Jakarta, Indonesia (AP) — Sri Dewi stood in the graveyard with his family, waiting for his turn to bury his brother. He had a stroke and needed oxygen, but no one was overwhelmed by COVID-19 patients in the hospital.

“We took him to this hospital, but there was no room for him,” Dewi said. “The hospital was short of oxygen.”

The family finally bought an oxygen cylinder at the store and took his brother home, but he died later that night.

After a slow rollout of vaccination, Indonesia is now competing to inoculate as many people as possible to combat the explosion of COVID-19 cases that are burdening healthcare. However, inadequate global supply, the complex geography of the world’s largest archipelago, and hesitation among some Indonesians are major obstacles.

The recent surge has pushed some hospitals to the limit, boosted by a trip during the Eid vacation in May and the spread of the delta variant of the coronavirus that was first discovered in India. Over the past two weeks, the 7-day moving average for the one-day case has risen from over 8,655 to 20,690. Almost half of the PCRs tested return positive results.

Even these numbers are underestimated, according to the World Health Organization, with nearly 75% of states reporting test rates below the recommended benchmark of one test per 1,000 people.

The impact is evident across Java, Indonesia’s most populous island. In mid-June, the hospital began building plastic tents as a makeshift intensive care unit, and patients waited a few days before being admitted. Fortunately, oxygen cylinders were installed on the sidewalk so that they could be received, and others were told that they had to find the oxygen cylinders themselves.

Apart from the hospital, new lands continue to be cultivated for the dead. As grave diggers work in slow shifts, families wait in turn to fill their loved ones. Last year, Indonesia’s highest Islamic clergy group issued a decree that mass graves (usually prohibited by Islam) are allowed during the crisis.

The surge is predominantly concentrated in Java, but it’s only a matter of time before the underfunded and understaffed medical facilities hit other parts of the vast archipelago that are more vulnerable and can collapse. Epidemiologist Dicky Budiman said. Australia.

The government is resisting imposing stricter COVID-19 restrictions for fear of damaging Southeast Asia’s largest economy, which recorded its first recession since 1988 last year. This week, the government announced the toughest steps since Saturday this year, including work from home. Only deliveries were allowed for the closure of places of worship, malls and restaurants.

“We have agreed with the Governor and Mayor to implement this emergency measure rigorously,” said Rufut Binsal Panjaitan, who appointed to lead the pandemic response.

Some medical professionals do not consider the measures to be adequate given the loose overall enforcement.

“Indonesia does not yet have sufficient testing capacity and quarantine and quarantine strategies are not effective … yet there is not enough aggressive case detection,” Budiman said. “The government needs to be interested in three strategies: enhanced testing, quarantine, and early treatment.”

If you are not willing to enter a complete blockade, Indonesia’s only way is a vaccine.

Like many other countries, Indonesia is below the required shots. By June 30, we had received 118.7 million doses of Sinovac and AstraZeneca vaccines. This is well below the amount required to vaccinate 181.5 million people, or 70% of the population. Millions of additional doses are planned in the coming months, but that’s still not enough to reach the goal.

The United States announced on Friday that it would donate 4 million doses of Moderna vaccine as soon as possible through a UN-sponsored COVAX facility. In addition, according to National Security Council spokesman Emily Horn, national security adviser Jake Sullivan and Indonesian Foreign Minister Letno Marsdi will increase support for Indonesia’s broader COVID-19 response efforts. Discussed the plan.

Indonesia is also working on developing its own vaccine, but even if it passes clinical trials, it is unlikely that production will begin until next year.

President Joko Widodo has set a goal of immunizing one million people a day by turning stadiums, community centers, police stations and nearby clinics into mass vaccination sites. The government is aiming to double the daily rate from August. So far, only about 5% of the population has been vaccinated.

Indonesian vaccination program spokesman Siti Nadia Tarmizi said areas with more cases would be prioritized.

Geography poses a major challenge in a country with thousands of islands in an area about the size of the continental United States, with transportation and infrastructure restricted in many places.

Government officials say they are ready to work on training staff and ensuring a stable cold supply chain needed to transport vaccines.

Hesitation and false information have hampered previous vaccination campaigns. In Indonesia, the vaccination rate for regular measles and rubella vaccinations is as low as 10%.

“Vaccine hesitation really influences vaccination efforts,” Budiman said. “Indonesia doesn’t have a strong communication strategy yet … and some people don’t think this pandemic still exists.”

He said the government “needs to make appropriate, strong, science-based decisions …”. Or I’m worried that I’ll be in a situation similar to what happened in India. “

___

Associated Press writer Niniek Karmini and videographer Andi Jatmiko contributed to this report.

___

The Associated Press’s Department of Health Sciences is supported by the Department of Science Education at the Howard Hughes Medical Institute. AP is solely responsible for all content.