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Endless first wave: How Indonesia failed to control coronavirus | Coronavirus pandemic News

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Only last week, Luhut Pandjaitan, Indonesia‘s maritime minister and close confidant of the country’s president, touted herbal mangosteen juice as a coronavirus remedy.

His suggestion was the latest in a string of unorthodox treatments put forward by members of Joko Widodo’s cabinet during the past six months, ranging from prayer to rice wrapped in banana leaf to eucalyptus necklaces.

The remedies reflect the unscientific approach to battling the coronavirus in the world’s fourth-most populous country, where the rate of testing is among the world’s lowest, contact tracing is minimal, and authorities have resisted lockdowns even as infections spiked.

Indonesia has officially reported 6,346 deaths from COVID-19, the disease caused by the new coronavirus, the highest overall toll in Southeast Asia. Including people who died with acute COVID-19 symptoms but were not tested, the death toll is three times higher.

Indonesia shows no signs of containing the virus. It now has the fastest infection spread in East Asia, with 17 percent of people tested turning out positive, rising close to 25 percent outside the capital, Jakarta. Figures above 5 percent mean an outbreak is not under control, according to the World Health Organization.

“This virus has already spread all over Indonesia. What we are doing is basically herd immunity,” said Prijo Sidipratomo, dean of the Faculty of Medicine at the National Veterans Development University in Jakarta. “So, we should just dig many, many graves.” Herd immunity describes a scenario where a large proportion of the population contracts the virus and then widespread immunity stops the disease from spreading.

Government spokesman Wiku Adisasmito did not respond to detailed questions from Reuters. He said the number of infections was “a warning for Indonesia to continuously improve its handling effort,” and that positive cases per capita in Indonesia were lower than most countries. President Joko Widodo’s office did not respond to questions sent by Reuters.

To be sure, Indonesia‘s confirmed 144,945 infections out of a population of 270 million are much less than the millions reported in the United States, Brazil and India, and below the neighbouring Philippines, which has less than half Indonesia‘s population. But the true scale of Indonesia‘s outbreak may still be hidden: India and the Philippines are testing four times more per capita, while the US is testing 30 times more.

Statistics from Our World in Data, a nonprofit research project based at the University of Oxford, show Indonesia ranked 83rd out of 86 countries surveyed for overall tests per capita.

“Our concern is that we have not reached the peak yet, that the peak may come around October and may not finish this year,” said Iwan Ariawan, an epidemiologist from the University of Indonesia. “Right now, we can’t say it is under control.”

‘Pure nonsense’

At the start of the pandemic, Indonesia‘s government was slow to respond and reluctant to reveal what it knew to the public, according to more than 20 government officials, test laboratory managers and public health experts who spoke to Reuters.

Despite surging cases in neighbouring countries and having 3,000 polymerase chain reaction (PCR) test kits – the WHO-approved test for detecting the coronavirus – ready by early February, the government said fewer than 160 tests had been conducted by March 2.

On March 13, Widodo said the government was withholding information so as not to “stir panic”. During the first two weeks of March, the government concealed at least half of the daily infections it was aware of, two people with access to the data told Reuters. The two people said they were later restricted from seeing the raw data.

A call by Widodo in March for a massive expansion of rapid diagnostic testing may have undermined the country’s testing regime, according to Alvin Lie, a commissioner in the office of the Indonesian Ombudsman, an official government watchdog.

Scientific studies have shown rapid tests, which test blood samples for antibodies, were found to be far less accurate than the PCR method, which tests swabs from the nose or throat for genetic material. Widodo’s push to use a less-reliable test diverted resources away from PCR tests, three lab managers told Reuters.

Lie told Reuters that importers of the rapid tests, including large state-owned enterprises and private companies, made “huge profits” by charging consumers up to one million rupiah ($68), even though each test costs only 50,000 rupiah ($3.50).

By mid-April, provincial governments said rapid testing in the provinces in West Java, Bali and Yogyakarta produced hundreds of false negatives and false positives.

But the tests continued to be widely used and it took until July for imports of rapid tests to be halted and for the government to introduce a price cap of 150,000 rupiah ($10). In July, Indonesia also formally advised provincial governments and others not to use rapid testing for diagnostic purposes in their updated guidelines for COVID-19 prevention and control.

But Lie said there is a huge stockpile and rapid tests are still being broadly deployed, including for screening office workers and travellers to allow them to move freely for 14 days.

“That is like saying for the next 14 days after the rapid test they are free from the virus. That’s pure nonsense. All it indicates, and not very accurately, is they were free from the virus when the sample was taken,” said Lie.

Adisasmito declined to comment on whether the president’s call for rapid testing undermined its overall testing efforts. He did acknowledge the inaccuracies of rapid testing but said it was still useful in some situations where the capacity to use PCR tests is limited, including screening travellers. He did not directly answer questions about companies making large profits from tests.

The central government does not disclose the level of national rapid testing. But data from West Java, Indonesia‘s largest province with 50 million people, shows that it has conducted 50 percent more rapid tests than PCR tests.

Government officials say 269 labs with PCR machines are now operating. However, the labs are increasingly unable to meet demand as infections rise. The number of suspected cases – those with COVID-19 symptoms who have not been tested – has doubled to 79,000 in the past month, according to government data.

Part of the problem is that lab capacity is far from being fully utilised, according to four health officials. One senior health ministry official, Achmad Yurianto, told Reuters Indonesia was able to test 30,000 people per day, more than twice the daily average of 12,650 people tested during the past month.

Five lab managers and consultants contacted by Reuters said the failure to use the country’s testing capacity was due to government mismanagement that had led to shortages of staff and reagents, chemicals needed for the tests.

Adisasmito did not respond to questions about the government’s management of testing. Last week, explaining the shortfall in testing, Yurianto said labs did not have enough time to check all specimens, with some labs working limited days and hours.

Minimal contact tracing 

Widespread PCR testing and quick results are essential for tracing the contacts of those infected by the coronavirus. According to national guidelines released by Indonesia‘s health ministry on July 13, contact tracing is “the main key in breaking the COVID-19 transmission chain”.

Reuters spoke to 12 health workers across Indonesia who described the country’s contact tracing effort as bungled and ineffective.

Passengers queue to board a commuter train during the morning rush hour on the outskirts of Jakarta on July 27. Doctors say the country is still battling an endless first wave of the coronavirus [Fakhri Hermansyah/Antara Foto via Reuters]

Rahmat Januar Nor, a health official in the city of Banjarmasin in Indonesian Borneo, said information about new coronavirus cases often came into his office in varying states of disorder, with incomplete names, inactive phone numbers or outdated addresses for patients and their contacts, problems seen by healthcare workers across the country.

“We asked the village leaders for help,” Nor told Reuters. “But in the end, we didn’t find them (the contacts) most of the time.”

When they did reach contacts, many refused to be tested, fearful they would lose their jobs or be ostracised in the community, Nor and other health officials said.

Unpublished data from the government COVID-19 task force, reviewed by Reuters, shows only 53.7 percent of people identified as confirmed or suspected carriers of the disease were subjected to contact tracing by June 6.

Adisasmito did not provide more recent contract tracing data but acknowledged it “remains low” and said the government aimed to track 30 people per positive case. That is still low compared with other Asian countries. South Korea said in May it traced and tested almost 8,000 people after a man with the virus visited a nightclub.

According to five people familiar with the matter, the WHO advised Indonesian authorities that contact tracing should involve at least 20 people tracked per confirmed and suspected case. But Indonesia is only averaging about two traced contacts per case, according to provincial officials and data reviewed by Reuters.

In Jakarta, where the epidemic first took hold in the country, the data shows fewer than two contacts traced, on average, for each confirmed and suspected case in July.

In East Java, another hotspot, tracing rates are 2.8 contacts per each confirmed and suspected patient, according to researchers from Airlangga University.

A WHO spokesperson said Indonesia began following its contact tracing recommendations in mid-July.

‘Always on the first wave’ 

Indonesia‘s decision to reject full lockdowns was driven by economic and security concerns, said government advisers.

Instead, it has urged Indonesians to wear masks, wash their hands and practise social distancing while working, travelling and socialising.

Firefighters Indonesia coronavirus

Firefighters wearing protective suits spray disinfectant at the National Monument area to prevent the spread of the coronavirus disease (COVID-19) in Jakarta in June [Wahyu Putro/Antara Foto via Reuters]

“The argument was that we could not [afford it],” Soewarta Kosen, a health economist who consulted the government on its coronavirus response, told Reuters. “We were afraid that there would be social unrest.”

Widodo’s emphasis on the economy is popular, polling shows. The Indonesian economy only shrank 5.3 percent in the second quarter of 2020, much less than many other regional economies. But epidemiologists said they fear the decision will cost Indonesia more in the long term, especially as its health system is poorly equipped to cope if positive cases continue to surge.

Dr Bambang Pujo, an avid runner and anaesthetist at the main COVID-19 referral hospital in Indonesia‘s second-largest city of Surabaya, said mortality rates in his ward are between 50 percent and 80 percent and there are not enough beds.

“Ten hours inside a hazmat suit is like running a marathon twice,” he said, describing the long hours he spends in protective gear inside the intensive care unit. “Imagine how we feel. It is like playing God. We hope that we don’t make mistakes and, if we do, we are forgiven.”

Indonesia has only 2.5 intensive care beds per 100,000 people, according to the country’s national disaster agency, which leads the COVID-19 task force. That compares with 6.9 per 100,000 people in India, according to an April report from Princeton University. Adisasmito said the healthcare system is being continuously improved.

“We must know that our infrastructure is not ready for a pandemic like this,” said Pujo. “Other countries have heard of second waves. We’re always on the first wave.”



Source – www.aljazeera.com

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Year of the Overcomer-Prophet Elvis Mbonye

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The eagerly awaited first fellowship of controversial Prophet Elvis Mbonye left viewers shocked as he declined to issue his now famous prophecies citing a refusal to settle for the new normal. In an on online service watched by thousands, the Prophet said him prophesying would “ be a concession to gathering online, rather than physically” further stating that it is not the will of God that church should meet online!

The Covid-19 SOPs given by the government and Ministry of Health have heavily impacted gatherings and as a result, ministries with large congregations have resorted to online services. The prophet however insists that this is a ploy to diminish the influence of the Kingdom of God.

He however proceeded to give the Prophetic Word of the year , saying “This is the year of the Overcomers” amidst cheers from those present. He also stated that this would not be a “gloomy” year, probably meaning that this would be a good year. Given that many of his prophecies have actually come to pass, should we pay more attention to him? We eagerly await the prophecies this year.

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Kabuleta blasts Media over “COFIT” reporting in new rant.

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Presidential hopeful Joseph Kiiza Kabuleta has expressed dissatisfaction with the media over what he says was”alarmist reporting” over the Covid-19 pandemic which he calls “COFIT” a term we believe is a wordplay between covid and profit, a view held by many that claims that the disease was exaggerated to maximize funding and corruption. Kabuleta has come to be known for his straight shooting style and admirable command of facts and policy, even being touted as the “smartest candidate” in the race.here is the full statement:

MEDIA AND THE COFIT ENTERPRISE

By Joseph Kabuleta

“Don’t look at where you fell, but where you slipped”
AFRICAN PROVERB

We know where the media fell. They fell when they were caught in the crossfire between opposition politicians and trigger-happy security hitmen; when they were unfairly targeted as they went about their noble duty of covering this explosive elective season. Sadly, some journalists are nursing wounds; others weren’t so lucky.
But it’s important for us to understand where they slipped.

If someone is sitting by the roadside sipping on his brew and he sees a gang of people sprinting past him, as if for their lives, it’s understandable if he impulsively joins without asking questions. But if after nine months he is still sprinting, and has still not asked any questions, then there’s something terribly wrong with him.

When we first went into lockdown in March, it was probably the best course of action because we didn’t know the full extent of the Cofit threat. But in the first 90 days, it was clear to all and sundry that it was never going to rank among Uganda’s top health challenges. And that’s not my opinion.

The Daily Monitor on July 15th quoted Dr Baterana Byarugaba, the Mulago Hospital Executive Director, describing the Cofit strain in the country as a mild form of flu which does not require hospital admission since it can be treated at home or in lower health facilities.
“l told Ugandans right from the beginning that the type of coronavirus we expect in Uganda is the mild one. It can be treated at health centre II, III, IV or the district hospital,” the top Medic said.

I read the story with glorious delight supposing that finally common sense, (or should I say science sense) would inform our decisions as a nation. But it’s difficult to know where science stops and politics starts. It’s become clear over the months that Cofit is not just a virus that causes respiratory problems, it’s a lot more than that; it’s a weapon in the hands of politicians that gives them power beyond their wildest dreams. In America, for instance, Democrat Congressman Jim Clyburn said Cofit is a “tremendous opportunity to restructure things to fit our (leftist) vision” while actress and activist Jane Fonda said that Cofit was “God’s gift to the left.”

Our media could have taken the side of poor Ugandans by showing the immense suffering and death from preventable sicknesses that resulted from the harsh Cofit measures; they could have highlighted the plight of businesses permanently closed and workers rendered redundant and sent back to villages. They could have wondered why truck drivers were testing negative in Kenya and positive in Uganda, or wondered why Cofit deaths only started after Prophet Museveni showed us a macabre lineup of coffins in his address, or why every celebrity who dies since then is ruled as Cofit (no autopsy required)

They could have told us that according to Worldometer, Cofit has a 0.28% mortality rate (or a 99.72 survival rate) and that it doesn’t rank anywhere in the Top 10 of Uganda’s health challenges; they could have told us that a child dies of malaria every two minutes (and Uganda accounts for 3% of the world’s malaria fatalities), which means that more Ugandans die from mosquitoes in ten days than Cofit has (allegedly) killed in the nine months it’s been on our lips.

Ugandans (especially of my age) have lived through real pandemics. As a young man growing up in the early 90s, nobody had to remind me that AIDS was real. Goodness me, I knew it was! And I didn’t need police to force me to wear protection, I knew the consequences. The fact that we are constantly being reminded that ‘Cofit is real’ tells a story of its own.

The media could have asked why Uganda, with one of the lowest Cofit cases or deaths, still holds on to a 9:00pm curfew when Kenya moved to 11:00pm in September, as did South Africa and several countries. The media could have told us that Malawi, Burundi, Tanzania and, recently, Ghana all held successful elections with full blown campaigns in 2020, and we aren’t hearing people dropping dead from Cofit in any of those countries. May be they should have tried to find out if people are dropping dead in Tanzania which altogether ignored all Cofit measures and went on to acquire middle-income status while Ugandans were still in lockdown.

They could have told us about the asymptomatic Cofit patients who were filmed dancing the night away in hospital wards, or of people suffering from other diseases who dare not go to hospital because they fear to be given a fake Cofit label and held for two weeks against their will.

The media could have told us that Cofit deaths across the world have been grossly inflated. Minnesota lawmakers say Cofit deaths could have been inflated by 40% after examining death certificates (according to The Washington Examiner) while Fox News reported that in Colorado 45% of Cofit corpses “were also found to have bullet wounds”.

They could have told us that 22 European countries, all of which had tens of thousands of Cofit deaths, opened their schools in the fall, and there has not been any reported spikes in cases as a result. They could have told us that more people have been killed by security men enforcing Cofit measures than by the virus itself.

Well, they could have…but they didn’t. And that’s where they slipped.

Instead they chose to go down the path of alarmist reporting and in so doing became, inadvertently or otherwise, enablers of Uganda’s trillion-shilling Cofit enterprise. Like Squealer in George Orwell’s Animal Farm, the media used flowery language to drum up fear by keeping people’s eyes transfixed on swelling numbers while the thieves carried their loot and stashed it away, and loan money was distributed among family members or used in regime prolongation.

The recent joint television news bulletin, and the adverts that followed, were the peak of hysterical reporting. “Zuukuka Tusaanawo” (wake up, we are perishing) screamed an advert featuring top media personalities. What a load of……(fill in appropriate word).

Remember, all the tyranny we have witnessed in this season has been done in the name of Cofit, and such sensationalist reporting justifies it; it gives dictators like Museveni the perfect pseudo-moralistic cover to unleash their most despotic fantasies while actually pretending that it’s for the good of the people. Unfortunately, the terror has now spread to the very media people whose hyperbole enabled it in the first place. There is such a thing as the law of cause and consequence, after all.

Instead of the media walking out of pressers and threatening to boycott government functions, let them threaten to stop all Cofit reporting. Museveni himself would come running with chocolate in hand.

If the president extended curfew by just two hours, for instance, he will have put as many as 200,000 Ugandans back to work especially in the hotel, restaurant and entertainment industries; but he doesn’t care, and sadly neither do many middleclass Ugandans who suppose that it’s their moral obligation as responsible citizens of the Global Village to fret over Cofit just because their ‘fellow citizens’ in Europe and America are doing so. Of course they can afford to do that because their corporate jobs have, for the most part, insulated them from the devastation of the government-instituted Cofit measures. They can enjoy working at home, beer in hand, as they listen to CNN and BBC and still expect the full complement of their salaries at the month end, and that makes them feel every bit like ‘their brothers’ overseas.

Such aspirational conformists are more likely to be offended by my stance on Cofit because they haven’t traversed crook and creek of this country and seen the damage reigned on this fragile society; not by the virus, but by the measures supposedly instituted to mitigate it.

You see, perhaps the most enduring damage this regime has done to our society is creating a three-part hierarchy of class and needs. At the zenith are a handful of connected ‘1986 generation’ and their families who feel entitled to all power and wealth. Beneath is a small (and shrinking) middleclass, and at the bottom of the pyramid is a mass of peasants. Every society, to various degrees, is ordered in the same fashion, but what makes Uganda unique is that the megalomaniacs at the top don’t give a nickel about the plight of the middleclass and the middleclass in turn don’t care a bit about the quandary of the peasant. The charlatans at the top will impose punitive taxes on the middleclass, then dip into NSSF coffers at a whim to share out their savings, and no one can stop them.

And the middleclass Ugandan, armed with his medical insurance, and safe in the knowledge that his wife is unlikely to die in child birth (20 Ugandans do EVERY DAY), and his children are very unlikely to die of malaria (20 do EVERY DAY), or from malnutrition (thousands do every year), will go around trumpeting Cofit because it’s more relevant to his status than malnutrition or malaria.

I could just as easily go down that path. I could also close my eyes to mothers failing to get breast milk because they can only afford half a meal a day (black tea with a piece of cassava), and the malnourished babies that emerge as a result; I could close my eyes to the teenage girls that were given out in marriage because schools closed, or those given out to meet family needs; I could ignore the fact that our president is opening 5-star markets in cities which have 1-star referral hospitals; I could also choose to look the other way and enjoy my middleclass lifestyle, but as an aspiring leader, I cannot.

As a leader, my aspiration is to remove the privileged/entitled class, to expand the middleclass (and their income), and to shrink the peasantry; but mostly to blur the lines that separate each category.
It doesn’t bode well for our country if the average Corporate Ugandan knows more about racism in America than about extreme poverty in Teso or Busoga because that disqualifies him/her from the solution to those local problems.

And finally, I have come to the realization that the biggest pandemic afflicting our country is poverty and the virus that causes it is called M7-1986. Vaccination against it is January 14

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Muntu Blocked in Kamwenge

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Alliance for National Transformation presidential candidate Gen. Mugisha Muntu has been blocked from campaigning in Kamwenge according to a statement he released earlier today.Below is the full statement:

STATEMENT
Today in Kamwenge, as we have done since the start of the campaign season, we headed out to speak with the people. We had earlier in the week agreed on the venue with security agencies. No one had anticipated that it would rain as much as it did, making it impossible for us or the people to access.

After identifying an alternative place only 100m away from the original venue, negotiating with the owner and communicating the same to the public, we headed to the second venue only to be stopped by police.

Our policy has always been to do all we can to be reasonable, even in the face of unreasonable action on the part of the state. We engaged the police leadership in a civilized, respectable manner well knowing that they intended to not only frustrate us, but cause us to act in ways that would give them an excuse to cause chaos. This was on top of their intimidating the radio we had booked and duly paid to appear on.

While we are confident that we are on the right side of both the law and reason, we have chosen not to endanger the lives of our supporters or the general public by escalating the situation. We will do everything humanly possible to avoid a single life being lost or blood being shed on account of our campaign.

And yet this truth remains: the regime’s days are numbered.

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