An attempt to get back to some sort of normality: Operation Restart
IO – It may seem a “daring attitude” when the government adopts a New Normal in July 2020. Understandably, the number of people undertaking rapid test or PCR is still small. Furthermore, many think that the country’s coronavirus pandemic is yet to peak.
New Normal is a new way of life where people have to maintain productivity in the midst of a COVID-19 pandemic. In the New Normal, health protocols still apply, or are even fine-tuned, based on input from various parties and adjustments to certain regions.
It is common knowledge that productivity has sharply fallen in the last three months, since the government imposed Large-Scale Social Restrictions (PSBB). Such implementation has crippled many sectors, from manufacturing, transportation, to trade and commerce, but has been relatively successful in keeping a lid on the pandemic.
Indonesia, similar to other countries, is faced with two dilemmas: to suppress the pandemic or stare at the risk of economic recession. The decision to go with a New Normal is seen as a compromise—the middle way— to keep the epidemic under control while resuscitating the economy.
Indonesia is not alone. Other countries also pursue a similar path, because a vaccine with international standards has yet to be discovered. It is estimated that a safe and effective vaccine won’t be available on the market until next year.
The New Normal will be implemented throughout Indonesia. However, it is noteworthy that the Head of Task Force for the Acceleration of Covid-19 Handling, Lt. Gen. Doni Monardo, recently stated that 110 regencies/cities have already achieved a ‘New Normal’ status because their people abide by the health protocols, which mandate among others, using a face mask or covering, diligently washing one’s hands with soap, and maintaining physical and social distance.
In addition to public behavior, community leaders also play a crucial role in overcoming and controlling the coronavirus pandemic. Furthermore, the 110 regencies/cities are relatively isolated and rarely visited by outsiders, he said.
The government’s enthusiasm to lift Large-Scale Social Restrictions (PSBB) was vigorously indicated by a telegram numbered STR/364/VI/ OPS.2/2020 dated June 25, 2020 to the police force. The telegram contained an instruction to revoke the previous edict issued by the National Police Chief forbidding mass gatherings. This aims to support the New Normal policy.
The government’s decision to revoke PSBB policy is considered risky, because the coronavirus pandemic in Indonesia has yet to peak. There are still many people yet to be tested either with a rapid test kit or Polymerase Chain Action (PCR)-based swab test which is more accurate.
Indeed, many have been found to be infected by the virus through the tests. Of the 4,000 South Jakarta residents who took a rapid test, 23 were found to be positive, a potential source of large-scale community transmission.
Although the number is relatively small, it can’t be dismissed because the SARS-CoV-2 virus, which causes the Covid-19 pandemic, has proven to be more virulent than the Severe Acute Respiratory Syndrome (SARS) virus which spread in China and around the world in 2002-2003.
SARS-CoV-19 which came to be known as COVID-19 has similar symptoms with MERS and the original SARS, such as fever, cough, fatigue, sore throat, headache, diarrhoea, kidney failure and loss of taste or smell.
According to many researchers, the Covid-19 virus will rapidly reproduce when it has found its host in the human body. It will not only damage the respiratory tract and lungs, but also infect the heart, kidneys and other body organs.
According to the World Health Organization (WHO), the Covid-19 virus, believed to have existed as early as December 2019, has infected 1.2 million people in 205 countries in just four months. The previous SARS pandemic in China and globally, as well as the Middle East Respiratory Syndrome (MERS) virus that struck the Middle East in 2012 did not infect as many humans even though they are from the same coronavirus family.
According to Worldmeter data as of June 27, the COVID-19 virus has infected 9,926,828 people globally, and killed 497,357 in 213 countries and territories. On the other hand, 5,357,532 people have recovered. Indonesia itself recorded a total of 52,812 infections with 2,720 deaths and 21,909 recoveries.
Those who succumbed generally have pre-existing health problems such as diabetes, high blood pressure, kidney, heart and lung disease. Otherwise, they have a greater chance of recovery.
The ratio between Indonesia’s population in 2020—at 269.6 million—and the data presented by Worldmeter is very small. But when viewed from the moral aspect and the ferocity of the virus, the ratio is frightening. Thus, a lockdown is considered an appropriate measure to cut off its transmission despite its ruinous effect on the country’s economy and political stability.
The government did not opt for total lockdown but instead PSBB and now a New Normal. Indeed, other countries also have a “tip of the iceberg” problem, meaning they also haven’t tested a majority of their population where the number of infected is estimated to be much higher than what tests revealed.
President Joko Widodo initially set an ambitious target to test ten thousand people per day. However, this target has not been achieved due to various obstacles, including the availability of facilities and infrastructure.
The tip-of-the-iceberg phenomenon does not need to cause panic, since the increase in number of positive cases does not mean that the patients need to be hospitalized. They can self-isolate at home and may eventually recover because they have good immunity.
Lately, there is a growing opinion that a rapid test is unnecessary because it is considered a waste of state resources. Rapid test is a way to pre-screen the virus though antibody isotypes (IgM and IgG). These antibodies will be automatically produced by the human body when a virus infection is detected.
PCR is considered more effective. It is a laboratory examination to detect the presence of genetic material from cells, bacteria, or viruses, including COVID-19. Unfortunately, the cost of this test is quite prohibitive at Rp 1.6 million per person (while a rapid test only costs around Rp 275,000), but many parties have offered it for free.
Preventing “leakage” of National Economic Recovery (PEN)
The SARS and bird flu pandemic in 2002-2003 weakened the economies of various countries. They killed nearly 800 people in 17 countries, and damaged the economy of Singapore and China, while Indonesia was able to survive thanks to the Micro, Small and Medium Enterprise (MSME) sector.
The COVID-19 pandemic, in comparison, has affected at least 215 countries and territories. The International Monetary Fund (IMF) on June 24 published a report titled “A Crisis Like No Other, An Uncertain Recovery.” Mentioned in the report is a prediction that global economy will shrink to a low of -4.9%, significantly lower than April projection at -3%.
Regarding Indonesia, the IMF projected that Indonesia’s economic growth in 2020 is to be -0.3%, the lowest since 1998, when the country experienced a multifaceted crisis.
Finance Minister Sri Mulyani Indrawati’s own prediction is not far from that figure, ranging between -0.4% to 1, due to severe contractions in the second quarter of 2020.
The position was stated in a working meeting with the Budgetary Committee (Banggar) of the House of Representatives (DPR) on Macroeconomic Framework and Fiscal Policy Principles (KEM PPKF) for the 2021 fiscal year, on June 18.
Forecast by Bank Indonesia Governor Perry Warjiyo is equally grim. He said in a virtual press conference on the same day that Indonesia’s economic growth was expected to fall to around -0.9 to 1.9%. The economy will pick up in the third quarter due to the easing of PSBB, favourable monetary policy and the National Economic Recovery (PEN) program in various fields.
On the Ministry of Finance’s website, this consists of a consumption stimulus (Rp 172.1 trillion), tax incentives (Rp 123.01 trillion), acceleration of compensation payments (Rp 90.42 trillion), utilization of government funds in banks (Rp 87.59 trillion), additional ministries/institutions and sectoral spending (Rp 63.97 trillion), interest subsidy (Rp 35.28 trillion), state capital injections (Rp 25.27 trillion), working capital loans (Rp 19.65 trillion), support for local government (Rp 15 trillion), MSMEs new loan guarantees (Rp 6 trillion), support for biofuel B-30 (Rp 2.78 trillion) and investment financing to cooperatives through LPDB UMKM (Rp 1 trillion).
Given the low growth projections, this means the impact of Coronavirus is more devastating than the moral hazard that occurred 22 years ago, which threatened to destroy the economy and looming specter of national disintegration.
Even now the moral hazard still takes place and in full display, as in the case of PT Jiwasraya and more. No wonder many are anxious that many businesses will be destroyed by COVID-19 while in fact they have been in ruins even before the pandemic. They will try to take advantage of PEN.
Is a sanction necessary?
Implementing a New Normal is actually a “gamble” because Indonesia is yet to pass the peak of the pandemic and the “iceberg” is still invisible. Moreover, the majority of the population still takes the severe respiratory disease-causing virus lightly.
In light of this, it is very appropriate if the health protocol remains in effect, because it has proven to be quite effective in curbing transmission. It is also appropriate if the implementation of health protocols is accompanied by sanctions to “educate” and to impose a deterrent effect.
In this regard, different holistic solutions in dealing with this epidemic should be put forward, because partial or patchwork solutions only cause new problems.
Remember, Indonesia must now tackle two complex problems at once—a major public health crisis and severe economic downturn. Let’s be united to move forward!
Bali and East Java: Two Polar Opposites
The National Task Force for the Acceleration of COVID-19 Handling has systematically divided regencies and cities in the 34 provinces into four zones. Each is color-coded to indicate the level of transmission. In other words, each color shows a risk category, for example a green zone means the area is not impacted. Yellow zone means low risk, orange zone medium risk and red zone high risk because many people in the area have been infected or exposed.
In theory, each district-city or province can be upgraded or downgrade in the zoning system, but in reality Jakarta and East Java until June 27 are still in a red zone. In contrast, Aceh (37 cases), Jambi (109), Bangka (147), Bengkulu (105) are stable in the green zone. In comparison, Bali has 829 cases of infection.
The four zones, established by the Ministry of Health and the World Health Organization (WHO) are characterized by:
1. RED ZONE
The rate of community transmission among the population in the region is rapid. The pandemic is widespread and many new clusters are found. The local government must:
● _Conduct more intensive testing
● _Aggressively conduct contact tracing in the event of confirmed or suspected cases
● _Put the community on home quarantine
● _Put a travel ban in place
● _Prohibit public gatherings and close down public places
● _Temporarily shut down business activities, except for those deemed essential, such as pharmacies, supermarkets, health clinics and fuel stations, with physical distancing observed
● _Prioritize the use of healthcare facilities for COVID-19 treatment
● _Close down all learning facilities
2. ORANGE ZONE
The rate of transmission is still high. Community transmission may occur quickly. Transmission from imported cases may occur quickly. The new cluster must be monitored and controlled through aggressive testing and tracing. The local government must:
● _Advise people to stay at home
● _Advise people to maintain safe distance at all times
● _Enforce stricter travel restrictions and health protocols on public transportation
● _Close down public places
● _Temporarily shut down learning facilities
● _Advise people to work from home except for certain occupations
● _Permit traveling with health protocols observed.
● _Partially open business activities beyond the essential sectors such as pharmacies, supermarkets, health clinics and fuel stations with physical distancing observed
3. YELLOW ZONE
In a yellow zone, the possibility of community transmission is still quite high and may rapidly spiral out of control. Transmission from imported cases can occur quickly. Transmission within a household may occur. However, the cluster spread is under control and doesn’t show any sign of increasing. The local government must:
● _Allow people to carry out activities outside their home with strict health protocols observed
● _Aggressively conduct contact tracing in the event of confirmed or suspected cases
● _Advise people to maintain physical distance, both inside and outside
● _Permit travel with very strict health protocols observed
● _Allow businesses to open with strict health protocols observed
● _Allow sports venues to open with strict health protocols observed
● _Allow healthcare facilities to run normally
● _Monitor people in vulnerable groups and advise them to stay at home
● _Allow limited religious activities
4. GREEN ZONE
There are 15 specific criteria that must be met in order for an area to be designated green zone or safe zone, namely:
● _Decline in the number of positive cases in two consecutive weeks since cases peaked.
● _Decline in the number of people under monitoring (ODP) and patients under surveillance (PDP) in the past two weeks
● _Decline in the death rate of positive patients in the past two weeks
● _Decline in the death rate of ODP and PDP cases in the past two weeks
● _Decline in the number of positive patients, ODP and PDP who need hospitalization in the past two weeks
● _Increase in the recovery rate of positive patients in the past two weeks
● _Increase in the number of ODP and PDP who received clearance in the two weeks
● _A slowdown of positive cases per 100,000 population
● _A slowdown in mortality rate per 100,000 population
● _The number of specimens tested has been increasing for two weeks
● _The rate of positive cases is less than 5 percent
● _The number of beds in isolation rooms of referral hospitals can accommodate up to more than 20 percent of the number of positive patients, ODP and PDP
● _Rt (effective reproduction number) is less than 1
If these 15 criteria are met, the regencies/city and provincial government can implement things that are not permitted in the other three zones. However, they still need to continue carrying out various prevention mechanisms, such as raising public awareness and vigilance of the potential danger of sudden pandemic; quickly respond to suspected cases and impose mandatory two-week quarantine for individuals; implement transmission prevention protocols (maintain social and physical distancing and frequent hand-washing with soap).
While there are several other provinces with lower rates of infection, the international community was amazed by the situation in Bali, given that it is a province that is most visited by domestic and foreign tourists, especially from China, the country where COVID-19 was first discovered in December 2019.
Based on data from the regional office of the Ministry of Law and Human Rights in Bali, as many as 4,820 Chinese tourists visited Bali in February 2020, and 113,646 in the previous month. Surely many of them are from Wuhan, the city where the virus first spread and which has direct flight to Denpasar.
So why is the number of infections in Bali relatively low, at just 829 cases compared to its 4.5 million population?
According to Henk Saroinsong, a former diplomat who has spent the past few years living in Bali, the island is geographically separate from Java, Lombok and other provinces so that when Ngurah Rai Airport and various ferry ports are closed, Bali becomes effectively isolated.
Balinese are also considered more disciplined in obeying health protocols and directives from local government officials and community leaders. More people also use private vehicles than public transportation.
He added, however, that there are potential risks from community transmission in traditional wet markets and imported cases brought by returning Indonesian migrant workers who previously worked on cruise ships, in hotels or spas.
The lower case numbers of COVID-19 infection are also attributed to the strong spiritual relationship between Balinese and God Almighty (Sang Hyang Widhi), he remarked.
Why East Java?
East Java is only ‘a stone’s throw away’ from Gilimanuk port in Bali but the number of COVID-19 infections as of June 27 totaled 10,115 cases, 2,915 recoveries and 741 deaths. That means the figure is the highest after Jakarta, which recorded 10,250 cases, with 5,228 recoveries and 594 deaths.
The worrying trend has prompted East Java Governor Khofifah Indar Parawansa to ask the central government to intervene mainly in Surabaya and Greater Surabaya. “Local governments are overwhelmed with the speed of transmission and rising numbers of cluster. One new cluster is from dead bodies,” she said.
Head of the COVID-19 Task Force Doni Monardo urged various parties in East Java to build a closer synergy to break the chain of transmission. Local government officials must also take extra measures to prevent people from reclaiming dead bodies of their relatives, which has been blamed for the resurgence of new cases.
The central government has been committed to fulfil the governor’s request for help, especially after the visit by President Jokowi to the province on June 25 where he gave an ultimatum to the local government to bring East Java out of its red zone.
This means that there will be a lot more equipment and medical personnel that will be allocated due to the province’s weaknesses is contact tracing those exposed to the virus. Another implication is that many regencies/cities at the eastern tip of Java may yet unable to embrace a New Normal. (Sjarifudin)
Sjarifudin is a senior journalist. He holds a BA from the Universitas Indonesia, graduating from the department of Social and Political Science. His writing has been widely featured in, Harian Bisnis Indonesia, Harian Sinar Harapan and was last Chief Editor for Majalah Suara. He writes for the Independent Observer.