Until then, though, as a stop-gap, the country is relying on rapid testing as the first line of action. Indonesia imported 500,000 rapid test kits in mid-March and has deployed tens of thousands at the city-level, with some success.
But they’re far from ideal.
Rapid tests, performed on blood samples, may be cheaper and easier to administer, but they also don’t check specifically for the Covid virus. They look for the existence of antibodies against it. The World Health Organisation (WHO) currently does not recommend using rapid tests as a first diagnostics tool, because a whole new set of risks is associated with them.
False negatives are likely: Someone diagnosed negative in a rapid antibody test may think of themselves as healthy and spread the virus before symptoms show up.
The data is hard to use effectively: At present, those who test positive in a rapid test do not factor into Indonesia’s overall score of confirmed Covid-19 cases. Should they? And what’s the course of treatment for those who test positive?
Despite the caveats, mass rapid testing is the best chance Indonesia has for now, while PCR test infrastructure gets scaled up. Besides, unlike PCR, which needs government sanction, rapid tests can be administered by private healthcare providers.
More labs, more staff, more kits
One of the big fears associated with rapid testing is false negatives, but not testing much at all increases the likelihood of cases being undiagnosed or misdiagnosed, putting more people at risk. Imagine patients being diagnosed with pneumonia, which is largely non-contagious, and carrying the highly-contagious Covid virus all along.
It is worth noting that Indonesia, of late, is seeing more deaths in general than is usual. The number of funerals in Jakarta in March saw a 40% spike compared to previous months.
This almost characteristically follows abysmally low Covid testing.
Time lost to bad samples
In February, when Covid-19 cases were already soaring elsewhere Indonesia reported zero. That may have been due to a faulty testing process. Media reports suggest that Indonesia wasn’t fully complying with WHO-guidelines about storing and transporting samples in a continuous cold chain.
In February, when cases in China and some other countries were already soaring, Indonesia had authorised all but one government-operated lab in Jakarta to test for Covid-19. After the first test came back positive on 2 March, this was extended to government-operated labs across Indonesia—of which the country has just over a dozen, at a population of close to 270 million—as well one private foundation in Jakarta.
Indonesia lags behind in its testing capacity compared to most of its neighboring countries, and it’s far behind India.
As of 8 April, the government, over a live-streamed press conference, claimed to have acquired 20 more machines that can conduct PCR tests. While two of the machines can conduct 1,000 tests a day, 18 can handle up to 500. From 13 April onwards, Indonesia expects to gradually increase capacity to between 5,000 and 10,000 tests a day.