Coronavirus Update: How Can Indonesia Not Have Confirmed Any Cases Yet?

A 19-year-old university student from the Maluku islands of Indonesia has been quarantined after showing symptoms of the novel coronavirus. The student arrived in Ambon, Indonesia on Feb. 7 from a visit to Malaysia, which has so far confirmed 19 coronavirus cases.

“As of now, [the student] is a suspected coronavirus patient,” Tanimbar Islands Health Agency head Edwin Tomasoa said on Thursday. The patient will remain in quarantine for 14 days.

However, as of Thursday morning, there were no confirmed virus cases in the entire country of Indonesia.

On Wednesday, Indonesia's health ministry’s research and development agency said it has examined 68 out of 70 samples from patients suspected of being infected by the virus. All 68 specimens tested negative.

“The other two samples are still being tested,” Vensya Sitohang, the health ministry’s surveillance and quarantine director, said on Wednesday. “We hope there will be no more suspected cases.”

However, some are skeptical.

Indonesia, a nation of 260 million people, has yet to confirm even one virus case in the country, while other nations in the region, including Singapore, Malaysia, Thailand, Vietnam and the Philippines, have reported many infections.

But Indonesia’s health minister insists his country is not concealing anything after critics suggested some cases must have gone undetected.

Researchers at Harvard University’s T.H. Chan School of Public Health warned last week that Indonesia should strengthen its outbreak surveillance and control measures, given that it conducted direct flights from Wuhan, China, the epicenter of the virus.

The Harvard study calculated that Indonesia should have already confirmed up to 10 cases of the coronavirus by now.

“We have the kits to check coronavirus and they’re certified. Nothing is concealed,” Health Minister Terawan Agus Putranto said.

Navaratnasamy Paranietharan, the World Health Organization’s Indonesia representative said on Tuesday that Indonesia “has taken concrete measures and the World Health Organization is quite confident that Indonesia is ready to be able to respond to this situation.”

Vivi Setiawaty, another Indonesian health ministry official, said it was unclear why Indonesia has not reported any virus cases yet.

“We remain cautious,” she said.

Australia’s Chief Medical Officer Brendan Murphy said on Wednesday it was "certainly very surprising" that Indonesia had not confirmed any virus cases and that it "should be a cause for some concern that there may be some undetected cases.”

Indonesia has prepared 100 hospitals across the vast country for potential virus patients. The government has also quarantined more than 240 of its citizens who were evacuated from Hubei province, home to Wuhan, to the island of Natuna, north of Borneo.

Indonesia is also scrambling to track down the movements of a Chinese tourist who was diagnosed with coronavirus in China after returning from a trip to the popular resort island of Bali.

Anung Sugihantono, director general of disease prevention and control of the Ministry of Health, told Reuters that local authorities were checking hotel records and other information to determine the itinerary of the tourist in order to find out if he may have infected others.

However, Bali has not reported any cases of the virus yet.

Another health ministry official, Achmad Yurianto, suggested the tourist might have been infected on public transport in China upon his return to the country.

The Chinese microblogging site Weibo quoted a report from the Anhui provincial government in China that the tourist in question, identified as “Jin,” traveled from Wuhan to Bali on Jan. 22 and returned to China on Jan. 28.

The tourist Jin apparently flew on a plane operated by Indonesia's Lion Air from Wuhan and returned on a Garuda Indonesia flight to Shanghai.

“For passengers on the aforementioned flights, please enact preventative measures immediately,” wrote the Anhui administration. "Please don't go out for a while and if you get a fever, go to the nearest hospital. Please use masks when you travel to the medical center and don't use public transportation.”

But Danang Mandala Prihantoro, a spokesman for Lion Air, stated that the airline determined that passengers and crew on board that plane do not have the virus.

“An examination [of the flight’s crew and passengers] by a medical team at Ngurah Rai International Airport [in Bali] showed that there was no indication of infection of the virus,” Prihantoro said.

Garuda Indonesia spokesman Ikhsan Rosan said the airline has since grounded and disinfected the plane Jin flew on.

The Huainan Center for Disease Control and Prevention in Anhui reported that Jin tested positive for the virus on Feb. 5. Thus it remains unclear how or where Jin contracted the virus.

Since the virus outbreak, Indonesia has halted flights to and from China and prohibited visitors who have been in China for 14 days.

Meanwhile, the ban on Chinese travelers is hurting Indonesia’s tourism industry, particularly Bali which has already seen 20,000 hotel cancellations.

About 1.2 million Chinese travelers visited Bali last year, while Australia sent the most, about 1.23 million tourists. On the whole, about 2 million Chinese visit Indonesia annually.

"With the travel ban, we are down about 27% [of total arrivals], it's roughly 100,000 per month of Chinese tourists," said Ida Bagus Agung Partha Adnyana of Bali's tourism board, "

Yuni Antari, a shopkeeper at Ngurah Rai airport said that since the ban on Chinese tourists "our sales dropped more than 50%.”

"The Chinese tourists have always come in big groups, it's not just the tourists, it's the tour guides, the travel agent staff handling them, they are all gone. The waiting area used to be full of them, now it's half empty," she said. "I am worried about the virus of course, but without the tourists we would be dead too in a way. I wish they could still come, maybe if we screen them better they can still come. If we use the proper protection."