One in four dying at Jakarta Covid hospital

Pressure is mounting on Jakarta to reimpose restrictions, with the COVID-19 death rate in one city hospital almost one in four.

Workers wearing protective suits carry a mock coffin as part of an awareness drive against the COVID-19 coronavirus in Jakarta on Tuesday. Picture: AFP

Pressure is mounting on the Jakarta government to reimpose large-scale restrictions on the ­Indonesian capital amid a surge in COVID-19 infections that has pushed the death rate in the city’s main referral hospital to almost one in four.

Persahabatan Hospital, the largest of the city’s 67 COVID-19 clinics which admits moderate to critically ill patients, has revealed that its case fatality rate for coronavirus patients from March to August was 22.3 per cent.

Yudhaputra Trisanto, the hospital’s planning director, said the pandemic was “showing no signs of abating”, contradicting President Joko Widodo’s assessment that Indonesia’s caseload would likely peak this month.

“Between March and August we have treated 851 COVID patients and 190 of them have died. Among those, 177 deaths were critically ill patients, eight were very ill patients, and five were moderately ill patients,” Dr Yudhaputra said. “You can see the case fatality rate here is quite high — 190 deaths from 851 patients is a case fatality rate of 22.3 per cent.”

The hospital saw a marked rise in patients within weeks of the city loosening its partial lockdown in June. By the end of August that had translated into a 30 per cent increase in “COVID positive deaths” and — worryingly — a 35 per cent increase in “COVID suspect deaths” that are not recorded in Indonesia’s official death toll.

President Jokowi (as he is known) emphasised the country’s high recovery rate this week — 72.2 per cent — though conceded Jakarta hospitals were under strain and the country’s morbidity rate of 4.2 per cent was higher than the global average of 3.3 per cent.

But that doesn’t begin to illustrate the challenges confronting some of the biggest COVID-19 hospitals in the city of 11 million people.

On Tuesday an exhausted doctor at Jakarta’s Cipto Mangunkusumo hospital lamented the impossible decisions he was now facing on every shift. “It’s at a point now where we are fighting for ventilators. Last night two people died and we just watched while they went through desaturation because there were no ventilators for them,” he told The Australian, referring to a process in which a patient’s blood oxygen falls to critical levels. “Whenever there is one free ventilator we discuss which patient to give it to, who is more ‘worthy’ to live.”

University of Indonesia’s head of epidemiology Tri Yunis Miko Wahyono said without at least a partial lockdown there would be “no clear end” to the pandemic.

“If we pulled the brakes now and applied a lockdown across the country our peak could be November, December, January or February, but with the regulations we have now — which are not enough — a peak in September is impossible,” he said. “If we continue with the current condition, then the disease spread will remain uncontrolled and our only hope will be the vaccine.”

Indonesia’s struggles to increase its testing capacity — still one of the world’s lowest per capita — have been well documented, a by-product of a seriously underfunded health system.

With a national caseload of 180,646, Indonesia no longer has the highest number of cases in Southeast Asia — The Philippines has that dubious distinction — though it has the highest fatalities at 7616. More than 100 of those deaths have been doctors, compounding the strain on the country’s health system.

Additional reporting: Chandni Vasandani