Rabu, 29 Juli 2020
Kamis, 23 Juli 2020
Kamis, 09 April 2020
INDONESIAN GOVERNMENT RESPONSE IN COVID-19 DISASTER PREVENTION
INDONESIAN
GOVERNMENT RESPONSE IN COVID-19 DISASTER PREVENTION
Mayusef
Sukmana1, Muhammad Aminuddin2, Dwi Nopriyanto3
1, 2, 3.
Lecture Faculty of Medicine, Mulawarman University
Anggur Street,
No. 88 Samarinda 75123 Indonesia
*1 200801sukmana@gmail.com
3 d.nopriyanto@yahoo.co.id
Abstract
WHO has designated COVID-19 as a health problem with a global
emergency status with the highest level of vigilance. Indonesia has a very
strategic area. The entry and exit of Indonesian citizens and foreigners who
carry out economic, educational, political, cultural, tourism, and other
activities in Indonesia are hazardous for the spread of Covid-19. Indonesia is
a country with two confirmed cases of Covid-19. Covid-19 has an impact on the
health, tourism, economic, social, and other sectors. Prevention of
dissemination is by responding to Covid-19 through early detection, human
surveillance, environmental surveillance, transport equipment inspection, and
goods inspection
Keywords: coronavirus, Covid-19, monitoring, response,
prevention
COVID-19 PHENOMENOM
The
coronavirus novel (2019-nCoV) is a new type of coronavirus that has never been
identified in humans that cause Corona Virus Disease-19 (COVID-19). Coronavirus
is a large family of viruses that cause disease in humans and animals. In
humans, it creates common cold to severe illnesses such as Middle East
Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS)
Syndrome. The coronavirus novel (2019-nCoV) has epidemiology with different
characteristics from SARS-CoV or MERS-CoV. The coronavirus novel (2019-nCoV)
self-replicates in the upper respiratory tract and causes moderate symptoms, similar
to pneumonia.(KemenkesRI 2020)(Kemenkes RI 2020)
WHO
has designated COVID-19 as a health problem with a global emergency status with
the highest level of vigilance.(Ghebreyesus, 2020) The
WHO China Country Office reported the discovery of a case of pneumonia of
unknown etiology in Wuhan City, Hubei Province, China, on January 7, 2020,
which was later determined as a new type of coronavirus (novel coronavirus,
2019-nCoV).
The
number of 2019-nCoV cases took place quite quickly, and there was a spread
outside the Wuhan region and other countries. On January 26, 2020, globally,
1,320 cases were confirmed in 10 countries with 41 deaths (CFR 3.1%). China
confirmed finding 1297 cases of 2019-nCoV (including Hong Kong, Taiwan, and
Macau) with 41 deaths (39 deaths in Hubei Province, one death in Hebei
Province, one death in Heilongjiang Province). Then followed by Japan (3
cases), Thailand (4 cases), South Korea (2 cases), Vietnam (2 cases), Singapore
(3 cases), USA (2 cases), Nepal (1 case), France (3 cases)), Australia (3
cases). Among these cases, there were already several health workers who were
reported to be infected(Kemenkes RI, 2020e)(Kemenkes RI, 2020d)
According
to Gardner (2020), on 27 February 2020, there were 81,743 confirmed cases
worldwide, resulting in 2,798 deaths and being declared cured of 30,538 cases. (Dong E, Du H, 2020) The
number and spread of covid-19 increased very significantly between 26 January
2020 until 27 February 2020 an increase of 80,423 confirmed cases and an
increase of 2,757 deaths and the range of situations in 63 countries around the
world and all continents except Antarctica.
The
rapid spread of this disease is caused by the city of Wuhan becoming China's
new silk route where the economic development of the central region of China.
Wuhan has very high mobility, and community mobility increases using flights
and railroad lines as it approaches the Chinese New Year on January 10, 2019.(Wu, Leung, & Leung, 2020) An average of
16,202 international passengers at Wuhan airport to Bangkok, Thailand. Two
thousand five hundred four passengers from Wuhan headed for London, England.
Indonesia has an average of 2,432 passengers from Wuhan who flights to Denpasar
every month. (Zaenudin, 2020)
Indonesia
as a country with a very strategic location is flanked by Asia and Australia,
bringing together in the Pacific and Indian oceans, has an international
airport and as one of the busiest airlines in the world including Soekarno
Hatta (CKG) - Changi (SIN) there are 27,046 flights. Indonesia has 353 national
entrances and borders (airports, ports and federal land border crossings).
(Kemenkes RI, 2020d) The entry and
exit of Indonesian citizens and foreigners who carry out economic, educational,
political, cultural, tourism and other activities in Indonesia are hazardous
for the spread of Covid-19.
The
WHO Scientific and Technical Advisory Group for Infectious Hazards (STAG-IH),
carrying out sustainable strategies to control and eliminate the spread over
the next 2-3 weeks until the end of February 2020 will be critical to monitor
the situation of the range of Covid-19 in the world community.(Heymann, Shindo, & WHO Scientific and Technical Advisory
Group for Infectious Hazards, 2020) The
most influential factor on the spread of Covid-19 is the result of
human-to-human transmission where population mobility from and out of Wuhan
city during the Chinese New Year.(Heymann et al., 2020)
Until
the beginning of March 2020, Indonesia was a country with two confirmed cases
of co-19 infection. The biggest challenge facing now is preventing as much as
possible the spread of 2019-nCoV, one of which is through surveillance and
response programs. (Kemenkes RI, 2020e)(Kemenkes RI, 2020d)(Dong E, Du H, 2020)
IMPACT
OF COVID-19
Impact
on the health sector until March 3, 2019, the number of infected 90,937 people,
recovered 48,017 and died 3,117 people with the spread in 75 countries. The
data show that Covid-19 has a cure rate of 52.8% and a mortality rate of 3.4%.
(4) Other data address the distribution of rapid morbidity, while the mortality
rate is around 2%. (Dirjen Perhubungan Darat, 2020)
WHO
has spent US $ 15 million to monitor the distribution of morbidity, investigate
cases, and national laboratory operations, overall US $ 675 million to fight coronaviruses
is expected to be able to withstand the spread of the virus if countries take secure
steps to detect cases early, isolate and treat patients, and track contacts. soon,
separate and treat patients, and track communications.(Sekretariat Kabinet RI, 2020b)
THE
RESPONSE OF GOVERNMENT
The
recommended standard set by the Ministry of Health of the Republic of Indonesia
to prevent the spread of covid-19 from human to human is to promote the
community to carry out PHBS and healthy lifestyles through regular hand
washing, applying the ethics of coughing and sneezing, cooking meat and eggs
until cooked and avoiding contact with sufferers of respiratory diseases such
as coughing. (Kemenkes RI, 2020d)
On
January 28, 2019, the Directorate General of Disease Prevention and Control of
the Ministry of Health issued a circular on preparedness to deal with the
Coronavirus novel infection (2019-nCOV) which contained: Surveillance and
Response, Clinical Management, Infection Prevention and Control, Specimen Management
and Laboratory Confirmation, Risk Communication and Empowerment Public
The
surveillance and response preparedness aims to: Conductivity, early detection
of patients in supervision / in monitoring/probability/ confirmation, 2019-nCoV
at the entrance of the country and region. Detect human-to-human transmission. Identifying risk factors 2019-nCoV.
Identifying areas at risk for infection of 2019-nCoV (Kemenkes RI, 2020e)(Kemenkes RI, 2020d)
The
President responded to readiness through instructions related to travel to
mainland China, and a limited meeting on 2 February 2019 instructed readiness
to deal with the effects of the coronavirus as follows: Take protective and
preventive measures, and also give an understanding of the whole community, all
people, wherever they are, so there is no need to panic. All direct flights to
and from mainland China are temporarily suspended from Wednesday, 5 February
2020 at 00.00. Imposing health protocols, not allowing all migrants who arrive
from mainland China, or have been there for 14 days to enter and transit in
Indonesia. Temporarily stop visa-free
and visa-on-arrival facilities for Chinese nationals. Indonesian citizens temporarily do not travel
to the mainland.(Sekretariat Kabinet RI, 2020a) Protect
Indonesian citizens in the PRC, evacuate our citizens in Wuhan, in Hubei
Province, and be observed in Natuna. Carefully calculate the impact of this
policy on our economy from the trade, investment, tourism and trade sectors.(WHO, 2020a)
The Indonesian
Embassy also gave the response by disseminating important information to increase
public awareness of the increase in the COVID-19 virus, coordinating community
leaders of the Indonesian Embassy, religious groups such as the Indonesian
Jemaah Mosque and also the Indonesian Church Congregation, regional communities
and students. (WHO, 2020b)
Early
detection and response carried out by the government following the objectives
of surveillance activities by the WHO are as follows:
Limiting
human-to-human transmission, including preventing secondary infections among
close contact and health workers, preventing further international transmission
and spread from China; Through the efforts at rapid collection, diagnosis and
case management, treatment and follow-up of actions, prevention and treatment
of infections in health care settings, application of health measures to those
who travel, increase public awareness about the risk of disease and its spread.
1.
Identifying, isolating, and treating patients early, providing
optimal care for protecting patients;
2.
Identification and conversation of transmission from animal
sources;
3.
Related to the unknown things that are important about the severity
of the clinical course, the level of transmission and infection, treatment
options, and the improvement of vaccine, therapy and vaccine development;
4.
Communicating critical risks and event information to all
communities and combating misinformation;
5.
Minimizing Social and Economic Impacts through multisectoral
partnerships.(Jung et al., 2020)
The
Early detection and response of the Ministry of Health of the Republic of
Indonesia by conducting a 2019-nCoV investigation through supervision of
patients under surveillance, everyone under surveillance, possibilities, and
confirmation. Patients under surveillance are: a. Associated with fever: (≥38 °
C) or fever, cough/cold /sore throat, mild to severe pneumonia according to
clinical and radiological. Required in patients with immune system disorders
(immunocompromised) because the symptoms and signs become unclear, and changes
in at least one condition as follows:1) Having a history of travel to China or
the affected region/country (according to disease progression) within 14 days
before the onset of symptoms; or 2) Is a sick health worker with the same
complaint after treating a patient with severe acute respiratory infections (SARI)
whose cause is unknown, regardless of where they live or the outcome of the
battle; or
b.
14 days before illness, have one of the following exposures: Have contact with
the 2019-nCoV truth report; 2019-nCoV in China or infected regions/countries
(according to disease progression); or have a history of contact with
infectious animals (if infectious animals have been identified) in China or the
affected region/country (according to disease development), or Have a history
of travel to Wuhan OR contact with people who have a history of travel to Wuhan
(there is an epidemiological relationship) and have (fever ≥38 ° C) or have a
history of fever. (Kemenkes RI, 2020e)(Kemenkes RI, 2020d)
Someone
in monitoring is someone who has symptoms of fever / a history of fever without
pneumonia who has a history of travel to China or the affected region/country,
within 14 days and does not have one or more history of exposure (history of
close contact with the 2019-nCoV confirmation case; Work or visit health
facilities associated with 2019-nCoV confirmation patients in China or the
affected region/country (according to disease progression), have a history of
contact with infectious animals (if infectious animals have been identified) in
China or the affected region/country ( according to disease progression). (Kemenkes RI, 2020e)(Kemenkes RI, 2020d)
Close contact means including health workers who inspect, treat, deliver and
clean rooms in special care places, people who care for or wait for patients in
the room, people who live at home with patients, guests who are in the same room
with patients, people travelling together with patients en covid-19.(Kemenkes RI, 2020e)(Kemenkes RI, 2020d)(Kemenkes RI, 2020a) Close human-to-human contact increases the
risk of transmission. (Kemenkes RI, 2020a) (Kemenkes RI, 2020c)
The
probable case of a patient is someone under surveillance who was examined for
2019-nCoV but was inconclusive or someone with positive confirmation results of
pan-coronavirus or beta coronavirus. The confirmed case is someone infected
with 2019-nCoV with positive laboratory results. (Kemenkes RI, 2020a)
Early
Detection and Response at the Entrance of the State is carried out on patients
under surveillance/people in monitoring / probable / confirmation 2019-nCoV.
Implementation of the International Health Regulation / IHR (2005), ports, airports,
and the State Cross-border Post (PLBDN) carrying out quarantine activities, an
inspection of transportation equipment, vector control, and sanitary measures.
Implementing the IHR (2005) at the entrance of the state and PLBDN is the Port
Health Office (KKP). Activities at the state entrance include efforts to
detect, prevent and respond to 2019-nCoV at ports, airports. Activities in the
form of supervision of transport equipment, people, goods, and the environment
coming from the 2019-nCoV infected area/country. (Kemenkes RI, 2020d) (Kemenkes RI, 2020a)
Early
detection by observing 238 citizens who
had been evacuated from China, they were quarantined for 14 days in Natuna
since February 2, 2020. All people observed were measured twice a day.(Kemenkes RI, 2020f) On February 27, 2019 crew members totalling
188 people were evacuated from the World Dream ship and quarantined in KRI dr.
Soeharso to be monitored and monitored while on the ship to The Sebaru Kecil
Island.(Guan et al., 2020)
Supervision is carried out on nine crew members (ABK) Diamond Princess who are
Indonesian citizens (WNI) positive Covid-19, and ABK who are negative Covid-19
are still aboard and after pick-up will be observed for two incubation periods
or 28 days.(Qun Li, M.Med., Xuhua Guan, Ph.D., Peng Wu, Ph.D., Xiaoye
Wang, M.P.H., Lei Zhou, M.Med., Yeqing Tong, Ph.D., Ruiqi Ren, M.Med., Kathy
S.M. Leung, Ph.D., Eric H.Y. Lau, Ph.D., Jessica Y. Wong, Ph.D., Xuesen Xing,
Ph.D., Nijuan Xiang, M.Med., Yang Wu, M.Sc, 2020)
The
evacuation of Indonesian citizens to avoid contact with patients is essential
because there are 72.3% of confirmed cases resulting from contact with
residents of Wuhan.(World Health Organization (WHO)-China Joint Mission on
Coronavirus Disease 2019, 2020)
Temperature measurement is the monitoring of fever symptoms, if fever occurs,
this shows the possibility of entry of 2019-nCoV, the most common symptoms are
fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8% ).(World Health Organization (WHO)-China Joint Mission on
Coronavirus Disease 2019, 2020) Supervision
is carried out because the incubation period can vary in several cases, the
results of research of 425 patients confirmed coronavirus novel (2019-nCoV)
-infected pneumonia (NCIP) average incubation period of 5.2 with the most
extended incubation of 12, 5 days.(PT Garuda Indonesia(Persero) TBK, 2020) On
in another case, 67 patients were observed for an incubation period of 2-7 days
(19). According to WHO the average incubation period is 5-6 days with a range
of 1-14 days(Prianto, 2020)
Distribution
of Health Alert Cards (HAC) to travellers from 12 affected countries. COVID-19
prepared one hundred referral hospitals. The Center for Biomedical and Basic
Health Technology (BTDK) is a laboratory designated to conduct examinations. As
of February 11, 2020, 71 samples had been examined with 67 negative COVID-19
and four results in the examination process.
Supervision
of conveyance, carried out disinfection inside and outside the hangar every
morning and night is also routinely carried out. Disinfection of the cabin,
cockpit and the aircraft cargo compartment were carried out after taking a
flight from China. Changing the air filter High-Efficiency Particulate
Arresting (HEPA) which is a standard feature of the aircraft-operated fleet
functions to kill viruses and bacteria in the aircraft cabin of the fleet that
previously served flights to and from China(World Health Organization (WHO), 2020)(European Centre for Disease Prevention and Control, 2020)(Menteri Perdagangan RI, 2020)
Monitoring
of people, whether passengers, crew or ships that have travelled from China
when through the airport entrance or port, is done by thermal scanners
detecting the onset of fever. The government provided 195 thermal scanners at
135 state entrances, 21 capsule transport devices at 21 Port Health Offices
(KKP) (Kemenkes RI, 2020e)(Kemenkes RI, 2020d). A
Health Alert Card (HAC) is given to people who have travelled from an infected
country(Kemenkes RI, 2020e)(Kemenkes RI, 2020d).
Disinfection also sprayed on the body and clothes of passengers who descend from
the plane. This is done to kill viruses that might stick to the body or
passenger clothing. The Covid-19 virus can last more than 48 hours. An average
room temperature (20 ° C) and will die if disinfected using 0.1%, hypochlorite
and ethanol 70%. (Menteri Perdagangan RI, 2020) (Badan Karantina Ikan, 2020)
Supervision
of goods, especially imported goods that allow infection in animals and are
zoonotic. The rules of trade ministry number 10 of 2020 temporarily ban imports
of live animals from the People's Republic of China.(Kemenkes RI, 2020b) Circular Letter from the Head of the Fish
Quarantine Agency, Fisheries Product Quality and Safety (BKIPM) Ministry of
Maritime Affairs and Fisheries (KKP) number SE No.276 / BKIPM / I / 2020 dated
January 24, 2020, BKIPM coordinates with the Ministry of Health, the Ministry
of Agriculture, and the Ministry of Trade to supervise fish imports, especially
those from mainland China. Fish imported from infected countries must be
healthy and safe for consumption, testing of fish is required, and the
possibility of exposure to coronavirus. If the fish has been confirmed as the
coronavirus carrier media, BKIPM will temporarily stop the import of fish from
countries suspected of having an outbreak. BKIPM requests information from the
General Administration of Customs of the People's Republic of China (GACC) that
fish from China have been tested and found to be free from coronavirus
contamination. (Zhang & Liu, 2020)
Environmental
control carried out the supervision of waste management, including medical
waste. Cleanliness of the observation area, operationalization of the autoclave
(sterilization of medical waste). Inspection of drinking water samples from the
kitchen and clean water of the hangar to ensure that drinking water meets the
quality standard requirements. The Natuna people were given health education
about the observation process by residents
from Wuhan and provided integrated health posts on Piwang Beach.(Kemenkes RI, 2020f)
The
Mitigation strategy by the Directorate General of Civil Aviation by issuing a
Circular of the Director-General of Civil Aviation through the Director of
Aviation Security Number: SE.001 / DKP / I / 2020 dated January 20, 2020, which
contains orders to airlines to:
1.
Complete the general declaration card (Gendec) to give to the
health quarantine officer at the arrival airport;
2.
Report to the air traffic officer on duty (by PIC) if there are
people/passengers suspected of being exposed due to being infected on an
airplane;
3.
Giving a health alert card (alert card) before arrival (for flights
originating from an infected country) to the passenger, and ensuring the
passenger to report to the officer if he feels there is a suspicion of
contracting the disease.
4.
Give announcements on board (on-board) so that passengers report to
the KKP officer on arrival if they are from or have stopped by the country
affected.
5.
Flight operators continue to improve surveillance at the
international arrival terminal and continue to coordinate with all flight
stakeholders to anticipate the spread of the pneumonia virus through flight
routes.(Sekretariat Kabinet RI, 2020a)
Prevention
of food-borne diseases, an examination of food samples for breakfast, morning
snacks, lunch and dinner for monitoring patients in Natuna(Kemenkes RI, 2020f).
Control applied to the community so as not to be infected and also applied to
patients with Covid-19 is nutritional provision good include vitamin A, B, C,
D, E, Omega-3 polyunsaturated fatty acids (PUFA), selenium, zinc, iron,
interferon, intravenous gamma globulin, thymosin alpha-1, thymopentin,
lepamisole, cyclosporine A, flavanoid. Influenza immunization can be given to
children. For those with confirmed Covid-19 given convalescent plasma(Zhang & Liu, 2020)
CONCLUSION
The
response of the Government of the Republic of Indonesia Prevention of dissemination is by responding
to Covid-19 through early detection, human surveillance, environmental
surveillance, transport equipment inspection, and goods inspection
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