Child deaths on the rise as Indonesia grapples with rapid Covid-19 surge

Hospitals struggle as senior paediatrician says cases rising rapidly among minors

Two children stand as their relatives pray by an ambulance in Yogyakarta, Indonesia
Children stand as their relatives pray by an ambulance in Yogyakarta, Indonesia
(Image credit: Ulet Ifansasti/Getty Images)

Indonesia is reporting a growing number of Covid-19 deaths among children as young as five, raising concerns over the belief that they face minimal risk from the virus.

The spike in child deaths, which The New York Times (NYT) places at “more than 100 a week this month”, come as the country faces rising infections that have seen it surpass India to become the new “Asian epicentre” of the pandemic.

“Our numbers are the highest in the world”, the head of the Indonesian Pediatric Society, Dr Aman Bhakti Pulungan, told the NYT. “Why are we not giving the best for our children?”

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Dangerous misconception?

Experts began warning of an increase in children being admitted to hospital around three weeks ago, with Pulungan telling The Guardian that cases were rising rapidly among minors as the Delta variant triggered a spike in infections across Indonesia.

According to the paper, “the number of weekly infections recorded among under-18s had doubled in less than one month”, with figures provided by Pulungan showing that “between 28 June and 4 July, 11,872 cases were found among children – an increase from 7,329 cases the previous week”.

“Children now make up 12.5% of the country’s confirmed cases”, the NYT reports, while “more than 150 children died from Covid-19 during the week of July 12 alone” with “half the recent deaths involving those younger than five”.

“Until now, children have been the hidden victims of this pandemic,” Dr Yasir Arafat, Asia health adviser to the non-profit group Save the Children, told the paper. “Not any more.”

“Not only are countries like Indonesia seeing record numbers of children dying from the virus, but we’re also seeing an alarming rise in children missing out on routine vaccinations and nutrition services that are critical for their survival, which should ring major alarm bells,” he added.

According to Al Jazeera, “the Covid-19 infection rate for children in Indonesia is also among the highest in the world”, while the country has already recorded “more than 700” child deaths with “half of them under the age of five”.

The majority of the deaths have “occurred in the past month”, The Times of India says, with doctors attributing the sudden spike to vulnerability due to “underlying health conditions”. Indonesia is also struggling with a slow vaccine rollout, with 16.26% of people having received at least one dose, according to Oxford University tracking.

Experts have also posited that some children “could be vulnerable to the virus because of underlying health conditions such as malnutrition, obesity, diabetes and heart disease”, the NYT says. A national “lack of awareness about the need to protect and test children” may also have contributed to rising infections, The Guardian adds.

Whatever the cause of the increase in child hospitalisation and deaths, the country’s hospitals have been “stretched beyond their limit by the recent surge in cases”, the NYT continues, “with patients waiting in hallways and overflow tents for a bed in a ward to open” and few hospitals currently “set up to care for children with Covid”.

“If the children get sick, where are we going to take them?” Pulungan said. “To the emergency room? Emergency wards are overwhelmed with adults. And as you have seen for the past couple of weeks, people have to wait at the emergency room for days. How do we expect children to go through that?”

‘These children should not die’

Pulungan told The Guardian earlier this month that the sudden rise in deaths is being caused because “we forget that children can also suffer from Covid and can die”, adding: “We are now in a really, really bad condition. We can call it a tsunami. The thing is right now there are so many cases.”

He also told the paper that there is no evidence thus far that the Delta variant is more likely to result in hospitalisations or deaths among young children, citing a lack of genome sequencing data.

Alongside the sudden spike in Covid-19 related fatalities, fears are also rising that Indonesian children may also be “at risk from some of the world’s most virulent diseases” due to around “800,000 Indonesian children missing out on routine vaccinations last year due to pandemic service disruptions”, says Al Jazeera.

Jabs to combat diseases including polio, mumps and hepatitis B are usually administered through schools, however, after classrooms closed their doors during the pandemic, “there was a drop in routine immunisation for kids from March to December”, Dr Siska Sinardja, a spokeswoman for the Indonesian Pediatrician Association, told the site.

“The effect of the delay on the immunisation of children will be an increase in infectious diseases. But no data is available on this yet because the Covid rate is still increasing and all the focus is on fighting Covid in Indonesia.”

In 2019, the infant mortality rate in Indonesia was 20.2 deaths per 1,000 live births, according to Statista, far higher than neighbours such as Thailand which reported an infant mortality rate of 7.7 deaths per 1,000 live births.

“Educating the public and getting more people to comply with health protocols would be a good start in protecting children”, Pulungan told the NYT.

“It all goes back to the adults,” he said. “The adults are the stubborn ones. They refuse to wear a mask. They bring their children to crowded places.”

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