DON'T PANIC.... well, maybe a little bit.

This is just an observation from daily life, but I wonder how prevalent it is that people around us are treating new normal as “back to normal”?

The Mas that delivers Aqua gallon and gas to our place was so good at observing health protocols (wears facemask, washes hands when entering our place, etc.) during the PSBB period that we thought he was pretty reliable health protocol-wise. But the last 2 times he’s delivered Aqua, however, he has ceased to wear a facemask and had to be reminded to wash his hands.

The same is happening with the tukang parkir at the local marts. All have started to slacken in their wearing of facemasks in recent weeks after all being so good at observing health protocols.
 
This is just an observation from daily life, but I wonder how prevalent it is that people around us are treating new normal as “back to normal”?

The Mas that delivers Aqua gallon and gas to our place was so good at observing health protocols (wears facemask, washes hands when entering our place, etc.) during the PSBB period that we thought he was pretty reliable health protocol-wise. But the last 2 times he’s delivered Aqua, however, he has ceased to wear a facemask and had to be reminded to wash his hands.

The same is happening with the tukang parkir at the local marts. All have started to slacken in their wearing of facemasks in recent weeks after all being so good at observing health protocols.

To be fair, this is observed the world over. People have started relaxing everywhere which will undoubtedly lead to more infections.

And really, everyone is guilty. Yes, upper middle class are going back to malls etc but as soon as you step out of Jakarta (Tangerang area or Serang) it's business as usual with packed traditional markets and inconsistent mask wearing.
 
If Indonesia were to use WHO's standard for counting, it would have 13,885 Covid-19 deaths as of July 3rd. This is 4x more than the official number, and would place Indonesia in 9th spot in the world, just ahead of Iran.

 
If Indonesia were to use WHO's standard for counting, it would have 13,885 Covid-19 deaths as of July 3rd. This is 4x more than the official number, and would place Indonesia in 9th spot in the world, just ahead of Iran.


Iran is 3,5 times smaller than Indonesia in population, meaning Indonesia is still OK.
 
If you look at the Jakarta public cemetery burials data (from Dinas Pertamanan) day by day, the long term average going back to 2010 is about 85-100 per day. This year it was in that range in Jan and Feb, then in March there was a massive jump to 140 (the first day of the big jump was 1 March - 153) and it kept climbing to a peak of 179 on 6 April. It then declined slowly. With an average of 153/day, April was the worst months for deaths. Now it is in the 120s. March was probably the most dangerous time for infections.

[yes I was bored and went to the daily data, counted it manually and put it all in a spreadsheet, which took hours. You can see the names of everyone that died so I don't think the data is fake, but if it is completely accurate I don't know]

Here is a graph I made to illustrate it (orange shaded part is the long term average 2010-2019). The number above each month is the daily average for that month.

Jakarta deaths.jpg


So there are several possibilities:
  • there is no 2nd wave in Jakarta, just more testing
  • a new spike could be just around the corner
  • the virus has become less deadly
  • treatments have got better so fewer deaths
  • people are getting more reluctant to register deaths at the public cemeteries because of covid protocols


 
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Here's some experiences with the 'healthcare system' in Indonesia.

Patient is sick. Patient works in market.

BPJS money sent by patient's 1st daughter to patient's 2nd daughter for years. But oops they only paid one month (and stole the rest), so now they have to pay 24 months fees even though it was only active one month, and there is a 'fine' of 30% of the hospital fee in case of 'inpatient' care.

Ok.

So rumour-mill locally is all private hospitals which work with BPJS are demanding 400k for rapid test before admitting patients. And then they might get sent off to a 'covid' hospital, which is effectively a prison.

So patient treated on drip at home, but patient gets worse, so got hospital.

Presents at hospital with complaint about GERD. Rapid test done. Told it is 'reactive'. Patient must be sent to another hospital. Many hours later they say 'ok, but you have to pay a 'deposit', because your BPJS is status 'denda''. [this is illegal, and the denda is paid to the government, not the hospital, and I think the hospital gets paid either way.]

So patient is imprisoned by hospital 1 until the bill is paid. I hear about this and say 'I know what these hospitals are like they are liars and frauds, demand a printed itemised bill, and the results of the test.'

None such forthcoming.

Patient leaves to second hospital 100 miles away.

Where is the receipt?

The receipt says 'outpatient treatment 2,820,000rp' No bill, just a 'kwitansi' like from a market stall or something.

I say 'these lying cheating scumbags are not going to pay you back. Why does that say outpatient treatment when they said it was a deposit'

Next day after several hours on the telephone they produce a new print out which says

'inpatient GERD, code xyz, 3200,000, denda 960,000rp'

so they go to pay the 960,000rp [to the government] and the hospital refunds the 2820,000rp.

So essentially the hospital has not treated the GERD because the patient has been sent to another hospital, but they are claiming the money from the government for treating GERD even though that wasn't really what happened, because from the minute you walk in the door they want a covid-19 rapid test.

So I ask for the test results.

These are sent.

They show

'antibody test covid-19

igM - reactive / non-reactive : blank
igG - reactive / non-reactive: reactive'

It's not completely clear to me but there are at least three antibodies, and two mainly tested, that is igM & igG.

a27a4bbd-34fe-43a7-b65e-044f35401446.jpg

So you can first detect igM (in which case the patient is sick and infectious), igM+igG (by which time the patient has maybe recovered and may be still infectious), and finally igG alone (which means the patient is no longer sick or infectious).

In civilized countries igG tests are used to measure the proportion of the population which has been infected. igM is not a good test for infectiousness, but it will detect most people sick NOW with covid.

So if you are igG+ then that could mean you started symptoms 10 days ago, or 100 days ago. The igM result is important.....

But they didn't test it, and said 'you go', demanded 3 million rupiah, and then lied to the government about what they had done.

[note BPJS does not have anything to do with covid - the hospital can reclaim covid expenses directly from the government, but it's separate from bpjs]
 
Iran is 3,5 times smaller than Indonesia in population, meaning Indonesia is still OK.

not really.

check the testing stats.

they are an absolute joke.

antibody reactive results should be counted but aren't.

rt-pcr tests are being done in tiny numbers relative to population and % positive, and in some regions are 45%+ positive with massive backlogs.

there will be many missing deaths from the total.

Indonesia's performance is the worst in SE Asia by far and an embarrassment.
 
not really.

check the testing stats.

they are an absolute joke.

antibody reactive results should be counted but aren't.

rt-pcr tests are being done in tiny numbers relative to population and % positive, and in some regions are 45%+ positive with massive backlogs.

there will be many missing deaths from the total.

Indonesia's performance is the worst in SE Asia by far and an embarrassment.


One of the previous posts said: "If Indonesia were to use WHO's standard for counting, it would have 13,885 Covid-19 deaths as of July 3rd. This is 4x more than the official number, and would place Indonesia in 9th spot in the world, just ahead of Iran."

Meaning if they counted correctly, they would have 14.000 deaths, instead of reported 4.000. That would be put them on 9th place with Iran, however, Iran has 3,5 times smaller population.

Indonesia is doing better than Brazil, the country of a similar size, and latitude and climate, US, UK, Britain, France, Spain etc. Worst in Southeast Asia also means relatively well in global terms.

As from posts above, we can see excess deaths are now 30-40 per day in Jakarta . If all are COVID-19, that is 900-1200 per month in Jakarta. The population grew in the last 10 years so better would be 5-year trailing average than 10-year average 85 or more precise would be year-to-year, as there is seasonal dengue fever,

Testing is not good but excess deaths could be relatively precisely estimated.
 
One of the previous posts said: "If Indonesia were to use WHO's standard for counting, it would have 13,885 Covid-19 deaths as of July 3rd. This is 4x more than the official number, and would place Indonesia in 9th spot in the world, just ahead of Iran."

Meaning if they counted correctly, they would have 14.000 deaths, instead of reported 4.000. That would be put them on 9th place with Iran, however, Iran has 3,5 times smaller population.

Indonesia is doing better than Brazil, the country of a similar size, and latitude and climate, US, UK, Britain, France, Spain etc. Worst in Southeast Asia also means relatively well in global terms.

As from posts above, we can see excess deaths are now 30-40 per day in Jakarta . If all are COVID-19, that is 900-1200 per month in Jakarta. The population grew in the last 10 years so better would be 5-year trailing average than 10-year average 85 or more precise would be year-to-year, as there is seasonal dengue fever,

Testing is not good but excess deaths could be relatively precisely estimated.

Precisely?

But there is a rampaging epidemic in places like Palangkaraya, based on % positive, but only tiny numbers of tests. What use would excess deaths in Jakarta be?

There is no real way for Indonesia to do as badly as the UK or Italy because the population pyramid is different - Indonesia has a tiny % over 80 , and the UK 5%.

With a much smaller vulnerable population, Indonesia should have a fatality rate that is much lower. Remember that death rates double every six years of age.
 
Precisely?

But there is a rampaging epidemic in places like Palangkaraya, based on % positive, but only tiny numbers of tests. What use would excess deaths in Jakarta be?

There is no real way for Indonesia to do as badly as the UK or Italy because the population pyramid is different - Indonesia has a tiny % over 80 , and the UK 5%.

With a much smaller vulnerable population, Indonesia should have a fatality rate that is much lower. Remember that death rates double every six years of age.

Jakarta is one of the epicentres of the pandemic, and it is a good proxy. Whole Kalimantan, where Palangkaraya is, has 15 million inhabitants, Palangkaraya has 200 thousand inhabitants, while the Jakarta Metropolitan area has 30 million people.

Again, Brazil, country similar to Indonesia by climate, population and with similar population pyramid has done much worse, they are second in the world by deaths, around 80.000 dead vs 212 million population.

From the persons that my wife personally know, only one has died of coronavirus or a similar disease.
 
Interesting side effect of Covid-19 pandemic? It seems premature births have dropped drastically. It's not clear why, but:

The researchers speculated about potential factors.

One could be rest. By staying home, some pregnant women may have experienced less stress from work and commuting, gotten more sleep and received more support from their families, the researchers said.

Women staying at home also could have avoided infections in general, not just the new coronavirus. Some viruses, such as influenza, can raise the odds of premature birth.

Air pollution, which has been linked to some early births, has also dropped during lockdowns as cars stayed off the roads.


 
Interesting side effect of Covid-19 pandemic? It seems premature births have dropped drastically. It's not clear why, but:
That is very curious. Considering that far less than 1% of pregnant women have had Covid, any significant change in premature births or birth weights couldn't be a direct result of the virus, but of something else more universal, like lockdown measures.
 
It really is hard to get a rational handle on the Pandemic. So far, in Victoria Australia, 44 people have died from the disease. This time last year 430 people had died from influenza. This year it is only 36 deaths.

Now we might suppose that the general focus on avoiding contact and other health measures may account somewhat for the dramatic drop in influenza rates It appears that in the US where early measures were not implemented early the infection rate and fatality rate for Covod 19 is much higher than influenza. However.....

"Harvard physician Jeremy Samuel Faust writes in Scientific American. The CDC flu death figures “are estimates that the CDC produces by multiplying the number of flu death counts reported by various coefficients produced through complicated algorithms,” Faust writes. The data we have on Covid-19 deaths are of recorded deaths. It’s possible that the CDC is overestimating the mortality of the flu. So comparing the two isn’t apples to apples. "

But he also cautions, "...the novel coronavirus killed between 9.5 and 44 times more people than seasonal flu. "

I am reminded somewhat of when during the 2nd World War it got around in Darwin that the Japanese were coming there was widespread panic and a frantic race down the highway with armed forces personnel included.

Perhaps we have panicked but then had emergency measures not been adopted the infection and fatality rates may have been much worse. Whatever, we have had economic devastation, the full effects of which have yet to be played out, and it is going to take years before things are sorted both in health and economic terms. We are on the back of a tiger and no easy way to get off.

Anyone talked to God recently and had it all explained to them?
 
Here's some experiences with the 'healthcare system' in Indonesia.

Patient is sick. Patient works in market.

BPJS money sent by patient's 1st daughter to patient's 2nd daughter for years. But oops they only paid one month (and stole the rest), so now they have to pay 24 months fees even though it was only active one month, and there is a 'fine' of 30% of the hospital fee in case of 'inpatient' care.

Ok.

So rumour-mill locally is all private hospitals which work with BPJS are demanding 400k for rapid test before admitting patients. And then they might get sent off to a 'covid' hospital, which is effectively a prison.

So patient treated on drip at home, but patient gets worse, so got hospital.

Presents at hospital with complaint about GERD. Rapid test done. Told it is 'reactive'. Patient must be sent to another hospital. Many hours later they say 'ok, but you have to pay a 'deposit', because your BPJS is status 'denda''. [this is illegal, and the denda is paid to the government, not the hospital, and I think the hospital gets paid either way.]

So patient is imprisoned by hospital 1 until the bill is paid. I hear about this and say 'I know what these hospitals are like they are liars and frauds, demand a printed itemised bill, and the results of the test.'

None such forthcoming.

Patient leaves to second hospital 100 miles away.

Where is the receipt?

The receipt says 'outpatient treatment 2,820,000rp' No bill, just a 'kwitansi' like from a market stall or something.

I say 'these lying cheating scumbags are not going to pay you back. Why does that say outpatient treatment when they said it was a deposit'

Next day after several hours on the telephone they produce a new print out which says

'inpatient GERD, code xyz, 3200,000, denda 960,000rp'

so they go to pay the 960,000rp [to the government] and the hospital refunds the 2820,000rp.

So essentially the hospital has not treated the GERD because the patient has been sent to another hospital, but they are claiming the money from the government for treating GERD even though that wasn't really what happened, because from the minute you walk in the door they want a covid-19 rapid test.

So I ask for the test results.

These are sent.

They show

'antibody test covid-19

igM - reactive / non-reactive : blank
igG - reactive / non-reactive: reactive'

It's not completely clear to me but there are at least three antibodies, and two mainly tested, that is igM & igG.

View attachment 1507
So you can first detect igM (in which case the patient is sick and infectious), igM+igG (by which time the patient has maybe recovered and may be still infectious), and finally igG alone (which means the patient is no longer sick or infectious).

In civilized countries igG tests are used to measure the proportion of the population which has been infected. igM is not a good test for infectiousness, but it will detect most people sick NOW with covid.

So if you are igG+ then that could mean you started symptoms 10 days ago, or 100 days ago. The igM result is important.....

But they didn't test it, and said 'you go', demanded 3 million rupiah, and then lied to the government about what they had done.

[note BPJS does not have anything to do with covid - the hospital can reclaim covid expenses directly from the government, but it's separate from bpjs]
I have a fun but effective way of remembering the IgM /IgG
I got Malady
It got Gone
 
I wonder about costs. The initial costs for AIDS treatments were considerable and beyond reach for people in so called second and third world countries.
 
I wonder about costs. The initial costs for AIDS treatments were considerable and beyond reach for people in so called second and third world countries.
Apparently the injections were around 21 GBP each - so I guess a 10 day @ 1 injection a day course would be way cheaper than a 10 day intensive care stay.
(The drug was available already- they are just testing it on COVID19 as far as I am aware.)
 
Fasten your safety belts.

For anyone planning their lives based on expectations of being past the Corona pandemic in the near future it would be best to think again. Worldwide it seems the dynamic of the virus is gathering momentum with the impact to be felt for many years. Melbourne, Austrlia has just introduced a six week long, 8pm to 5am curfew with police and troops patrolling the streets and heavy fines for those breaking the curfew. Each time some new dramatic lockdown comes into effect more and more small businesses are pushed over the edge into oblivion.

For those hoping to get back to Indonesia sometime soon, a serious consideration has to be that there may be no reliable form of continuous employment unless for those in specialist areas such a IT and health related industries. For those living here and linking their fortunes to vulnerable activities such as hospitality it may be a long time before profit based business are a viable possibility.

For countries such as Indonesia it will be challenging to find a balance between managing health issues and ensuring survival for those out of work. I fear the worst is yet to come. I don't wish to be alarmist but clearly many people are seeing the future based on wishful thinking.
 

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