Laboratory preparedness to support the Covid-19 pandemic respond in Indonesia

Abstract

Latar belakang: Penyakit jenis baru COVID-19 yang disebabkan oleh virus corona menjadi sebuah pandemic di akhir tahun 2019. Kota Wuhan (China) merupakan lokasi pertama terdeteksinya kasus COVID-19. Tanpa adanya kecurigaan apapun penyakit ini dengan cepatnya menyebar ke seluruh dunia mengikuti alur mobilitas manusia. Dalam kondisi tersebut sistem kesehatan di setiap negara tampak kelabakan khususnya dalam pengendalian transmisi penyakit. Studi ini ingin mengidentifikasi kesiapan jejaring laboratorium kesehatan di Indonesia. 
 Metode: Penilaian cepat dilakukan terhadap ketersediaan dan kesiapan laboratoriaum dalam pennanganan pandemi Covid-19. Pengumpulan data dilakukan melalui pengisian questioner yang dikirim secara elektronik. Waktu pelaksanaan adalah minggu ketiga dan keempat, Maret 2020. Terdapat 44 laboratorium jejaring laboratorium dibawah Kementerian Kesehatan yang menjadi subjek penelitian, dan sebanyak 33 yang merespon secara lengkap Variabel ketersediaan, kecukupan dan kebutuhan bahan dan alat. 
 Hasil: Jejaring laboratorium kesehatan dibawah Kementerian Kesehatan sudah terbentuk sejak tahun 2009. Dengan terjadinya pandemic COVID-19 Surat Keputusan Menteri Kesehatan telah direvisi hingga dua kali agar dapat meningkatkan kapasitas dan memperluas jejaring ke seluruh wilayah NKRI. Hasil studi menunjukkan, laboratorium jejaring dibawah Kementerian Kesehatan belum siap dalam menghadapi pandemic COVID-19. Dua jenis laboratorium jejaring yaitu laboratorium surveillans maupun laboratorium diagnostic memiliki kondisi yang sama. Ketersediaan bahan dan alat laboratorium standar masih tergolong rata-rata, bahkan dari sisi kecukupannyapun masih jauh dibawah kapasitas kebutuhan dalam penanganan specimen COVID-19. Kondisi yang sama juga tampak untuk bahan pendukung laboratorium termasuk alat pelindung diri untuk petugas. 
 Kesimpulan: Kesiapan laboratorium sebagai bagian dari system kesehatan dalam kondisi pandemic masih lemah. Keberadaan alat penunjang diagnose khususnya untuk penyakit menular harus dilengkapi sesuai dengann type laboratorium. Pandemi COVID-19 menjadi alarm dalam menghadapi era baru dan antisipasi masalah dimasa yang akan datang. 
 Kata kunci: Kesiapan laboratorium, COVID-19, Indonesia
 
 Abstract
 Background: A novel coronavirus disease called COVID-19 has become pandemic in late 2019. Wuhan City was the first place detected as the source of the pandemic. Without suspicion, it spreads over the world, along with human mobility. In such a condition, every country seems quite stuttering to prepare its health system to prevent its people from the possible transmission. This paper aims to describe the preparedness of the networking laboratory in Indonesia.
 Methods: We conducted a rapid assessment of laboratory availability and preparedness to respond to the Covid-19 pandemic. We held the data collection on the third and fourth week of March 2020 by sending an electronic questionnaire to all 44 networking laboratories under the Ministry of Health structure. The variables assessed in this study were the availability and the requirements of the Covid-19 related laboratory's substances, including reagents and other equipment types.
 Results: The Ministry of Health established the networking laboratory in 2009, but due to the COVID-19 pandemic, it has renewed twice to enhance and expand the laboratory capacities over the country. Our studies showed preparedness among networking laboratories in Indonesia regarding this new emerging COVID-19 condition was quite devastating. Both surveillance and diagnostic laboratories have a similar situation. The availability of their primary materials was mediocre, but the adequacy was far beyond the capacity in handling the COVID-19 specimen. We found a similar case in the laboratory, supporting materials, and personal protective equipment (PPE).
 Conclusion: Laboratory preparedness during initial period of time of the COVID-19 pandemic as part of the health system is still weak. The availability of the necessary equipment, supporting materials, and personal protective equipment are far beyond the requirements. The COVID-19 has alarmed the laboratory and the whole health system in Indonesia into a new era with better future preparedness.
 Keywords: laboratory preparedness, COVID-19, Indonesia

Prevalence and epidemiological characteristics of COVID-19 after one year of pandemic in Jakarta and neighbouring areas, Indonesia: A single center study

“…In the early phase of COVID-19 pandemic, besides the vast territory, Indonesia was also challenged with limited laboratory infrastructure and capacity for COVID-19 diagnosis. Lack of test reagents, consumables, personal protective equipment, and shortage of human resources further exacerbated the situation [ 5 – 7 ]. The recent emergence of more transmissible variants, such as the Alpha and Delta variants, put an additional burden on the government effort to contain COVID-19 [ 8 , 9 ].…”

“…Eijkman Institute for Molecular Biology (EIMB) in Jakarta, Indonesia, was appointed by the Indonesian Ministry of Health as one of the regional laboratories to test for SARS-CoV-2 [ 5 ]. Since then, over 69,000 specimens have been submitted from primary healthcare centers (PHC) and hospitals mainly from Jakarta and neighboring areas.…”