Lack of testing, mixed messages from the government and a rush to reopen.
No, not the U.S., but Indonesia, which has been hit far worse by the coronavirus than any country in Southeast Asia — more than 80,000 confirmed cases with over 3,200 dead, as of Thursday.
Epidemiologists say it didn't have to be this way.
"We have a lot of big, missed opportunities," says Pandu Riono at the University of Indonesia. "If you want to protect the people, do something seriously and do something right."
Indonesia's central government, he says, hasn't done much of either.
As the coronavirus started sweeping the world in February, Indonesia's health minister stubbornly insisted that the country was virus-free and that prayer was keeping it away. Indonesia continued to welcome thousands of visitors from China, the center of the pandemic.
Indonesia's president, Joko Widodo, almost certainly knew better but stayed silent, later telling reporters that he hadn't wanted to "create panic." It wasn't until March that authorities confirmed the country's first case. And that delay, experts say, cost Indonesia dearly.
"The central government for the most part was fairly slow in deciding what to do," says Panji Fortuna Hadisomemarto of Pajadjaran University in Bandung, West Java. "I guess one of the explanations was there was a big pull and push between [the] economy and controlling the disease."
Unlike other Southeast Asian nations that have successfully contained the virus — Vietnam and Thailand, for example — Indonesia has had no nationwide lockdown, with local governments left largely to fend for themselves. Partial lockdowns in the capital, Jakarta, and other cities started late, in April, and ended early, in June. Too early, many scientists say.
"I don't think Indonesia has the means to stop the disease now," says Panji. "You know, people have talked about the second wave. I think we haven't even seen the peak of the first one."
Epidemiologists also point to a lack of testing and a proliferation of bad information. For example, Indonesia's agriculture minister said earlier this month that his team had developed a eucalyptus necklace that helps ward off the virus, a claim rejected by health experts. There's also the fear of stigmatization or of losing one's job for those who test positive — leading some Indonesians to avoid testing at all costs.
The most recent modeling done by the University of Indonesia's Riono suggests Indonesia's infection rate will keep rising through October or November. By then, Riono says, Indonesia could have as many as 4,000 new cases per day, more than double current daily totals.
Mohammad Habib Abiyan Dzakwan of the disaster management research unit at the Center for Strategic and International Studies in Jakarta says the government should be working harder to get people to take the virus seriously instead of suggesting things are getting better.
"I think the government now tries to defend the increasing cases by saying, 'OK, this is due to more testing being carried out,' and that is somehow worrying," Dzakwan tells NPR.
Epidemiologist Pandu believes the government needs to impose and enforce what he calls the "Three Ms" — Masker, Menjaga jarak and Mencuci tangan—wearing a mask, social distancing and washing hands — if it has any hope of flattening the curve.
"My scenario is based on the assumption that the government will do something more after they get up to 4,000," he says. "If they don't do anything, then there will be more [cases]."
ARI SHAPIRO, HOST:
Indonesia has the most COVID-19 infections and deaths in Southeast Asia with more than 88,000 confirmed cases and more than 4,200 dead. Partial lockdowns and social distancing have apparently failed in the world's fourth most populous nation. And as Michael Sullivan reports, epidemiologists say it's going to get a lot worse.
MICHAEL SULLIVAN, BYLINE: As the coronavirus started sweeping the world in February, Indonesia's health minister stubbornly insisted the country was virus-free, that prayer was keeping it safe. Indonesia's president knew better but stayed silent, later telling reporters he hadn't wanted to create panic. That delay, epidemiologists say, cost Indonesia big time.
PANDU RIONO: We have a lot of big missed opportunity. This is the problem. If you want to protect people, do something seriously, and do something right.
SULLIVAN: That's Pandu Riono, an epidemiologist at the University of Indonesia who says the government did neither. Panji Fortuna Hadisoemarto is a lecturer at Padjajaran University in Bandung, Indonesia.
PANJI FORTUNA HADISOEMARTO: The central government, for the most part, was very slow in deciding what to do. I guess one of the explanation was that there was a big pull and push between economy and controlling the disease.
SULLIVAN: Unlike other Southeast Asian nations that have successfully contained the virus - Vietnam, Thailand - Indonesia has had no nationwide lockdown, with local governments left largely to fend for themselves. Partial lockdowns in the capital of Jakarta and other cities started late - in April. And most ended early - in June - too early, experts say.
HADISOEMARTO: I don't think Indonesia - the central government, I'm saying - has the means and resources to stop the disease now.
SULLIVAN: Again, Panji Fortuna Hadisoemarto.
HADISOEMARTO: I think it's going to be a fairly long way for Indonesia to recover from COVID-19. You know, people have talked about the second wave. I think we haven't even seen the peak of the first one.
SULLIVAN: A lack of testing and a proliferation of bad information haven't helped. Indonesia's agriculture minister, for example, said two weeks ago that his team had developed a eucalyptus necklace to ward off the virus - a claim that frustrated public health experts. Critics say the rising number of infections may also be a result of mixed messages from the government. For example...
HABIB ABIYAN DZAKWMAN: I think the government now tries to defend the increasing cases by saying that, OK, this is due to more testings. And I think this is somehow worrying.
SULLIVAN: That's Habib Abiyan Dzakwman with the Disaster Management Research Unit at the Center for Strategic and International Studies in Jakarta worrying, he says, because it encourages people to think the worst is over.
UNIDENTIFIED GROUP: (Speaking Indonesian).
(SOUNDBITE OF WAVE CRASHING)
SULLIVAN: For example, these children playing on the beach on the tourist island of Bali could soon have company when Bali reopens to international tourists in September, including planned direct flights from the U.S. despite both countries' poor record in containing the virus. By then, epidemiologist Pandu Riono says if the central government doesn't impose and enforce strict rules on masks, social distancing and washing hands, his modelling suggests...
RIONO: Maybe the possibility we report 4,000 cases daily.
SULLIVAN: That's almost double the highest daily total so far. Pandu says at this pace, Indonesia's infection rate won't peak until October or November.
For NPR News, I'm Michael Sullivan in Chiang Rai, Thailand.
(SOUNDBITE OF SEA WOLF SONG, "OLD FRIEND") Transcript provided by NPR, Copyright NPR.