WHO joined a team from Ministry of Health in Bali province on Thursday 27 February to observe the readiness of the region for a potential outbreak of novel coronavirus (COVID-19). As a top tourist destination in Indonesia and a busy international travel hub, it is imperative that Bali is committed to thorough COVID-19 readiness.
The visit started with a presentation and discussion on readiness by Bali provincial authorities. During the discussion, WHO Representative to Indonesia, Dr N. Paranietharan, appreciated the efforts of Bali health authorities, while drawing on a hypothesized potential scenario requiring response activities to manage possible ongoing transmission in Bali. Dr Paranietharan emphasized that in such a situation it is critical to expand the definition of suspected cases and to collect appropriate samples from anyone admitted to healthcare facilities with respiratory illness.
“The only way we can be sure that there’s no transmission of COVID-19 is to detect severe acute respiratory infections and influenza-like illness cases, and collect and transport at least five hundred samples correctly from patients with respiratory infection in Bali in the next few weeks,” Dr Paranietharan said.
“If all these samples are tested negative after having taken the appropriate steps, including samples taken from all the contacts of confirmed cases reporting travel to Bali, then we might be able to exclude COVID-19 transmission”.
He further elaborated on potential scenarios of the outbreak and requested the Bali provincial authorities to plan for circumstances where there may be 10-20 cases, 100 cases, and 1000 cases. As part of this scenario planning, the authorities were requested to develop a contingency plan to clarify how these various situations may be effectively managed.
The response from Bali authorities was positive. Representatives agreed to ensure adequate and appropriate readiness activities, and the prompt implementation of appropriate contingency plans.
WHO Representative then attended Bali’s Sanglah General Hospital (RSUP). As the largest hospital on the island, it has been identified as one of Indonesia’s 100 COVID-19 referral hospitals. During his visit, Dr Paranie discussed case detection, case management, patient isolation, and infection prevention and control (IPC) with hospital staff. The hospital has a dedicated COVID-19 preparedness team, an IPC specialist doctor as well as 14 isolation rooms with 34 beds, including 4 negative pressure isolation rooms.
WHO Indonesia appreciates the good work being done to ensure appropriate case management of suspected cases and the high level of commitment shown by the medical and management teams of the RSUP. The hospital has a preparedness plan for disease outbreak scenarios, including converting additional wards into isolation rooms if needed.
Furthermore, it is important that the readiness of hospital ensures adequate stocks of the various relevant supplies - especially personal protective equipments (PPEs) - to be able to cope with a potential COVID-19 outbreak scenario that may see hundreds of patients seeking healthcare. Before departing, the team also visited Ngura Rai International Airport, the main airport in Bali, to observe the screening of international arrivals.
Caption: WHO Representative to Indonesia joined Ministry of Health and Bali provincial authorities to discuss COVID-19 readiness in Bali province.
Photo credit: WHO/Endang 2020
Background:
Beginning in December 2019, an upsurge of unknown pneumonia cases was detected in persons from Wuhan city in China. The unknown infection comes from the family of coronaviruses. These viruses are common – many cause less severe illness such as the common cold; others are known to cause more severe illness (such as SARS and MERS).
Since December, cases of this virus have been detected throughout China, and in many countries across the world. While many cases can be traced back to contact or travel history in Wuhan city, human-to human transmission of the virus has been confirmed globally.
As of 29 February, there have been no confirmed cases of COVID-19 reported by Indonesia. The World Health Organization is working with the Government of Indonesia to ensure that suspected patients are treated adequately and in case of any potential confirmed cases, the spread of the virus is contained through appropriate measures as per WHO guidelines.
More information on COVID-19 preparedness in Indonesia can be found here: https://www.who.int/indonesia/news/novel-coronavirus
Main image caption: WHO Representative to Indonesia conducts a site visit to Bali’s largest hospital, Sanglah General Hospital (RSUP), to review infection prevention and control practices.
Photo Credit: WHO/Endang 2020