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Indonesia faces Indian-style Covid crisis as fears grow over deaths among fully vaccinated doctors

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Questions emerge over Chinese vaccines given to frontline workers amid a ‘frightening’ vertical trajectory of infections
Gravediggers in PPE bury a Covid-19 victim as relatives watch from a distance at a government burial area in Jakarta
Gravediggers in PPE bury a Covid-19 victim as relatives watch from a distance at a government burial area in Jakarta CREDIT: WILLY KURNIAWAN/REUTERS
  • Nicola Smith, Asia Correspondent
  • Dewi Loveard, in Jakarta
8 JULY 2021 • 7:00 AM


Double vaccinated and wearing a hazmat suit, Dr Ahmad Syaifuddin had hoped he would be protected from the catastrophic Covid-19 surge sweeping Indonesia, but when the thumping headache hit and he began to cough, he knew the virus had caught up with him.

Fifteen colleagues at the Islamic Hospital of Sunan Kudus, central Java – one of the epicentres of the Southeast Asian nation’s latest outbreak – were also infected as they dealt with scores of patients flooding onto the wards.

“With such a high level of fatigue and almost all of them exposed to Covid, how can we survive this virus?” said Dr Syaifuddin. “The vaccine works to improve immunity, but immunity also depends on the condition of our body. If we are tired or unfit, our immunity will be low.”

Exhaustion and record numbers of patients during Indonesia’s largest Covid-19 waveyet are believed to be factors behind the steady rate of infections and deaths among medical staff, but the heavy toll on frontline workers is also raising questions about the Chinese vaccines they received.

Healthcare workers prepare a swab sample at a testing centre in Bogor, on the outskirts of Jakarta
Healthcare workers prepare a swab sample at a testing centre in Bogor, on the outskirts of JakartaCREDIT: ANTARA FOTO/ADITYA PRADANA PUTRA/VIA REUTERS

In June, it was reported that more than 350 Indonesian doctors and medical workers had caught the virus despite being vaccinated with China’s Sinovac, with dozens of them hospitalised.

Almost all had received the vaccine developed by Chinese biopharmaceutical company Sinovac, the Indonesian Medical Association (IDI) said. It later revealed that at least 10 of of the 26 doctors who died last month had been given the Chinese-made shot that is widely being used across Asia.

And this week, local media reported that the scientist leading Sinovac vaccine trials in Indonesia died from what is suspected to be Covid.

Novilia Sjafri Bachtiar had headed dozens of clinical trials at a state-owned vaccine manufacturer, BioFarma, which has been producing Sinovac under licence from the Chinese company.

Novilia, who was in her 50s, had been receiving hospital treatment for the virus in the city of Bandung, the capital of Indonesia’s West Java province and the site of a BioFarma manufacturing facility.
A man receives a dose of Sinovac's coronavirus vaccine during an inoculation drive in Pusong village, Lhokseumawe, Aceh
A man receives a dose of Sinovac's coronavirus vaccine during an inoculation drive in Pusong village, Lhokseumawe, Aceh CREDIT: AZWAR IPANK /AFP

State enterprises minister Erick Thohir said he was grieved to hear of the “huge loss”.

“She was lead scientist and head of dozens of clinical trials done by BioFarma, including Covid-19 vaccine clinical trials in cooperation with Sinovac,” he wrote on Instagram.

“It has been produced and injected into tens of millions of people in Indonesia, as part of our effort to be free from this Covid-19 pandemic.”

The Telegraph contacted Sinovac for comment.

Indonesia, the world’s fourth most populous nation, now has a total of 2.3 million confirmed cases and close to 62,000 deaths as the current surge, fuelled by the more transmissible Delta variant, turns into a frightening vertical trajectory.

On Wednesday, it reported another record daily high of 34,379 infections and 1,040 deaths.

Experts have warned the country faces an Indian-style crisis as hospitals on its main island of Java started treating patients in car parks and are running out of medical oxygen supplies. The government has appealed to China, Singapore and other countries for urgent help.

Toni Tanama, 31,  at the funeral of his 51-year-old mother at a burial area for Covid-19 victims, in Jakarta
Toni Tanama, 31, at the funeral of his 51-year-old mother at a burial area for Covid-19 victims, in Jakarta CREDIT: WILLY KURNIAWAN/REUTERS

The pandemic has been a brutal period for Indonesian health workers, about 1,000 of whom have died since the first outbreak last year. While deaths have dropped in recent months, public health officials are still concerned about hospitalisations.

A report last month by Project Hope, a charity supporting global healthcare workers, warned that more than 80 per cent of Indonesia medical staff have reported moderate levels of physical and mental exhaustion or burnout due to Covid-19.

It said that after just one month of treating Covid patients, workers are more than five times more likely to experience depression, nearly twice as likely to have anxiety and four times more prone to burnout.
“The pandemic has been so long, and the healthcare system is already distressed,” said Edhie Rahmat, Indonesia executive director of Project Hope.

“There is excessive work, they are already depressed with the situation. They have a high risk of getting sick and infected, and some of them dying. There is also a shortage of supply of personal protective equipment,” he said.

People queue to refill oxygen tanks at a filling station in Jakarta as hospitals grapple with soaring infections
People queue to refill oxygen tanks at a filling station in Jakarta as hospitals grapple with soaring infectionsCREDIT: ACHMAD IBRAHIM/AP PHOTO

Mr Rahmat said “rocketing numbers”, the lack of personal protective equipment and a high viral load in hospital wards without good ventilation had contributed to the burden on health workers.

But he added: “It is unfortunate for Indonesian healthcare workers that they have received vaccines with low efficacy…compared to mRNA vaccines.”

Mr Rahmat appealed to the government to revaccinate healthcare workers with mRNA vaccines - such as the Pfizer and Moderna jabs - when they arrive in the country later this summer. In trials these vaccines have higher efficacy rates - both over 90 per cent - compared to Sinovac's 51 per cent. However, trials showed it was much better at preventing severe disease and hospitalisation.

“That’s one policy that everyone has to think about because risking healthcare workers means risking the health system,” he said.

In Thailand, a leaked health ministry document this week prompted similar calls for fully vaccinated medical staff to be given a booster of an mRNA vaccine.
According to the Bangkok Post, the document discussed how Pfizer’s vaccine – 1.5 million doses of which are due to arrive this month and 20 million later in the year – should be allocated.

An aerial picture of family members at their relative's grave at the Pedurenan Covid-19 public cemetery in Bekasi, West Java
An aerial picture of family members at their relative's grave at the Pedurenan Covid-19 public cemetery in Bekasi, West Java CREDIT: BAGUS SARAGIH/AFP VIA GETTY IMAGES

It allegedly admitted that if the Pfizer vaccine was given to healthcare workers as a booster, “it is tantamount to admitting that the Sinovac vaccine offers no protection. This will make it harder to defend it”.

In Indonesia, doctors are struggling to protect themselves and their families as best they can.

“As the head of the emergency
department, I have worked round the clock since early last year and have tried to avoid [the virus] as far as I could. But at the end of the day, I got infected anyway,” said Dr Ririek Andry, who works in a hospital in Serang, Java.

He had also been fully vaccinated, but believes he caught the virus before having enough time to develop antibodies. After 14 days he was back at work.

For unvaccinated medical workers, the risk is even more acute.

Dr Ulul Albab, an unvaccinated gynaecologist treating 30-40 patients a day, nearly died after the contracting the virus and ending up on a ventilator.

“Our struggle in this pandemic will continue for the next five years. This is a long-term war, we must not be weak and unaware,” he said.

But he also urged the public to play its part.

“I want them to open their eyes and realise that Covid is really there and exists. This is not a game. The pandemic is real, cruel and getting serious,” he said.

“If you are exposed, we will be busier at work. If we are too busy to help you, our immunity decreases. If our immunity decreases, we are vulnerable to Covid. If there are a lot of sick doctors, we can't help you.”
 
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That’s expected. Chinese vaccines with inactive virus are of low to medium efficacy. the effectiveness will sink lower even to zero with newer virus variants. But the people are right. It’s better than nothing.

@Indos
 
. . .
That’s expected. Chinese vaccines with inactive virus are of low to medium efficacy. the effectiveness will sink lower even to zero with newer virus variants. But the people are right. It’s better than nothing.

@Indos

I have posted the clear research on Sinovac effectiveness to prevent death until 98 % among our health worker ( 2 complete jobs ) many times in PDF, and also what has happen in Kudus region related to our health worker condition.

Indian variants become deathly due to the more effective spreading that make health sector collapse thus more death happens.

I dont need to repeat this again and again here in PDF
 
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That’s expected. Chinese vaccines with inactive virus are of low to medium efficacy. the effectiveness will sink lower even to zero with newer virus variants. But the people are right. It’s better than nothing.

@Indos


Learn statistic. "Many" is a relative word ...you need to count .. how many of the vaccinated worker died (below 100) from how many (thousands) of the vaccinated workers, it end up with how much % (low percentage).

Another variable needed to be considered :
- "Viral Load". Even if you get vaccinated if the viral load you received is so huge then your immune system will be defeated.
- Health condition of the workers; if the workers work around the clock they will get tired then their immune system will drop too, even if they already get vaccinated.
 
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Learn statistic. "Many" is a relative word ...you need to count .. how many of the vaccinated worker died (below 100) from how many (thousands) of the vaccinated workers, it end up with how much % (low percentage).

Another variable needed to be considered :
- "Viral Load". Even if you get vaccinated if the viral load you received is so huge then your immune system will be defeated.
- Health condition of the workers; if the workers work around the clock they will get tired then their immune system will drop too, even if they already get vaccinated.
So everything is fine?
About virus load, in dense populated and less developed countries as India and Indonesia the “load” is naturally higher. About statistics, Indonesia has one of lowest doctors per 1,000 people. It’s big difference if a doc dies in Germany or Indonesia. The most concern I see is the trajectory of infection rate. Because of close proximity Vietnam will be among the ones that will bear the brunt.
We can’t afford another virus. We have enough now with the indian virus variant that wrecks havoc in Vietnam.
 
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I think Sinovac and Pfizer are pretty much the same.

Luckily Kudus cases are overwhelmingly asymptomized.

While the same case for Pfizer had also happened in Singapore, but Western media is trying not to mention it, outweighed on Chinese vaccine case.

Both are Delta variants.


In my opinion, whatever Sinovac or Pfizer, we need the third dose, and maybe fourth, fifth, and so on.

Indonesia is planning Moderna for the third dose.


The most dangerous of all is thinking that the vaccine is 100% effective and then made people careless.

For example, is the rising Covid case in the UK and many other European countries despite they are being injected with the more powerful vaccine. While at the same time Uruguay is successful despite using the least powerful vaccine and surrounded with Lambda variant.
 
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There is one big advantage of the Chinese inactive vaccines, you don’t need to worry about some unknown side effects such as heart inflammation.
 
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There is one big advantage of the Chinese inactive vaccines, you don’t need to worry about some unknown side effects such as heart inflammation.

Inactive is the same technology used in flu shots. It only helps if you are already primed, since it don't generate any cellular response, since obviously dead virus cannot infect cells.
 
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