The COVID-19 pandemic in Indonesia is part of the worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was confirmed to have spread to Indonesia on 2 March 2020, after a dance instructor and her mother tested positive for the virus. Both were infected from a Japanese national.
By 9 April 2020, the pandemic had spread to all 34 provinces in the country at that time. Jakarta, West Java, and Central Java are the worst-hit provinces, together accounting more than half of the national total cases. On 13 July 2020, the recoveries exceeded active cases for the first time.
The number of deaths may be much higher than what has been reported as those who died with acute COVID-19 symptoms but had not been confirmed or tested were not counted in the official death figure.
Instead of implementing a nationwide lockdown, the government applied "Large-Scale Social Restrictions" (Indonesian: Pembatasan Sosial Berskala Besar, abbreviated as PSBB), which was later modified into the "Community Activities Restrictions Enforcement" (Indonesian: Pemberlakuan Pembatasan Kegiatan Masyarakat, abbreviated as PPKM). On 30 December 2022, the restrictions were lifted for all regions in Indonesia since satisfied population immunity exceeded the expectation, although it did not lift the pandemic status.
On 13 January 2021, President Joko Widodo was vaccinated at the presidential palace, officially kicking off Indonesia's vaccination program. As of 5 February 2023 at 18:00 WIB (UTC+7), 204,266,655 people had received the first dose of the vaccine and 175,131,893 people had been fully vaccinated; 69,597,474 of them had been inoculated with the booster or the third dose.
The pandemic is estimated to have caused at least 1 million excess deaths in Indonesia.
Background
On 12 January 2020, the World Health Organization (WHO) confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster of people in Wuhan, Hubei, China, which was reported to the WHO on 31 December 2019.
The case fatality ratio for COVID-19 has been much lower than SARS of 2003, but the transmission has been significantly greater, with a significant total death toll.
Timeline
From January until February 2020, Indonesia reported zero cases of COVID-19, despite being surrounded by infected countries such as Malaysia, Singapore, the Philippines, and Australia. Flights from countries with high infection rate, including South Korea and Thailand, also continued to operate. Health experts and researchers at Harvard University in the United States expressed their concerns, saying that Indonesia is ill-prepared for an outbreak and there could be undetected COVID-19 cases.
On 2 March 2020, Indonesian president Joko Widodo announced the first cases in the country: a dance instructor and her mother in Depok, West Java. Both of them had held a dance class at a restaurant in Kemang, South Jakarta on 14 February, which was attended by more than a dozen people. One of whom was a Japanese, who was later tested positive for COVID-19 in Malaysia. As Malaysia reported the case, the government of Indonesia began to trace anyone who have had close contact with the Japanese and the infected Indonesians.
The cluster was initially identified as the "Jakarta cluster" or the "dance class cluster", owing to the location of the infection. Since then, confirmed cases of COVID-19 in Indonesia began to increase slowly. By 8 March, a total of 6 people who had attended the dance class were infected by the COVID-19, including one case of repatriated Indonesian from the Diamond Princess. Several COVID-19 cases in West Java and Jakarta were found to have a link with the cluster.
The positive cases first confirmed in March are not the first Indonesians to have been infected with the SARS-CoV-2 virus. In January, an Indonesian maid in Singapore contracted the virus from her employer.
The first confirmed death of COVID-19 in the country occurred on 11 March when a 53-year-old British citizen in Bali died. However, a Telkom employee who died on 3 March was found positive on 14 March.
Classifications
Cases
Since 14 July 2020, the Ministry of Health of the Republic of Indonesia classifies people involved with COVID-19 into four levels:
- A suspect is a person showing symptoms of respiratory infections, and has stayed within 14 days in any country or any region in Indonesia with local transmission and/or has established contact within 14 days with a confirmed or probable case and/or requires treatment at the hospital and has no possible diagnosis of other diseases.
- A probable case is a person, alive or deceased, who shows or showed obvious signs of COVID-19 symptoms and awaiting results of his or her swab test.
- A confirmed case is a person whose sample produced positive results based on swab or molecular rapid test. A confirmed case may be symptomatic or asymptomatic. Due to lower accuracy and higher chance of false positives, a positive rapid or antibody test is not counted into the official number of cases.
- A close contact is a person who established contact with a probable or confirmed case between 2 days before and 14 days after symptoms show up, or the date of testing for asymptomatic cases. The close contact must quarantine for 14 days. Reclassification into suspect may be done should if the person show symptoms.
Other classifications include:
- A recovered case is recorded after a confirmed case is discharged from isolation. For an asymptomatic case, it is 10 days after a sample testing; for a symptomatic case, it is after a swab test or 10 days after onset of symptoms, and at least 3 days after no fever or respiratory difficulties.
- Death is recorded after someone who had been confirmed COVID-19 positive died. People who were classified into probable case's deaths are not counted in the official tally.
Location
According to the Ministry of Domestic Affairs, a regency or municipality may be classified into three levels depending on the severity of COVID-19 cases within the region, according to these parameters:
- The number of positive cases within 14 days
- The number of suspected cases within 14 days
- The number of deaths buried according to COVID-19 protocol within 14 days
- Threat of disease contagions to healthcare workers
Each has a score of 15 points for increasing trends, 20 for stationary trends, and 25 for decreasing trends.
The three levels were assigned to a specific region:
- Red Zone if the total score reaches below 80 points. Large-scale social restrictions may be enforced.
- Yellow Zone if the total score reaches 80 to 95 points.
- Green Zone if the total score reaches 100 points (all 4 parameters show a decreasing trend).
Cases
Confirmed cases
Jakarta became the first province that confirmed COVID-19 cases, while Gorontalo was the last to do so. On 6 July 2020, Jambi became the last province to report a death, 53 days after the penultimate province East Nusa Tenggara did. West Java and Banten had ever reported 16,251 cases and 22,667 recoveries in a day respectively; both are the highest by a single province. Central Java hold the record for death numbers with 679. All six provinces in Java have the highest number of cases compared to other provinces, making it the worst-affected region in the country.
Suspected cases
Several travellers who had visited or transited through Bali later tested positive for SARS-CoV-2 shortly after their return to China, Japan, New Zealand, and Singapore.
An additional 50 to 70 people were put under surveillance after coming into contact with the first two confirmed COVID-19 patients. This number includes those who had visited Mitra Keluarga Hospital in Depok, the hospital the two confirmed patients were previously admitted to before being transferred to North Jakarta.
A 37-year-old man who died in a hospital in Semarang suspected of having COVID-19 reportedly tested negative, and was instead afflicted by swine flu, probably picked up from recent travels to Spain.
In West Sumatra, two people who returned from abroad died at Padang's Dr. M. Djamil Central General Hospital. On 13 March, a woman who was being treated as a suspect of COVID-19 after returning from Umrah died. On 16 March, a 47-year-old man from Kuala Lumpur, Malaysia landed at Minangkabau International Airport, showing symptoms of COVID-19. He was subsequently hospitalized at Padang's hospital and died on the same day.
Responses
International
WHO
Director-General of the World Health Organization Tedros Adhanom Ghebreyesus sent a letter to President Jokowi on 10 March 2020, urging countries with large populations, like Indonesia, to focus on increasing capacity of laboratoriums to detect cases of infection. Early detection is a key factor in limiting the spread of the virus as authorities are able to identify clusters faster. WHO gave advices, such as improving the mechanism of emergency responses, including asking for Indonesia to declare a national emergency situation as soon as possible, educating people and actively communicating while applying the appropriate risk communication measures, involving the local communities more, intensifying COVID-19 tracings, performing lab decentralization so that quick response teams can quickly map spread and clusters, and sharing detailed data on measures of the government in supervision and examination, including identification of patient contacts and summary of tracing patient contacts.
International aid
On 21 March 2020, the Asian Development Bank through the Asia-Pacific Disaster Response Fund granted US$3 million to Indonesia to counter COVID-19. The grant is a part of a $6.5 billion initial package prepared by ADB on 18 March 2020 to aid developing countries in countering COVID-19.
As of 24 April 2020, the COVID-19 Response Acceleration Task Force has received US$77.49 million from 9 countries, 9 international organizations, and 70 NGOs.
Central government
Early responses
Indonesia banned all flights from and to mainland China starting from 5 February 2020. The government also stopped giving free visa and visa on arrival for Chinese nationals. Those who live or have stayed in mainland China in the previous 14 days were barred from entering or transiting through Indonesia. Indonesians were discouraged from travelling to China.
On 6 March, the government announces 5 main protocols relating to COVID-19, which are health protocols, communication protocols, border control protocols, education institution protocols, and public area and transportation protocols.
Starting on 8 March, travel restrictions expanded to include Daegu and Gyeongsangbuk-do in South Korea, Lombardy, Veneto and Emilia-Romagna regions of Italy, and Tehran and Qom in Iran. Visitors with travel history within these countries but outside the aforementioned regions have to provide a valid health certificate during check-in for all transportation into Indonesia. Despite the restriction on travellers from South Korea, Indonesia was still allowing flights from the country.
The Ministry of Health ordered the installation of thermal scanners for at least 135 airport gates and port docks, and announced that provisioning over 100 hospitals with isolation rooms (to WHO-recommended standards) would begin. Starting on 4 March, Jakarta MRT also began scanning the temperature of passengers entering the stations and denying access to those with symptoms of high fever. Other public places such as mall and school also began to scan people at all their entrances.
After the first victim died, the Indonesian government admitted that they had difficulties in detecting incoming imported cases on airports, doing contact tracing and also location history for each case.
The Indonesian government announced on 4 March that it planned to turn a site on Galang Island, previously used as a refugee camp for Vietnamese asylum seekers into a 1,000-bed medical facility specially equipped to handle the COVID-19 pandemic and other infectious diseases.
On 13 March, the government designated 132 treatment facilities across Indonesia. On the same day, President Jokowi announces Presidential Decree No. 7 Year 2020 on the COVID-19 Response Acceleration Task Force, establishing the task force and appointing then- Chief of BNPB Doni Monardo as its head. On the same day, Minister of Home Affairs Tito Karnavian urged all of Indonesia's regional leaders to suspend all non-essential travel to foreign country.
On 15 March, President Jokowi called on all Indonesians to practice what epidemiologists call social distancing to slow the spread of COVID-19 in the country. Indonesian tax authorities announced that they would move back the tax reporting deadline to 30 April 2020.
On 16 March, the Ministry of State-Owned Enterprises instructed its employees aged 50 and over to work from home. President Jokowi also clarified that the decision to implement lockdown on cities or regencies are only to be made after consultation with the central government.
As schools were closing in some regions, Minister of Education Nadiem Makarim announced the readiness of the Ministry of Education to assist schools in online learning by providing free teaching platforms. Minister of Finance Sri Mulyani also announced a shifting of infrastructure budget of IDR 1 trillion into healthcare and pandemic prevention.
On 17 March, COVID-19 health protocols have been released to public. Ministry of Foreign Affairs also expanded the travel restrictions to temporary abolish visa free entry to Indonesia for one month and deny transit or arrival for visitors who have been in Iran, Italy, Vatican City, Spain, France, Germany, Switzerland, and United Kingdom within the past 14 days.