Warning over children as Indonesia suffers its worst Covid outbreak
The number of Covid infections and deaths among children in Indonesia has risen sharply over the past month, a senior paediatrician has said, as the country faces its most severe outbreak since the start of the pandemic.
Indonesia introduced new restrictions last week in the capital Jakarta, Java, and Bali in an attempt to curb its latest wave. Hospitals in cities across Java, which have been overwhelmed by the surge in patient numbers, have been forced to turn people away because they have run out of oxygen and beds.
On Tuesday, Indonesia reported 31,189 new infections and 728 deaths, both record daily increases. The country’s daily case numbers have more than quadrupled in less than a month, and it is feared infections will continue to rise. The government said it was preparing for a worst-case scenario where daily infections reach up to 50,000, and that it had ordered oxygen from neighbouring countries to meet demand.
Dr Aman Pulungan, the head of Indonesia’s paediatric society, said there was a misconception children were not affected by Covid, yet cases were rising rapidly among minors. The number of weekly infections recorded among under-18s had doubled in less than one month, he said. Between 28 June and 4 July, 11,872 cases were found among children – an increase from 7,329 c the previous week, and 5,255 the week before.
Health experts blame the recent wave on the more infectious Delta variant, as well as gatherings and domestic travel related to Eid al-Fitr. “We are now in a really, really bad condition. We can call it a tsunami. The thing is right now there are so many cases,” said Aman. “During the festivities [people] had a lot of holidays and didn’t do the protocols … They took children everywhere, [but] children don’t use masks,” he said. Children are also far less likely to get PCR tests, he added.
A lack of awareness about the need to protect and test children had contributed to rising infections, he said. When children do get severely sick, there is little specialist care available because hospitals are so overrun with patients, he added.
It is not clear if the Delta variant was more likely to cause deaths in infected children, he said, because genome sequenced data is not available.
As of 5 July, 556 children were confirmed to have died after testing positive, an increase from 340 deaths at the end of May. Many more Covid cases and related fatalities were likely to have been unrecorded, Aman added.
Since the start of the pandemic, at least 12% of Indonesia’s Covid cases have been among children, according to government estimates cited by Aman. However, many of these are unrecorded. Indonesia’s paediatric society has tracked 140,877 cases among children, out of a total of 2.3m.
Indonesia, which performs 49.46 tests for every 1,000 people, has one of the lowest testing rates in the world. The UK, which has one of the highest, conducts 3,083.73 tests for every 1,000 people.
The number of tests among under-18s in Indonesia was especially low, said Aman, partly because of a belief tests were difficult to perform on young children. “We forget that children can also suffer from Covid and can die,” he said.
About half of the child fatalities were among under-fives. Many had underlying health conditions. “These children should not die,” said Aman.
Dino Satria, the chief of humanitarian and resilience at Save the Children in Indonesia, said the recent rise in cases among children was extremely concerning and that there was “no sign that rates will go down anytime soon without urgently speeding up the Covid-19 vaccine programme”.
So far, about 5% of the total population has been fully vaccinated.
“We desperately need more vaccines – that’s the bottom line. Without help from the international community through Covax, the Covid crisis in Indonesia will quickly spiral out of control,” said Dino.
A senior minister, Luhut Pandjaitan, said Indonesia was seeking supplies from China and Singapore to prepare for a further rise in cases. Shipments of 10,000 concentrators, which generate oxygen, had begun arriving from Singapore on Tuesday, officials said.The current outbreak is concentrated in Java and Bali, but the health minister, Budi Gunadi Sadikin, said the government was closely monitoring Sumatra and Kalimantan, the Indonesian part of Borneo, after a rise in cases of the Delta variant.
While Indonesia has recorded 2.3m cases since the start of the pandemic, health experts believe this is a significant underestimate.