Coronavirus Disease 2019 ( COVID-19 )

The epidemic of 2019 novel coronavirus (2019-nCoV) has been emerged from a major city named Wuhan in the Hubei Province of China. It appears to have the potential to cause a major health problem globally. Earlier it is called 2019-nCoV but now this virus is taxonomically termed SARS-CoV-2. World Health Organization has named it as “coronavirus disease 2019” and abbreviated “COVID-19” [1].

• On 19 August, 1 902 new and 144 945 cumulative confirmed  cases were reported (Fig. 2). The average for the last seven days was 2 032 cases per day, compared to 1 978 per day for the previous seven days.
• As of 19 August, most confirmed cases were in Java: DKI Jakarta followed by East Java, Central Java, and West Java. South Sulawesi is the only province outside Java that has one of the highest numbers of confirmed cases. Java contributed 58% of the total cases in Indonesia. The cumulative number of confirmed COVID-19 cases by province is shown in Figure 3.   • As of 19 August, the daily number of specimens and suspected cases tested were 26 078 and 14 940, respectively (Fig. 5). The weekly average number of specimens and suspected cases tested in the last seven days were 22 492 and 12 027, respectively. It is important to set the testing target to achieve the benchmark of suspected cases tested each day, in line with the fifth revision of the national guidelines for COVID-19 prevention and control. The guideline states the target as one suspected case tested per 1 000 population per week, adopted from WHO's recommendation for comprehensive surveillance 5 .  Disclaimer: Due to the transition to a new data management application, there may have been reporting issues in timing. Therefore, on certain days the number of specimens tested is almost the same as the number of suspected cases tested, which might not have been the situation. Criterion 1: Decline of at least 50% over a 3-week period since the latest peak and continuous decline in the observed incidence of confirmed and probable cases • None of the provinces in Java have shown a decline of at least 50% for three weeks since the latest peak (Figs. 6 to 11). Most provinces in Java experienced an increase in the number of confirmed COVID-19 cases in the last week. Criterion 2: Less than 5% of samples positive for COVID-19, at least for the last 2 weeks, assuming that surveillance for suspected cases is comprehensive

EPIDEMIOLOGICAL CRITERIA TO ASSESS COVID-19 TRANSMISSION
• The percentage of positive samples can be interpreted only with comprehensive surveillance and testing of suspected cases, in the order of one per 1 000 population per week. DKI Jakarta has achieved this minimum case detection benchmark (Fig. 12).  Disclaimer: The data are provisional. Since 20 July, DKI Jakarta and East Java are in the process of adopting case definitions based on the fifth revision of the national guidelines on COVID-19 prevention and control. There may be a discrepancy in the number of deaths of confirmed COVID-19 cases between national and provincial data sources.
• On 13 August, WHO, the Food and Agriculture Organization (FAO), and the United States Agency for International Development (USAID) -LINKAGE -convened a meeting to discuss measures to strengthen surveillance and contact tracing. Volunteers and field staff from various organizations will support activities at the subnational level. A refresher training on surveillance will take place next week, along with an orientation on the new contact tracing application with mobile and desktop versions: the mobile application will enable contact tracers to input information while the desktop version will compile and analyse the data.
• The number of confirmed COVID-19 cases hospitalized in DKI Jakarta since the beginning of June had gradually decreased until 07 July; however, since 08 July, the number has been progressively increasing (Fig. 14). • As reported by the government on 19 August, the number of suspected cases tested for COVID-19 with polymerase chain reaction (PCR) was 14 940 and the cumulative number of suspected cases tested was 1 096 294 (Fig. 15).

HEALTH SYSTEM CRITERIA TO ASSESS COVID-19 TRANSMISSION
• On 12 and 14 August, the Intra-Action Review (IAR) met to discuss the laboratory response for COVID-19 and design short-and long-term plans for the laboratory response during the pandemic. Relevant stakeholders highlighted best practices and challenges identified.
Some best practices include: i. Expanded laboratory network since the beginning of the pandemic (from 13 laboratories in March to 320 laboratories in August); ii. Virtual as well as on-the-job training for laboratory technicians and volunteers; iii. Mobile PCR laboratory in some provinces to enhance testing. Lack of coordination between national and provincial laboratories;

LABORATORY
ii. Delays in testing due to limited human resources, PCR reagents, extraction kits, viral transport media and consumables; iii.
Limited regional laboratories reporting their results in real time to the national laboratory; iv. Limited participation in the external quality assurance (EQA); and some laboratories not meeting the EQA standards yet.
• As of 19 August, the proportion of people that recovered among the total confirmed COVID-19 cases was 68.1% (Fig. 16). As of the same date, there were 39 942 confirmed COVID-19 cases under care or in isolation 6 . • From 11 to 14 August, WHO supported an IAR for the COVID-19 response. Multiple sector stakeholders including, among others, the Ministry of Health (MoH), the National Board for Disaster Management (BNPB), the Secretariat of the Cabinet, selected Province Health Offices (PHOs), hospitals and the armed forces actively shared best practices, gaps and challenges and provided input to formulate recommendations to strengthen the national COVID-19 response. These recommendations will guide the review of the national and provincial response plans for COVID-19. The core team of focal points for each pillar of the response plan will monitor the implementation of the IAR recommendations and the Directorate of Surveillance and Health Quarantine, MoH, in collaboration with BNPB, will coordinate periodic meetings to track progress. The results of the IAR will be published on the Partnership Platform and will be presented to the Directorate General of Disease Prevention and Control (International Health Regulations Focal Point for Indonesia) and the COVID-19 Task Force. Indonesia will also share the IAR outcomes with relevant stakeholders and regional and global communities.
• WHO is regularly translating and sharing important health messages on the website and social media platforms -Twitter and Instagram -and has recently published: i. The number of districts/cities conducting early detection of hepatitis B (Deteksi Dini Hepatitis B or DDHB) among pregnant women from January to April 2020 was significantly lower compared to the same period last year (Fig. 18). ii.
There was equally a decline in the total number of pregnant women who were tested for hepatitis B during the same period (Fig. 19). A more detailed and specific analysis comparing data from before and after the COVID-19 outbreak in Indonesia shows that the number of pregnant women tested 7 MoH analysis of COVID-19 impact to Hepatitis B and Hepatitis C services, 2020 • WHO, IGCN, ILO and UNDP convened the third webinar of the 'Business Unusual in the New Normal' series on 19 August. The webinar discussed new protocols and guidelines for the hospitality and tourism industry with representatives of the private sector as the main stakeholders. Resource persons were available from WHO, ILO, the Ministry of Tourism and Creative Economy, the DKI Jakarta Provincial Government for Culture and Tourism, the Indonesia Tourism Development Corporation (ITDC) as well as the Indonesian Hotel and Restaurant Association (PHRI). WHO presented its guidance on the 'Operational considerations for prevention of COVID-19 in the accommodation sector'. The webinar aimed to facilitate dialogue between UN agencies, governments, business associations, the private sector and workers regarding the needs, concerns and challenges for health and safety standards for businesses in the hospitality and tourism industry during the COVID-19 pandemic (Fig. 25). Figure 24: A woman undergoes testing for hepatitis at a health facility. Routine health screening, including sexually transmitted diseases, should continue alongside the COVID-19 response. Credit: MoH WHO Indonesia Situation Report -21 who.int/indonesia Data presented in this situation report have been taken from publicly available data from the MoH (https://infeksiemerging.kemkes.go.id/), BNPB (http://covid19.go.id) and provincial websites. There may be differences in national and provincial data depending on the source used. All data are provisional and subject to change.