In the face of a pandemic, the choice of the initial approach taken by countries before a vaccine was discovered was the non-pharmaceutical method (social distancing, city lockdown or total lockdown) and the 3T pharmaceutical method (testing, tracing and treatment).
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Sweden is the only country that has chosen not to apply the non-pharmaceutical method approach. Vietnam and China are two countries that have been successful in fully implementing both approaches.
China is said to be successful mainly because of the support of the big data system on population analysis, the accuracy of the government in implementing all their policy choices along with the support of compliance from all of their citizens.
How is Indonesia? Since the beginning of the pandemic, Indonesia has implemented a choice of non-pharmaceutical methods, especially social distancing measures accompanied by a “city lockdown” on a certain scale. Apart from that, Indonesia also applies the pharmaceutical 3T method. In the evaluation, there are four notes that explain the reasons why Indonesia has not optimally implemented the 3T pharmaceutical method.
First, there is not much testing equipment available. It can be said that the testing equipment is lacking compared to the population. Second, tracing is only done on 3 to 5 to 10 people. In fact, tracing must be done in large numbers of people who met with or were around the patient. Third, self-quarantine cannot be relied on because most of those who carry out quarantine do not comply with the provisions. In addition, this process is not supported by the big data system. Fourth, social distancing can apparently create tiring situations for the community.
From the notes above, the steps to implement the approach chosen by Indonesia are technically leading to a rational choice. However, its effectiveness is not optimal because it faces technical and non-technical obstacles. Until now, the government has continued to improve in order to optimize the effectiveness of this approach.
Vaccine discovery
The most important element to accelerate overcoming a pandemic is the discovery of a vaccine. High-tech advances have enabled scientists to produce a vaccine for this pandemic at least 9 months since the pandemic spread. According to Prof. Dr. Drh. I Gusti Ngurah K. Mahardika, a virologist from Udayana University, Bali, this vaccine discovery also explained that Covid-19 is a type of virus that can be overcome with a vaccine. Supported by the efficiency and effectiveness of advances in high technology support structures, this vaccine can be immediately produced in large quantities for wide distribution to foreign countries.
There are three types of vaccines approved by EUA (Emergency Use Authorization) from the BPOM (Badan Pengawasan Obat dan Makanan, or Food and Drug Administration) based on clinical trials until the third phase in Indonesia, namely (1) Pfizer Vaccine, (2) AstraZeneca Vaccine, and (3) Sinovac Vaccine.
Until January 15, 2021, only Sinovac Vaccine is available in Indonesia. The Indonesian government's policy to choose the Sinovac vaccine is very precise, both for momentum and medical reasons. Prof. Dr. Dhr. I Gusti Ngurah K. Mahardika stated that the Sinovac vaccine is safe and effective. The Sinovac vaccine has been applied to curb the pandemic in Indonesia by the government by starting the Covid-19 vaccination program in January 13, 2021 to form herd immunity against the virus.
Like most of the world’s leaders, Indonesian President Joko Widodo was the first recipient of this vaccine. Sinovac Life Science, a pharmaceutical company from Beijing, China, sent 3 million doses of Sinovac vaccine in its finished form in early and late December 2020. Fifteen million doses of raw materials have also been sent by Sinovac Life Science to be produced by PT Bio Farma from Indonesia. According to calculations, at least 426 million doses of vaccine are needed to form herd immunity in Indonesia.
Technical and non-technical challenges
Apart from trying to maximize the choice of approach in dealing with a pandemic and efforts to procure vaccines, another challenge that is no less important to consider is the strategy in implementing vaccination, including efforts to overcome doubts from several parties regarding the effectiveness of vaccination.
According to Prof. Sri Rezeki Hadinegoro, chairman of the Indonesian Technical Advisory Group on Immunization (ITAGI), a party that shows that anti-vaccine attitudes are not only happening in Indonesia, but also in almost all over the world. A survey conducted by UNICEF, the Indonesian Ministry of Health, WHO and ITAGI of 15,000 respondents online shows that approximately 64.8% are willing to receive vaccinations, 27.6% are still doubtful, and 7.6% refuse vaccination.
From these results, the challenge is how to optimize education for those who have been willing to receive vaccinations, so that they are truly determined on their choices and can share the right information with others around them. For those who are still in doubt, there is still an opportunity for persuasion by providing a true explanation of the benefits of getting vaccinated, while tracking down the problems that cause their doubts.
Based on the survey above, it seems that problems can be traced about groups that are still hesitant to receive vaccinations. In the mapping, there are three problems that make this group still have doubts: safety, effectiveness and the halal-ness of vaccines. If we assume that this mapping can be trusted, these three problems are basically normative-legally resolved, so that the factors tend to lead to a lack of accurate and complete information.
As described above, with regard to vaccine safety issues, the UEA from the BPOM has established an approval for three types of vaccines based on clinical trials up to the third phase in Indonesia, especially the Sinovac vaccine. This agreement, of course, contains confirmation of the safety and effectiveness of vaccines based on reliable, valid data. Another momentum that is no less important in disseminating the safety and reliability of the Sinovac vaccine is to maximize publications regarding President Widodo’s public appearance as the recipient of the first vaccine injection, and then followed by similar publications by government officials at the regional level on a national scale, even now, these efforts have reached some of the farthest cities, for example cities in Papua province.
With regard to the halal vaccines, especially the Sinovac vaccine, this problem can also be resolved at the legal-normative level, considering that the MUI (Majelis Ulama Indonesia, or the Indonesian Council of Ulama), after visiting Beijing to review the vaccine manufacturing factory and understand all the ingredients and how it all works, at January 11, 2021, issued a fatwa that Sinovac is a halal and holy vaccine. The challenge is the efforts to disseminate complete information about this to the wider community. If these challenges can be converted into the right strategy, it is certain that the effectiveness in overcoming the Covid-19 pandemic, especially through the vaccination process, can be implemented better and will bring success.
(The author is the China Study Unit Convenor at CSIS Indonesia. The opinions expressed here reflect those the author, not neccesarily those of the People’s Daily.)
