Jakarta doctors losing battle and their lives
AMANDA HODGE CHANDNI VASANDANI: AFP, REUTERS
A COVID mural goes up in Jakarta on Thursday; a wife grieves for her husband and fellow doctor Titus Taba, below
Live music is back on in Jakarta, the cinemas are soon to reopen and shoppers are trickling back to its ubiquitous malls, but nowhere in the Indonesian capital is it as crowded as in its hospitals, which are reaching capacity as infection rates soar to record numbers.
"It feels like my brain is going to break," Debryna Dewi Lumanauw, a 28-year-old doctor told The Weekend Australian between shifts at Pertamina Hospital, one of the city's COVID- 19 referral hospitals.
"It's been crazy for the last month. We're severely understaffed and more doctors and nurses are resigning or getting infected and having to go into isolation, which is making us more understaffed."
Jakarta and Indonesia have posted two consecutive record days of infections, with 869 new cases in the capital and 3003 nationwide on Friday, bringing the total to 165,887.
While COVID-19 tests conducted in Jakarta account for almost half of Indonesia's notoriously low daily testing rate, 9.9 per cent of all those tested in the city this week came back positive (compared to 12.5 per cent nationally) suggesting that infection is rampant across the Jakarta city.
Official intensive care occupancy rates in Jakarta jumped from between 40 and 50 per cent last month to 71 per cent on Monday. But in the city's COVID hospitals, The Weekend Australian has been told occupancy rates are reaching 90 per cent or higher."*
Jakarta's largest COVID referral *hospital, Persahabatan, has 208 beds, but only 16 of those are for ICU patients, says Erlina Burhan, a pulmonologist who works there and helped draft Indonesia's treatment guidelines.
"We are all a bit nervous about the situation because it doesn't look like cases are reducing at all and the capacity of our ICUs are very limited," she said on Friday.
What makes us anxious is that the occupancy rate is very high — almost 90 to 100 per cent
— since we are getting an increasing number of patients referred to us and they are mostly those who need ICU care. We have a long queue of patients that need to be admitted to our hospital. We are only taking the … patients with moderate to severe symptoms and the critically ill."
At Pertamina Hospital, Dr Debryna says she is handling 10 to 15 ICU patients in a shift, which she describes as crazy
ICU is different from inpatient wards because you have to know the patient from A to Z. The optimal number of ICU patients we should be monitoring in one shift is five or six."
Recovered patients are at least moving out of the hospital quicker after Jakarta overruled the central government edict that patients must first test negative twice for COVID, but as fast as they are discharged more are taking their place.
A doctor at Jakarta's Cipto Mangunkusumo hospital, who asked not to be named, said the situation felt more "controlled" than it did two weeks ago.
"But that's because we're seeing many patients coming in a serious condition — extreme shortness of breath, fever so high they're barely conscious — and they don't last long in the hospital," he said. "This week during my shifts, I've seen a 34 and a 35-yearold die. Many are dying because of co-morbidities made worse by COVID, acute asthma, obesity or heart disease, but I'm also seeing patients coming in when it's too late. They've ignored, or didn't think much of early symptoms and only come when they're in a serious condition. They may not even make it to the ward."
Zubairi Djoerban, head of the Indonesian Medical Association's COVID taskforce, predicts the situation will be more difficult next month, even in areas where things seem under control, and more hospitals must be assigned as referral clinics now so they are ready as others reach full occupancy.
"First we thought it was only an issue in Italy and Spain, and then we saw the UK and US, and then India and Brazil, and now we see it here also. The whole world is facing this and healthcare systems all over the world are struggling," he said. "The most urgent problem right now is more and more infections and doctors among those getting infected, which means the number of doctors available to treat patients will be fewer."
But with one of the highest COVID death rates among doctors in the world (2.4 per cent), hospitals are struggling to recruit new staff.
This week a picture of a doctor in a pink PPE suit, grieving alone over her husband's casket — another doctor who died of COVID— went viral on social media. Titus Taba was head of the Indonesian Medical Association in West Papua and the 94th Indonesian doctor to die from the virus.
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