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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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Another blow as Judge throws out Kiggundu’s lawyer Muwema

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When court sat on Friday to hear the Kiggundu’s application to stop independent audit, he did not have a written application, and Justice Henry Adonyo instead ordered the plaintiff’s lawyer Fred Muwema to go make a written application seeking court to dismiss the audit and return to court on September 30 for a hearing of the application. But this adds more pressure on Kiggundu who is choking with the loans.

On 31 August, the judge ordered the Institute of Certified Public Accountants of Uganda (ICPAU) to carry out and independent audit into the accounts of the businessman and financial statements exchanged between the two parties, and present a report to court.

When asked by journalists why he has filed for an application seeking dismissal of the audit, Fred Muwema had this to say. “We are saying that let the validity and legality of those credit facilities (loans) be decided first before you can audit” He said.

The ruling on the application of the main suit to determine whether the businessman owes loan arrears to the bank is set for 5th October 2020, after which a date for hearing of the case will be set.

Background

Hamis Kiggundu through his companies Ham enterprises and Kiggs International (U) ltd sued DTB branches in Kenya and Uganda for deducting money from his accounts something which the bank contends and said they only acted as per the loan agreement of deducting 30% from Kiggundu’s accounts to recover the credit facilities rendered to him between February 2011 and September 2016

But Court documents filed by the bank in their defense shows that Kiggundu, between February 2011 and September 2016, was granted various credit facilities by the said DTB Banks.

First, via Ham Enterprises Limited, Kiggundu obtained a loan of $6,663,453 and another Sh2.5bn from the DTB (U) to finance his projects in the real estate business.

Later, according to New Vision, he got a facility worth $4.5m through Kiggs International (U) Limited from DTB (K) and mortgaged his properties, which include Plot 328 located at Kawuku on Block 248 Kyadondo, three plots that include 36, 37 and 38 on Folio 1533 Victoria Crescent II situated in Kyadondo and land on Makerere Hill Road on LRV 3716 Folio 10 Plot 923 Block 9.

Documents show that as of January 21, 2020, Kiggundu was in default on payment obligations of $6.298m on the loan facility of $6.663m, as well as sh2.885b on the demand overdraft facility of sh1.5b and the temporary demand overdraft facility of sh1b.

The banks say that Kiggundu was in default on the payment of another $3.662m out of a total loan facility of $4m and another $458,604 on a loan facility of $500,000, as of January 21, 2020.

The DTB consequently served him with a demand notice to either pay up or lose the assets that he submitted as collateral security. The bank threatened to attach a plot on Makerere Hill Road and other prime commercial properties.

Analysts says that Kiggundu’s lawyer is playing delaying tactics aimed at stopping the independent audit as ordered by the court earlier. Kiggundu had wanted court to believe his own audit of loan transactions, but that would amount to injustice to the banks that gave him money-DTB Uganda and DTB Kenya.

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Minister Rukutana charged with attempted murder, remanded

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The state minister for Labour, Gender and Economic Development Mwesigwa Rukutana has been remanded to Kyamugorani prison in Mbarara district.

Rukutana appeared before Ntungamo Grade One magistrate Nazifah Namayanja this afternoon from where he was charged with seven offences related to attempted murder, assault, malicious damage, and threatening violence.

Rukutana was captured in a video that went viral on social media showing him grabbing a gun from one of his bodyguards and started shooting at a vehicle belonging to supporters of his political rival Naome Kabasharira. At the time of the incident, Rukutana had just lost the Rushenyi country NRM flag to Kabasharira.

The prosecution alleges that on September 5, 2020, at Kagugu village in Ntungamo district, Rukutana and others still at large assaulted Julius Niwamanya and threatened to kill or injure him together with three others. The others are Stuart Kamukama, Dan Rwibirungi, and Moses Kamukama. 

It is also alleged that Rukutana also willfully and unlawfully damaged a motor vehicle registration number UAR 840X Toyota Rav 4 type which belongs to Moses Muhumuza.

According to the Judiciary public relations officer, Jameson Karemani, Rukutana has not taken a plea of these charges against him since they can only be tried by the chief magistrate who was not in court today.

As a result, the magistrate decided to send him to Kyamugorani, awaiting his return to court on Tuesday.      





Source – observer.ug

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Lira district headquarters closed over COVID-19

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Lira district headquarters have been closed after one staff tested positive for COVID-19 last week. 

On Monday morning, district staff were blocked at the gate with only the deputy chief administrative officer, his secretary and the receptionist allowed access to their offices. 

Paul Samuel Mbiiwa, the deputy chief administrative officer says that only heads of department will be allowed at the headquarters while the rest will work from home. He adds that the restriction will help to curb the spread of the virus.

“You see corona is not a joke. We have taken a step at fighting it and that is why you are seeing the staff outside. Even in my office here I do not want people to come if there is anything we can discuss on the phone.”

Francis Okello Olwa, a senior community development officer who doubles as the district spokesperson says that the entire district offices will be fumigated and closed for two days.

Health authorities in the district are planning to take samples from all the staff because they could have interacted with the one who tested positive. Currently, there are 19 COVID-19 patients under treatment at Lira regional referral hospital.     

On Sunday four health workers at the hospital tested positive for COVID-19. Dr Patrick Odongo, a senior medical officer at the hospital also succumbed to the virus.  





Source – observer.ug

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