The World Health Organization or the World Health Organization has declared Coronavirus Disease (COVID-19) as a pandemic because of its very fast spread and has infected 216 countries. Since the first time until July 2020, as many as 14,500,000 people from 216 countries have been infected and caused 606,000 deaths. Indonesia as a tropical country and an archipelagic country is also facing the transmission of COVID-19 as a public health threat. The number of islands in Indonesia as many as 17,504 islands and 34 provinces is a challenge for Indonesia to break the chain of transmission of COVID-19. The latest data in July 2020, shows the number of COVID-19 cases as many as 88,124 cases and 4,239 deaths. Indonesia also still has challenges in dealing with tropical diseases, such as dengue virus infection. The number of dengue cases experienced a rapid increase in early 2020 compared to the previous year. The Ministry of Health has recorded 68,000 cases of dengue infection and 446 deaths. The world health agency in its article entitled "WHO Global Strategy for Dengue Prevention and Control 2012-2020" shows that countries in the Southeast Asian region are dengue endemic areas. Dengue infection is often associated with seasonal changes that occur in the region. The pattern of increasing the number of dengue fever cases in Indonesia occurs from January to February, which is the peak of the rainy season. From January to June 2020, there were 68,753 dengue cases, while from mid-March 2020 where COVID-19 cases were first discovered, there were 6500 dengue cases. This allows for coinfection between COVID-19 patients and dengue fever. Recent studies have shown similarities between clinical symptoms and laboratory results between dengue and COVID-19. Clinical symptoms in dengue-infected patients are fever, petechiae, and skin rash. Differences in symptoms with COVID-19 patients are respiratory problems such as shortness of breath, cough, and diarrhea. Laboratory examinations between dengue infection and COVID-19 which show similarities are the occurrence of thrombocytopenia and thrombocytopenia. The causative agent of dengue infection and COVID-19 is a virus belonging to the RNA virus group, so that cross reactions can occur with the same ADE (Antibody dependent enhancement). This cross-reaction allows the occurrence of false positives in the rapid dengue examination. Failure to diagnose COVID-19 due to positive rapid dengue test results can have a negative impact on patients and health services. This will be a problem in Indonesia because of the limitations of diagnostic tools, especially real time RT-PCR which functions to carry out early detection and prevent transmission of COVID-19.
Sources of funding for the health system in Indonesia are private funding and funding from the government/public. Public health system funding refers to a decentralized system of government with responsibility for provincial and district governments. The Ministry of Health as an extension of the central government has the responsibility to manage several tertiary and specialist hospitals. Excellent health services are very important in this pandemic era. Since the number of COVID-19 cases and dengue cases continues to increase, the number of beds in hospitals is limited. The central government has established regulations on distance restrictions in several areas, also known as PSBB (Large-Scale Social Restrictions) in several cities in Indonesia, namely Jakarta and Surabaya. The points in the PSBB include WFH (work from home) for office workers and online schools. However, in practice, it did not show a significant decrease in cases. Based on data in 2018, the number of hospitals in Indonesia is not evenly distributed with the highest distribution in East Java Province (381 hospitals) and the lowest in North Kalimantan (10 hospitals). The number of beds in hospitals throughout Indonesia in 2018 was 281,081 cases, with a population of 270 million in Indonesia, it can be estimated that for every 1000 people, only 1 bed is available. Management of COVID-19 patients with severe symptoms requires the presence of an intensive care unit (ICU) with a ventilator. The number of ventilators in Indonesia is 8413, so the ratio of ventilators to the population is 3.11 per 100,000 population, while the number of ICU beds is 3,500 (1.29 per 100,000 population). If it is estimated that the number of COVID-19 patients who experience severe symptoms is 5%, severe dengue patients are <1% and each COVID-19 patient requires 3 weeks of treatment to recover, then this can cause chaos in the health system. Based on the analysis of this situation, it can be concluded that it is necessary to avoid the transmission of COVID-19, so that a double burden on the health system can be avoided. The more human interaction, the higher the transmission of COVID-19 that occurs. Written by: Shifa Fauziyah, Febriana Aquaresta, Teguh Hari Sucipto, Herisa Nataliana Junus Source : news.unair.ac.id Picture's Source: liputan6.com