Abstract
BackgroundAs in many countries, quantifying COVID-19 spread in Indonesia remains challenging due to testing limitations. In Java, non-pharmaceutical interventions (NPIs) were implemented throughout 2020. However, as a vaccination campaign launches, cases and deaths are rising across the island.MethodsWe used modelling to explore the extent to which data on burials in Jakarta using strict COVID-19 protocols (C19P) provide additional insight into the transmissibility of the disease, epidemic trajectory, and the impact of NPIs. We assess how implementation of NPIs in early 2021 will shape the epidemic during the period of likely vaccine rollout.ResultsC19P burial data in Jakarta suggest a death toll approximately 3.3 times higher than reported. Transmission estimates using these data suggest earlier, larger, and more sustained impact of NPIs. Measures to reduce sub-national spread, particularly during Ramadan, substantially mitigated spread to more vulnerable rural areas. Given current trajectory, daily cases and deaths are likely to increase in most regions as the vaccine is rolled out. Transmission may peak in early 2021 in Jakarta if current levels of control are maintained. However, relaxation of control measures is likely to lead to a subsequent resurgence in the absence of an effective vaccination campaign.ConclusionsSyndromic measures of mortality provide a more complete picture of COVID-19 severity upon which to base decision-making. The high potential impact of the vaccine in Java is attributable to reductions in transmission to date and dependent on these being maintained. Increases in control in the relatively short-term will likely yield large, synergistic increases in vaccine impact.
Highlights
As in many countries, quantifying COVID-19 spread in Indonesia remains challenging due to testing limitations
Non-pharmaceutical interventions (NPIs) have included national social distancing measures encouraging people to work, study, and worship at home (March 15) [4]; mandated social distancing measures implemented on April 10 as part of a lockdown, named Pembatasan Sosial Berskala Besar or PSBB in Indonesian [4]; and a ban on domestic travel during the month of Ramadan (April 24 to June 7) [5]
We estimate that 31 (22–41 95% CrI) and 124 (107–139 95% CrI) confirmed deaths and COVID-19 protocols (C19P) funerals had symptom onset occurring before 2nd March when COVID-19 was first identified in Indonesia
Summary
As in many countries, quantifying COVID-19 spread in Indonesia remains challenging due to testing limitations. As a vaccination campaign launches, cases and deaths are rising across the island. The city of Jakarta (the capital of Indonesia) subsequently became the epicentre of the country’s epidemic, following which the disease spread throughout the island. In June, Indonesia entered the Adaptasi Kebiasaan Baru (AKB or ‘new normal’) period where some restrictions were lifted (Fig. 1a and b) [4]. During this AKB period, the reported incidence of COVID-19 cases and deaths increased across Indonesia, with community transmission evident across the six provinces of Java (Fig. 1c and d). The campaign initially involved vaccinating health care workers but was extended to the elderly and public workers on 17 February 2021 [9]
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