COVID-19’s effects in Indonesia
How many real positive cases of Coronavirus are in Indonesia; How fast is its growth; and How it will impact local small and medium businesses in Indonesia
In the last couple of months, we have been flooded by news related to COVID-19 (also known as Novel Coronavirus). It was first dominated by news from mainland China, especially from the city of Wuhan, but then it grew significantly to other countries across continents. The first spread of the virus in China was unfortunately close to the Chinese New Year holiday period, when most Chinese in the mainland travel across the country. Non-Chinese citizens were also likely to travel abroad to fill-up their holiday time, which might have increased the spread velocity. The World Health Organization (WHO) has then declared COVID-19 as a global pandemic on March 11, 115 days after its first existence was confirmed in China.
To date, the Coronavirus has had a relatively low (estimated-) basic reproductive number (R0) of 2.13 to 3.33 [ref] (other studies predicted R0=4 [ref]). The R0 means that one infected-person could infect two to three other people. It is important to note that the R0 may be further updated, as the virus is not yet well-known. Despite its relatively low R0 compared to previous infectious disease outbreaks, the impact of the pandemic has heavily affected different aspects of life, ranging from economics, tourism, education to religious matters (Figure 1).
This article gives an overview about the COVID-19 outbreak in Indonesia, especially about its penetration into the country, the general public’s reactions, and the potential outcomes from possible actions the government could take.
Coronavirus’ Penetration in Indonesia
Indonesia, the 4th most populous country in the world, was one of the latest countries in Southeast Asia to experience the Coronavirus outbreak. The Indonesian government initially claimed that they had been prepared to fight the outbreak since the endemic began in China. Despite all the efforts to prepare the country from the contagion, unfortunately, Indonesia officially announced its first COVID-19 positive case on March 2nd, involving two citizens in West Java (Jawa Barat) who had been in direct contact with a Japanese tourist from Malaysia. Since then, similar to other infected-countries, the number of COVID-19 cases has exponentially grown.
Estimating the Initial Risk in Indonesia’s Provinces
In Indonesia, since the outbreak started from overseas, it is fair to assume that the early phase of the disease’s spread is likely correlated with proximity to international travelers and tourists who unknowingly carried the virus. Given the popular tourist destinations in Indonesia, we estimate the risk of top fourteen provinces to get a new positive COVID-19 case from overseas (Figure 2).
The main contributor of the high-risk of the top-three provinces is the number of tourist visits, especially international tourists from infected-countries. As Indonesia is an archipelago, a country consisting of thousands of islands, many people travel domestically via air travel, which could lead to fast wide-spread contagion once the virus got into the country.
Distribution of Confirmed COVID-19 Cases
As of March 22nd, the number of confirmed positive cases in Indonesia is 541, mostly affecting people in productive-ages (21 to 69 years old). For reference, China and Hong Kong have similar age distributions (Figure 3). It’s no surprise that productive people are more likely to come into physical contact and allow the disease to spread, since the virus transmits through close human contact. The fatality rate, however, increases up to 7x for the senior population (>80 years old) as compared to those in the productive population[ref].
The numbers of reported cases are what we hear from the news. However, the real number is likely to be higher than that, which we will explore in the next section. This is either due to lack of proper test kits, poor coordination by officials, or reluctance of the general public to get tested.
So the question is, just how different are the number of real cases from the reported cases?
Modeling COVID-19 real positive-cases in Indonesia
From the reported cases, we can get two data points: total number of confirmed positive Coronavirus cases, as well as total deaths in the country. These are the cases from people who wanted to be tested, and received a test kit for COVID-19.
To estimate just how many real cases of Coronavirus in Indonesia, we would need to create a model from the number of reported cases. In this model, we would need three additional parameters, namely fatality rate, doubling time and days from infection to death. The parameter definitions are as follows:
Fatality rate = total reported deaths / total reported positive cases
Doubling time = days for positive cases to double in number
Days from infection to death = days from infection to symptoms + days from symptoms to death
We can infer this by either using the current statistics in Indonesia, or using other countries as proxies for comparison. For this simulation, we compared the rates in South Korea (where officials took swift measures of containment) and Italy (which unfortunately now has the largest total deaths in the world).
Surprisingly, even with the conservative numbers from the simulation, we can see our current (22nd March) estimated real positive cases (~3,500), approximately 7x larger than the current reported cases (514). This suggests that we can expect the Coronavirus issue to be more severe and widespread than the current numbers suggest.
Gauging Indonesia’s Reaction to COVID-19 using Bukalapak Data
Initially, the public did not have a significant reaction towards COVID-19, when endemic only in China. As it began to spread rapidly in Indonesia, people started seeking defensive measures against the virus. The demand for health-masks started to increase (Figure 5) as it was believed to prevent virus infection. However, according to the WHO, masks are not effective for general Coronavirus prevention. These are the suggestions from WHO related to the issue,
- If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection.
- Wear a mask if you are coughing or sneezing.
- Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.
Despite the aforementioned-comments from WHO and the increasing prices of masks due to limited supply, demand continues growing exponentially. From Bukalapak’s internal data, we see the trend is similar with hand sanitizer, hand soap, and alcohol-based hand rubs. We also notice that demand for thermometers has also increased, suggesting that people might have increased their awareness of the importance of early detection by monitoring their body temperature. (Figure 5)
WHO has also suggested boosting the body immune system, e.g. by doing physical exercise and consuming healthy foods. In Indonesia, folk medicine (well known as Jamu) are believed to serve that purpose. Figure 6 shows the significant trends on the interest towards herbaceous plants, the base-material for Jamu.
As people minimize human contact, demand for commuting and traveling has substantially decreased. Below you can see the demand for travel-related products at Bukalapak, such as train tickets.
Several major provinces in Indonesia (e.g. West and Central Java) have suggested for its residents to work from home; to limit their outdoor activities; and to cancel any activities that involve a large number of people. This has pushed people to stock-up their food-supplies. In Bukalapak, we see an increasing trend of search actions in the food-category, especially those related to daily basic needs such as rice and sugar.
Planning for Uncertain Futures
A number of countries, including Indonesia, are currently recommending citizens to undergo Social Distancing by reducing non-essential gatherings and keeping significant distance from one another. Another recommendation not touching your face, and deliberate hand washing with soap. However, tackling the ongoing crisis will require more serious effort. Learning from other countries’ attempt to control the growth of the spread, there are a couple of options that should be considered by the Indonesian government.
Option 1 — Testing the Masses
South Korea, Japan, Taiwan and Singapore are countries that have undertaken mass-testing to early detect their citizens with COVID-19, allowing for individual treatment and mitigation plans to prevent further spread. If Indonesia follows this route (which is currently planned by the Indonesian government), we can expect the number of positive cases to rise drastically for all those who have yet to be tested. This will hopefully incentivize the government to take necessary actions to cope with the rising number of cases.
Option 2 — Lockdown
Indonesia’s closest neighbors, Philippines and Malaysia have taken a more aggressive way to combat the outbreak. Lockdown has applied in those countries since March 12 and March 18, 2020, respectively. Despite detecting the first positive cases more recently, Indonesia has the highest mortality rate (as of March 22) and fastest time to double in Southeast Asia. The government should take immediate but wise actions to suppress this spread. As it’s been effectively proven to reduce the growth in Wuhan [ref], should the Indonesian government take the lockdown option?
If it is applied in Jakarta, where the most cases are reported (~60%, as of March 23), the immediate impact of this policy to our small and medium enterprises (SMEs) are obviously the loss of their transactions. We estimated that more than a half million potential transactions on SMEs would be lost during the first week of lockdown in Jakarta (the number was estimated from a time-series model by considering weekly and monthly seasonal effects and by using internal data at Bukalapak).
Remarks
People have proactively sought protection against COVID-19, especially since the first positive case was announced in the country. Using the current data points that we have, we notice that the Coronavirus crisis is unfortunately growing at an alarming rate. These extraordinary times have caused a surge in demand of maskers, hand sanitizers, and other goods thought to be important to combat the pandemic. However, social distancing and hand washing with soap are key actions to slow down the spread of the pandemic. Furthermore, the government must take extra measures to enforce social distancing and prevent the ballooning growth of positive cases in Indonesia.
Keep yourselves up to date with the latest Coronavirus news and statistics: bl.id/PantauCorona
Authors: Putri Wikie Novianti, Alben Tumanggor, Hafizha Husnaisa and Jonathan Kurniawan
