Written by: Fira Abdurachman, Richard C. Paddock and Muktita Suhartono
By the thousands, they sleep in hallways, tents and cars, gasping for air as they wait for beds in overcrowded hospitals that may not have oxygen to give them. Others see hospitals as hopeless, even dangerous, and take their chances at home.
Wherever they lie, as COVID-19 steals their breath away, their families engage in a frantic, daily hunt for scarce supplies of life-giving oxygen.
Indonesia has become the new epicentre of the pandemic, surpassing India and Brazil to become the country with the world’s highest count of new infections. The surge is part of a wave across Southeast Asia, where vaccination rates are low but countries had, until recently, contained the virus relatively well. Vietnam, Malaysia, Myanmar and Thailand are also facing their largest outbreaks yet and have imposed new restrictions, including lockdowns and stay-at-home orders.
In Indonesia, cases and deaths have skyrocketed in the past month as the highly contagious delta variant sweeps through densely populated Java island, as well as Bali. In some regions, the coronavirus has pushed the medical system past its limits, although hospitals are taking emergency steps to expand capacity.
Bekasi Regional Public Hospital, where some COVID patients have waited days for treatment, has erected large tents on its grounds, with beds for up to 150 people. Nearby in Jakarta, the capital, a long line of people waited for hours outside a small dispensary, hoping to fill their portable tanks with oxygen.
Among them was Nyimas Siti Nadia, 28, who had been searching for oxygen for her aunt’s family, all sick with COVID.
“She is a doctor and she is afraid to go to a hospital because she knows the situation,” Nyimas said. “There are many instances where patients do not get beds or oxygen. If we go to the hospital, we have to bring our own oxygen.”
On Thursday, Indonesian authorities reported nearly 57,000 new cases, the highest daily total yet — seven times as many as a month earlier. On Friday, they reported a record 1,205 deaths, bringing the country’s official toll from the pandemic to more than 71,000.
But some health experts say those figures vastly understate the spread in Indonesia, the world’s fourth-most-populous nation, because testing has been limited. Dicky Budiman, an Indonesian public health researcher at Griffith University in Australia, estimates that the true number of cases is three to six times higher.
In India, where the delta variant was first identified, daily cases peaked at more than 414,000 in May, but they have since dropped to about 40,000.
Despite Indonesia’s mushrooming caseload, officials say they have the situation under control.
“If we talk about the worst-case scenario, 60,000 or slightly more, we are pretty okay,” said Luhut Pandjaitan, a senior minister assigned by President Joko Widodo to handle the crisis. “We are hoping that it will not reach 100,000, but even so, we are preparing now for if we ever get there.”
Many Indonesians, however, have been facing their worst-case scenarios for weeks.
Family members describe nightmare scenes of trying to get a hospital to admit their sick relatives. Some hospitals were accepting only patients who brought their own oxygen, they said. At others, patients waited wherever they could find space to lie down.
Even being admitted does not make getting oxygen a certainty. At Dr Sardjito General Hospital, in the city of Yogyakarta, 33 patients died this month after the central oxygen supply ran out. The staff switched to tanks donated by the police, but it was too late for many patients.
Overwhelmed hospitals have added thousands of beds, but on average, 10 per cent of their health care workers are in isolation after exposure to the virus, said Dr Lia G. Partakusuma, secretary-general of the Indonesian Hospital Association. Some hospitals are using five times as much liquid oxygen as normal, and distributors are having difficulty keeping up with the demand, she said.
“Some hospitals have said, ‘If you brought your own oxygen tank, please use it first because we have a limited oxygen supply,’” she said. “But it is not a requirement for them to bring their own oxygen.”
With hospitals so overcrowded, many people choose to stay home — and many die there. Lapor COVID, a nonprofit group that is tracking deaths from the disease, reports that at least 40 COVID patients a day are now dying at home.
The president has stopped short of a nationwide lockdown but ordered restrictions in Java and Bali, including closing places of worship, schools, shopping malls and sports facilities, reducing public-transit capacity and limiting restaurants to takeout. The restrictions are set to expire Tuesday, but officials are weighing whether to extend them.
Only about 15 per cent of Indonesia’s 270 million people have received a dose of a coronavirus vaccine, and just 6 per cent are fully inoculated. Indonesia has relied heavily on the vaccine made by Sinovac Biotech, a Chinese company, which has proved less effective than other shots. At least 20 Indonesian doctors who were fully vaccinated with Sinovac have died from the virus.
This past week, the United States donated 4.5 million doses of the Moderna vaccine to Indonesia. Officials said the first priority would be to give booster shots to nearly 1.5 million health workers.