Lessons from Indonesia, a country with highest COVID-19 mortality rate in the world: dissecting multiple aspects

COVID-19 has been infecting every continent and Indonesia had suffered greatly as it ranked first for confirmed cases in Southeast Asia region with almost 100,000 deaths. We summarized Indonesian population demographic, socio-behavior, multiple government policy and public health interventions contributed to the high mortality. Although the virulence of COVID-19 strain was found to be similar as other countries, it might be inaccurate due to the low amount of sequenced genome and publicly accessible data of the virus’ strain. As Indonesia recorded higher testing number than WHO’s target, there were imbalances of testing capacity between capital cities and remote areas, hence the actual case number would be larger. The availability of healthcare facilities and skilled healthcare workers were also dispersed unequally, causing Indonesian health systems near collapsing. Moreover, individual sense of urgency and hazard of the pandemic were low, as shown by the low compliance of wearing masks and social distancing. Even though Indonesia was unprepared early in the pandemic, currently these systems are being improved. Indonesia has experienced an extensive problem in conquering the pandemic, hence, the country needed a comprehensive approach from the government, citizens, even private sectors to cease the pandemic.