government is to respond swiftly to the pandemic in a coordinated fashion. On the other hand, incompetence and weak leadership will be disastrous in this kind of situation. We can observe how many political leaders initially underestimated and trivialized the emergence of this pandemic. They brushed off the threat of the outbreak that originated in Wuhan, China. Instead they focused on minimizing market turmoil with more forceful measures, whereas persuading the public to stay at home or wear a mask can only be successful if they take command from the outset. 

Leaders of countries such as South Korea and Taiwan, in contrast, were able to take swift and effective action, through establishing open and transparent public communication and seriously implementing appropriate mitigation measures. 

South Korea and Taiwan have become the “poster boys” of democratic countries that succeeded in overcoming the complexity of handling the pandemic. Although they were hit by a second wave following easing of restrictions, their governments were able to suppress transmission rates of the virus. 

Vietnam, an authoritarian state, has also been considered quite successful in curbing the spread of Covid-19, with an enviably low fatality rate. The Vietnamese government was responsive from the start and had the courage to put a ban on celebrating Chinese New Year, which is usually characterized by boisterous festivities – people holding parties and attending large gatherings, all this suppressed even though the country still had zero cases at that time. 

In Wuhan, China, where SARS-CoV-2 virus outbreak originated, the government took extreme measures: locking down the metropolis and nearby cities in Hubei Province from January 23, leading to eventual success in containing the outbreak. At least 50 million people were forcibly confined under home quarantine; the city lockdown effectively prevented further spread to other parts of the country. The PRC government also conducted massive testing that extended to a large portion of the city’s dwellers. 

Meanwhile there are leaders who are woefully unprepared and lack leadership integrity, tending to resort to protectionist measures, driven by ignorance and hatred as they manipulate their people, while continuing to deny and find justification for their view and action in dealing with a public health emergency. At the same time, certain incompetent leaders took the opportunity to exploit the pandemic for their consolidation of power, some even eyeing reelection. 

Brazil is one democratic country that is adjudged to be a spectacular failure in dealing with this pandemic. President Jair Bolsonaro underestimated the pandemic and actively undermined any effort to fight it. As a result, as of August 21, 2020, Brazil has recorded 3.5 million positive cases with 112,000 succumbing to the disease. 

The United States, considered a champion of democracy, is also led by an incompetent politician. Donald Trump’s refusal to acknowledge the scale of the problem is evident in his comparing the coronavirus to the common cold, even though it is very clear that this virus is more many times more dangerous. Most Americans who become infected cannot even get tested, let alone receive proper medical care or supervision. To date, America has been named the country with the highest number of Covid-19 cases and death rate in the world. According to the latest official data, as of August 21, 2020, the US caseload stood at 5.59 million, with a death tally at 174,000. 

It is precisely at this moment that a pro-active role of the government and scientists, as well as credible media, are sorely needed to inform the public about the real facts behind the Covid-19 pandemic. 

Public Trust 

Ideally, in a pandemic, people should be able to trust what scientists tell them. People should also be able to place their trust in public authorities, as regulators and policy-makers. 

In the case of Brazil’s President Jair Bolsonaro, he not only attacked the media but also questioned the advice of his own scientists and academics, and even WHO. He even went as far as to spread misinformation on behalf of the Brazilian government, thus eroding public trust and confidence in him and the government as a whole. 

The US leadership also rejects scientific explanations. As a result, the country’s pandemic policies are directionless, response is slow, cumbersome, and not well-coordinated. Overall, it can be said that the US has failed to containing a major public health crisis. This was exacerbated by Donald Trump’s decision to cut funding to the World Health Organization (WHO), precisely when we need to step up international cooperation in battling the virus. 

This stands in stark contrast to the Ebola outbreak of six years ago, when the US was lauded for its leadership. The country was able to provide assistance in tackling the pandemic, playing an active role in supporting many countries in forestalling a global economic crisis at the time. 

Other countries would hesitate to follow America’s leadership because the country has lost its legitimacy, due to its own incompetent and inconsistent actions, moves which failed to get Covid-19 under control. 

In contrast, the Vietnamese displayed a high level of trust in their government, whom they considered legitimate and competent. As a result, they abide by government policy without having to be forced to do so. 

 One lesson that we can learn from Vietnam is the importance of transparency on the part of the government, where data is made widely available to the public, backed by scientific facts, clear direction and consistent messages, so the public can access infection data around them, and be reminded to be vigilant if they are about to venture outside. 

Stricter government 

Six months into the Covid-19 pandemic, Indonesia has yet to bring the situation under control. New caseloads continue to rise drastically. In line with the increase of patient numbers requiring treatment, data from the Ministry of Health also shows a spike in the utilization of isolation beds in August and September, as compared to July. 

New clusters of community transmission continue to emerge – offices, factories, households – indicating that the stipulated health protocol is largely ignored: public discipline – the basics of prevention, popularly known as “3M”, (1) wearing face masks, (2) vigorously washing hands with soap, and (3) maintaining safe distance. 

There are still many loopholes, even as restrictions are being eased and public mobility surges – for example, during long weekends. A steep rate of transmission is expected to persist into 2021, when it is projected to peak. 

Many people have begun to lower their guard when traveling during the long holidays, as they are encouraged to travel to resuscitate the country’s ailing economy. It is not surprising that the potential for contagion has become greater and has led to a dramatic spike in positive cases. This is a result of the government being incompetent and reluctant in its response from the beginning, made worse by inconsistent policies that tilt more toward economic recovery than robust public health measures. 

There needs to be a shift in focus, prioritizing basic prevention strategies. In other words, the government should be more consistent in carrying out testing, tracing and isolation as part of its measures in strengthening surveillance. The “3M” campaign needs to be intensified. If the face mask wearing rate climbs above 90 percent, it will exert a significant impact on flattening the curve. 

In fact, the handling of the Covid-19 is a litmus test for central and local governments to demonstrate the quality of their leadership, and whether they can overcome the pandemic more swiftly and decisively. 

Should year-end regional polls be postponed? 

The government persists in its intention to carry out the 2020 Regional Elections, scheduled to be held simultaneously in 270 regions in Indonesia, covering nine provinces, 224 regencies and 37 cities, on December 9, 2020. This has led to a renewed polemic in society. Many people believe that the simultaneous regional elections will generate new clusters of infection. 

The polemic can also result in counterproductive social reactions, including skepticism, antipathy, and pragmatism during the actual campaigning and voting. Many people believe than holding a major political event amid a still-raging pandemic is unethical, especially at a time when many people’s livelihoods are under threat from virus-induced economic fallout. 

At every stage of the regional elections, from candidate registration, campaigning and the actual voting, we must conclude it is too risky to go forward with this year, a time when Indonesia is still struggling to deal with the pandemic. The risk lies not only in the emergence of new clusters, but also degraded quality of the most important event in a democracy. 

The Indonesian Election Supervisory Agency (Bawaslu) continues to note many problems when prospective candidates register with the General Election Commission (KPU). One of these was violations of the health protocol, including mass gatherings, carried out by 141 candidates, according to Bawaslu record. 

Conducting regional elections during a pandemic is a highly-complex undertaking, not simply a local but also a global concern, because the quality of a country’s democracy is measured by how successful its elections are, as well as a testament to how successful the country’s pandemic management is. Many factors that must be assessed, such as the capacity of the state, policies, regulations and budgets. Also, the level of public trust in government and leadership, including the president, election organizers, political parties and contesting candidates. 

At stake in the year-end regional elections are public participation and the quality of Indonesia’s democracy, as regional leadership succession can be hampered by the threat of Covid-19 rapid transmission. 

The timeframe to prepare election regulations aligned with Covid-19 health protocol is very short, while the pandemic is yet to be brought under control. As a result, quality of the elections may be compromised. Voter turnout may not be optimal. This clearly contradicts the purpose of the election itself. If it is held during a worsening pandemic, voters may be reluctant to go to polling stations, due to anxiety and fear of contracting the virus. 

Data from the International Institute for Democracy and Electoral Assistance (IDEA) lists the six countries that held elections during the pandemic: Australia, France, Iran, Mali, Bavaria and South Korea; of these, only Bavaria and South Korea had a high voter turnout. 

Local government elections in Queensland, Australia held on March 28, 2020 saw voter turnout decline from 83% to 77.5%. A similar downward trend was also evident with the French municipal election on March 15, 2020 (from 63.6% to 44.7%), Iranian legislative election on February 21, 2020 (from 60.09% to 42.32%), and the sharpest drop of all, Malian parliamentary elections on March 29, 2020 (plunging from 42.7% to 7.5%). 

On the contrary, Bavarian local elections on March 15, 2020 and South Korean parliamentary election on April 15, 2020 saw higher voter turnout. For the latter, at 66%, or 8.1% higher than previously, it was the highest participation since 1992. This despite the country having more than 10,000 Covid-19 positive caseloads. South Korea’s success was made possible by three major factors – a robust election system, swift handling of Covid-19, and a high level of public trust in the election organizer. 

One strategy that the South Korean government pursued was to allow the public to vote by mail, filling out a ballot form from home, which is then mailed to the election commission. voters were able to vote two days before the election day to avoid higher concentration of people at polling stations. South Korea also had a sufficient budget to ensure voter safety, such as the provision of personal protective gear for election officials, hand sanitizers, body temperature gauges, and other equipment for massive screening. 

Thanks to a smooth-running election system and the government’s responsiveness, the public had a high level of trust. The South Korean election commission also went to great lengths to ensure transparency during polling. They invited television stations and media to conduct live broadcasts from the polling stations. That way the public can still observe vote-counting from their homes without having to worry that it might be rigged. 

To successfully hold an election during the pandemic, public safety must take precedence. Health risks faced by voters and election organizers must be minimized, if not eliminated. Hence the need for clear and robust regulations to govern the process of regional elections, so that they can run properly and their integrity can be maintained. Additionally, health protocol must be strictly adhered to at all stages during the election process by organizers, participants and all other parties involved. 

On the other hand, it is irresponsible for leaders to set reckless policies aimed merely at promoting vested interests. This could result in an explosion of cases and the virus spreading out of control. Furthermore, government would sacrifice public trust and the social fabric might be shattered. To respond to the pandemic effectively, we need competent and responsive leaders who can make wise, scientifically-informed and effective decisions. 

The government’s firm stance must be followed by public obedience and discipline, which is key to prevent new infection. The handling of the health crisis should also instill a sense of optimism that it is a shared responsibility, that we are all in this together. 

So far, the government still relies on patchwork regulations, with many loopholes compromising their effectiveness. The bulk of the responsibility must be shouldered by the state, no longer in the hands of ad hoc committees created to handle the emergency, because it is predicted that this pandemic could endure up to 3 years or even longer. The purpose of the state is to protect and defend the homeland. As a modern state, pandemic-handling should be well-managed, with a clear action plan, adequate supervision and measurable targets. The President and his cabinet should be the ones to directly deal with countering this pandemic. 

A well-informed society is an empowered one. Thus, the “3M” campaign must be carried out consistently, by involving community or religious leaders using language that is simple and straightforward, so the public can easily discern the message and implement it into their daily lives.  

Dr. Pandu Riono, MPH, PhD is a senior faculty member at the Faculty of Public Health, Department of Biostatistics and Population, Universitas Indonesia. He graduated from the Faculty of Medicine of the same university and received his Master’s Degree in Biostatistics from the University of Pittsburgh. 

 Drg. Tince Arniati Jovina, MKM is a public policy analyst with the Research and Development Agency of the Indonesian Health Ministry. She obtained her Master’s Degree in Public Health from Universitas Indonesia.