Our third Leadership Speaker Series featured a presentation and open Q&A session with Septian Seto, Deputy ad Interim of Investment and Mining Coordination to the Indonesia Coordinating Minister for Maritime Affairs and Investments and Jonathan Sudharta, CEO & Co-Founder of Halodoc, along with participation from Roderick Purwana, Managing Partner of SMDV, and ACV Partners Pandu Sjahrir, Michael Soerijadji, Adrian Li, and Donald Wihardja.
This session’s goal was to share insights on both the public and private sector’s involvement in building on Indonesia’s healthcare system and mitigating the impact of COVID-19.
Here are our key takeaways:
According to WHO, approximately 80% of COVID-19 patients will recover without requiring special treatment from hospital. This creates an opportunity for HaloDoc to help in managing the symptoms of these patients from home, preserving the capacity hospitals in Indonesia for those most at risk. Indonesia currently has 12 hospital beds for every 10,000 citizens, compared to China with 42 beds, or Italy with 34. HaloDoc facilitates the treatment of COVID-19 symptoms through their telemedicine consultation, e-prescription service and at-home medicine delivery. HaloDoc has also added more doctors into their ecosystem to reach more patients, and to strengthen the medical discussion communities around the region with the sharing of the latest developments on COVID-19.
HaloDoc’s adds additional support measures for managing COVID-19. In addition to telemedicine, e-prescriptions and medicine delivery, HaloDoc has also developed a self-assessment analysis tool via chatbot, as well as built Indonesia’s first drive-through rapid testing service for COVID-19. In the last month, HaloDoc has had 300K users on their platform (with a week-on-week growth of 300%), and now currently works with 500 hospitals in their joint mission to help Indonesia fight COVID-19.
In Indonesia, COVID-19 is classified into three segments – People under Monitoring, People under Surveillance and Positive Cases, as demonstrated below:
The Indonesian government continues to be proactive in further building on the country’s healthcare capabilities. The government is adding 17 labs for COVID-19 testing, as well as purchasing the machines required to increase test capacity to 17K samples a day. These laboratory facilities are essential, seeing that these testing machines been used by countries like China and Japan in the past, who have more relevant experiences in mitigating pandemics.
Indonesia is now experiencing a recovery rate that surpasses the fatality rate. Due to increase awareness, testing, and treatment, as of April 21 the recovery rate was at 12%, with the fatality rate at ~8.5%.
There are numerous activates that the government is doubling down on to continue to address the health impact of COVID-19. The key activities of focus begin with mass testing, which is currently targeted only to individuals presenting with strong COVID-19 symptoms. Once the testing capacity increases, individuals that are being monitored for mild COVID-19 symptoms will also be tested. After testing, the government will then focus on tracing positive test cases to understand who they have made contact with, and then test those individuals and provide treatment if needed. Positive cases with mild or moderate symptoms will be monitored and recommended to self-isolate at home. The next priority for the government is to improve healthcare facilities by acquiring more ventilators, protective equipment and increasing ICU capacity.
Indonesia has chosen to implement a large-scale social restriction over a lockdown. These restrictions include mandatory work from home (WFH), except for sectors such as healthcare, food production and logistics. School facilities will remain closed, with classes moved to online learning platforms. The government has limited public transportation operations and has placed a mandatory 14-day self-isolation period for those that travel from red zone areas. According to the Oxford Policy Stringency Index, Indonesia’s current restrictions in place are on par with Singapore and South Korea, as demonstrated below:
Indonesian’s are aware of COVID-19, with data to suggest that public awareness for the pandemic is high. On a national level, 97% of Indonesians believe that COVID-19 is infectious, and 92% believe that COVID-19 is deadly.
Although Indonesia’s main priority is to contain COVID-19, it cannot adopt the same government policies adopted by developed markets. To mitigate the impact of the pandemic successfully though social distancing and self-isolation, social assistance has to be adequate, for those who are losing daily income. Indonesia’s stimulus package is aimed at strengthening the economy, but more importantly, maintaining financial stability, with IDR 110T going towards the social safety net.
PERPPU no.1 is the foundation of regulation to help Indonesia take coordinated action towards mitigating COVID-19. This includes the issuance of government bonds, tax incentives for corporates, a national recovery program, and on the banking side, supporting banks, OJK and the financial system to help maintain stability.
Here are some questions from our audience to our speakers and Q&A participants:
1. What measure can be taken to resume work, especially for business sectors that suffer the most from closing, if the virus hasn’t been eradicated?
Based on the data that is available, there is no yet a clear indication as to when work and social activities can resume, as it is difficult to assess when the peak will take place. Based on several models, there are assumptions that the most optimistic case is that the peak will occur in the middle of May, whereas the pessimistic case is that the peak will take place in July. We need at least 60 days after the peak to witness the curve flattening. Regardless, social distancing is essential in ensuring that less individuals get infected.
2. What would you like to see to see in order to feel comfortable with removing large-scale social restrictions (PSBB)?
For the government to feel comfortable in lifting social restrictions or PSBB, we would have to see indications of the fatality rates decreasing, as well as recovery rates increasing. Additionally, we need to see a flatter curve, or indications that the number of new cases is decreasing every day. Once the government has comfort, through strong signals that COVID-19’s condition is improving, then perhaps PSBB can get lifted. Furthermore, we may have to wait for a vaccine, which is currently under clinical trials, to completely eradicate the virus.
3. Are there any challenges in providing social financial protection to people?
The challenge is reaching out to individuals that are difficult to find, especially since they tend to need it the most. Currently, the government is targeting the group in the lowest 40% of the population in terms of income, to provide social assistance. These households might not have clear names and addresses, but the government is currently crunching numbers to build a database, to effectively provide them with support.
4. Since we are low on hospital beds, what is the ideal number for hospital beds for Indonesia?
The ideal number is relative, the question is more around how we can optimize healthcare facilities so that we can approach the pandemic effectively. The issue at hand is that viral infections like this cannot be avoided, so the key here is to ensure that the public has confidence in the healthcare system. Governments must also stay open to public and private partnerships, to help mitigate this pandemic, and the next.
5. What’s key learning from this pandemic?Is it different from other countries?
One of the key learnings is that, the demographic of a country will help indicate the level of infection spread. For example, having a younger population will reduce the number of people that die from COVID-19, as 70% of individuals who are COVID-19 positive and die are those over 51. Another key insight is that countries with a mandatory BCG vaccine are experiencing lower fatality rates that countries that do not. Another key learning is that to truly eradicate COVID-19, participation from all citizens of the country is required.
6. How is the government collaborating with the mainstream media to keep reinforcing the importance of social distancing?
At the moment, the government is working on campaigns and have partnered with the media for programs to help prepare people on the dangers of COVID-19, and the health and safety protocols that should follow, particularly for the low to middle income areas for continuous education and support.