As Indonesia detects India and South Africa variants, fears grow over possible case spikes

Content image - Phnom Penh Post
Passengers of a ship from Dumai, Riau, Indonesia line up to get their travel documents checked at the arrival terminal of Sekupang Port, Batam, Riau Islands on April 21. A ban on this year's Idul Fitri 'mudik' (exodus) has forced some people to travel home early for the Islamic holiday, slated for May 12 or 13. THE JAKARTA POST

Indonesia has detected coronavirus variants linked to more transmissible variants first detected in India and South Africa, ahead of the Idul Fitri mudik (exodus) season when mobility is expected to rise, prompting concerns of a possible case resurgence as seen in other countries.

Data from Germany-based GISAID database, which was created to track genetic data on influenza viruses, showed Indonesia had detected a case each of B16172 and B16173, which are related to the B1617 variant first detected in India containing slightly different mutations. Indonesia recently also reported a case of the B1351 variant first detected in South Africa and three new cases of B117, another concerning variant first detected in the UK, making a total of 13 UK variant cases so far.

The Indian variant cases were detected in Jakarta with samples collected in early and late April, before Indonesia banned travellers from the virus-stricken country on April 25. Meanwhile, the South African variant case was sampled back in January.

Health minister Budi Gunadi Sadikin has confirmed these findings but he did not specify whether they were imported cases. He previously revealed that some of the UK variant cases were locally transmitted.

"These mutations are categorised as variants of concern by the [World Health Organisation (WHO)] because they have relatively higher transmission rates,” Budi told a virtual press briefing on May 3.

“We have to guard it now when there are still a few cases, because they will certainly spread soon as their transmission rate is relatively higher.”

Among these variants, only the UK and South Africa variants have been deemed variants of concern, while the transmissibility of India's B1617 variant is still under investigation – although it has been linked to the dramatic spike of Covid-19 cases in India.

The WHO has deemed B1617 a variant of interest. Its latest epidemiology update cited several early studies revealing that other variants of interest containing the same mutations as the India variant had been associated with increased transmissibility, a reduction in naturalisation by some man-made antibody treatments and a moderate reduction in neutralisation in post-vaccination sera. Serum is the part of blood that contains antibodies against the virus.

Molecular biologist Ahmad Utomo said that while there was no need for panic now, both authorities and people could no longer act like it was business as usual. Whether these variants could actually grow dominant and take a toll on the country's healthcare system would depend on the mobility and compliance with health protocols of the people as their hosts, he said.

The issue was that Indonesia was still lacking the capacity to detect variants, both by using the "luxurious" whole genome sequencing, as shown in the late reporting of the emerging variants, as well as in the fundamental containment efforts of testing, contact tracing and isolating, he said.

Let alone concerning variants from other countries, Indonesia would have a hard time detecting mutations emerging domestically if such insufficient efforts were to continue, Ahmad said.

Indonesia's testing and quarantine policies have been the talk of the country lately with a state-owned clinical laboratory company using recycled testing kits at an airport in North Sumatra, as well as breached mandatory quarantine of people arriving from foreign countries, including India.

"The example is already right in front of us – India. The question is whether we want to be like India or not?" Ahmad said.

Wien Kusharyoto, a biotechnology researcher involved in whole genome sequencing at the Indonesian Institute of Sciences (LIPI), said the country was still not fast enough in improving testing and whole genome sequencing.

These were important means to identify as early as possible any "symptoms" of case resurgence like in India that started off with scattered local outbreaks, he said, warning against dismissing such trends.

The health ministry has expressed concerns of recent increases in confirmed cases, hospitalisations and deaths related to Covid-19 in some regions, including those receiving homebound Indonesian migrant workers. Budi said that any increase would always be "exponential in nature hence hard to control".

The government has prohibited Idul Fitri mudik but acknowledged possibilities of people finding their way around the ban to return to their hometowns for the Idul Fitri holidays coming in the next two weeks.

The ministry has previously identified dozens of regions deemed to be the main destinations for mudik, urging that they accelerate vaccine rollout on the prioritised seniors – who are most at risk when catching the disease – and teachers in anticipation of the increased mobility.

Now that the country has detected these concerning variants, Budi has called on targeted groups to receive their Covid-19 jabs as soon as possible.

But the country's vaccination drive has been slowed down to around 300,000 injections daily due to limited supplies, ministry spokesperson Siti Nadia Tarmizi said.

Despite such limitations, the country has decided to proceed with using about one million doses of the vaccine made by Chinese drug giant Sinopharm it received recently for the private vaccination programme on workers of participating companies. Half of these vaccine doses were given to Indonesia by the UAE.

A health ministry regulation has made it impossible for the government's free vaccine rollout and the private vaccination scheme to deploy the same vaccine brands – never mind that only four per cent of the country's total population has received at least the first jab.

Only 2.6 million of the targeted 21.5 million elderly people have gotten at least their first jab so far, a stark contrast to the 8.5 million of the targeted 17.3 million public workers.