Indonesia: Raging pandemic provides fertile ground for new variants

Indonesia: Raging pandemic provides fertile ground for new variants

The speed and scale of the coronavirus outbreak in Indonesia has created the perfect breeding ground for a potential new super strain that could be even more contagious and deadly than the Delta variant, warn infectious disease experts around the world .
Last week, Indonesia overtook India and Brazil to become the country reporting the highest number of daily cases in the world. As of Thursday, the archipelago reported more than 49,500 new cases and 1,449 deaths.

“New variants are always appearing in regions or countries that cannot control epidemics,” said Dicky Budiman, an Indonesian epidemiologist researching coronavirus variants at Griffith University in Australia. “The World Health Organization [WHO] says if more than 5% of tests are positive, the outbreak is out of control. In Indonesia, it had been above 10% for 16 months at the start of the pandemic. Now it’s over 30 percent. So you can imagine how much opportunity Indonesia has to create a new or super variant of COVID-19. “

Amin Soebandrio, director of the Eijkman Institute, a government organization that studies tropical and emerging infectious diseases, says that no new variants have surfaced in Indonesia yet, vigilance is crucial.

“With the increasing number of cases, we cannot deny that it is possible and must observe carefully to identify new variants as soon as they appear,” he said.

Indonesia reported a record number of deaths from COVID-19 on Thursday. With hospitals unable to cope with spike in cases, more people are forced to self-isolate at home [File: Adi Weda/EPA]

Worrisome variants

Viruses are constantly changing through mutations in their genes, creating more advanced variants.

Dr Stuart Ray, vice president of medicine for data integrity and analytics at Johns Hopkins University School of Medicine, says new variants of COVID-19 are being detected around the world every week, but “it is in the nature of RNA viruses such as the coronavirus to evolve and change – gradually”.

He says “most come and go – some persist but do not become more frequent; some increase in population for a while, then fades away.

It is only when a variant exhibits a jump in its transmission capacity, increased severity based on hospitalizations or deaths, or reduced efficacy of treatments and vaccines, that the WHO classifies the strain as a “variant. worrying ”.

Globally, there are four variants of concern: the so-called Alpha variant, first identified in the UK; the Beta variant, first identified in South Africa; the Delta variant, first identified in India; and the Gamma variant, first identified in Brazil.

Soebandrio says that all but the Gamma variant have been detected in Indonesia, and that the country now has the diagnostic capacity to detect new strains at short notice. More than 3,000 genome chains have been sequenced since the start of the year in Indonesia compared to only 200 to 300 last year. The results show that the Alpha variant is still spreading but Delta is dominant.

The Delta variant is “four to five times more contagious than the original virus,” said Shahid Jameel, India’s top virologist who until recently headed the advisory group for the Indian SARS-CoV-2 genomics consortium, which monitors the variants of COVID-19.

Jameel says the situation in Indonesia is now “very similar” to India’s second wave due to “poor rates” of vaccination. According to the Ministry of Health, only 8 percent of Indonesians are fully immunized.

An Indonesian army officer checks a driver’s papers at a checkpoint in Jakarta. Indonesia has imposed travel restrictions and bans in an attempt to limit travel and control spike in coronavirus cases [Bagus Indahono/EPA]

Possibility to go wild

Representatives from two of the world’s leading coronavirus research groups in the United States fear conditions in Indonesia may be ripe for the emergence of a worrying new variant of COVID-19.

“The more infections there are in a community, the more likely it is for a new variant,” said Ali Mokdad, professor of health metrics sciences at the Institute for Health Metrics and Evaluation in Seattle. He also expressed concern about the Indonesian Eid al-Adha festival, which took place this week, and “the activity around it”.

Indonesia’s COVID-19 task force has issued a special directive for the holiday week, banning public travel across the country. He also extended an emergency partial lockdown, introduced on July 3, until next Monday.

Thousands of security personnel have been deployed across the country to enforce the travel ban, after an order similar to Eid al-Fitr, the end of the fasting month of Ramadan, was passed. not doing much to prevent people from traveling.

But over the weekend, police and military at Gilimanuk port in west Bali watched thousands of migrant workers board overcrowded ferries to return to their families in Java, the epicenter of the world. epidemic in Indonesia, to celebrate the holidays. I Nengah Tamba, the head of the regency in which Gilimanuk is located, refuses to apply the extension of the emergency partial confinement.

Dr Robert Bollinger, professor of infectious diseases at Johns Hopkins University School of Medicine, warns that COVID-19 “has the potential to mutate into a new variant every time it infects a new person.” The risk of new variants is therefore highest in communities and countries with the highest number of new cases, including Indonesia. “

But predicting where and when a new variant of concern will emerge, is currently beyond the capacity of scientists today.

“All I can say is that when you give an RNA virus like this the chance to let loose, it will accumulate random mutations more frequently and the chances of a new variant will increase,” said Indian virologist Shahid Jameel.

“They should learn from India’s experience, the main one being a very rapid increase in hospital capacity and oxygen availability. Unfortunately, the worst is yet to come for the region.

A Balinese Hindu takes part in the Ngrastiti Bhakti ritual to pray for the end of the pandemic on July 14. [File: Fikri Yusuf/Antara Foto via Reuters]


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