Hidden Covid-19 Deaths in Indonesia

In May I posted about some difficulties with Indonesia’s official Covid-19 statistics. One issue highlighted by the post was under-reporting of Covid-19 related deaths. A few months down the line, I wanted to look again at the issue.

It is important to note that the government has tended to only include confirmed Covid-19 cases in the official mortality statistics. It does not include those who have not received a positive test result, but have symptoms consistent with Covid-19. Given the low levels of testing in Indonesia, that may mean excluding many who die from the virus from the headline statistics.

(On the low levels of testing in Indonesia, see the below chart from ourworldindata.org)

Reporting in the Jakarta Post, Tempo and Kompas, among others, has give indications of the difference this can make to overall Covid-19 deaths statistics. Particularly useful is the Tempo report, which provides a perspective on how the data published by the Indonesian  government is assembled. It outlines competing efforts to control the data from a special task force and the Ministry of Health, and the use of alternative definitions of what constitutes a death from Covid-19. It also cites sources saying that the World Health Organisation (WHO) has queried Indonesia’s official statistics.

Most strikingly, the Tempo investigation shows the size of the potential under-count of Covid-19 deaths, based on data obtained from government sources. They indicate that taking a broad definition of Covid-19 deaths may increase the total by 4-5 times:

	Cumulative Covid-19 Deaths for Indonesia
	Narrow definition (those who tested positive)	Broad definition (those who tested positive + those with symptoms consistent with Covid-19)
17.6.2020	2,276	10,735
22.6.2020	2,500	11,477
3.7.2020	3,036	13,885
Source: Majalah Tempo, 4.7.2020

In the context of this media coverage and scrutiny from the WHO, the government has expanded its definition of Covid-deaths. However, looking at the current published statistics, there still seems to be the potential for significant under-counting. As per 15 August, statistics from the central government’s Covid-19 task force gave a cumulative total of 6,071 deaths, and on 16 August Ministry of Health data put the toll at 6,150. Of these 6,150 deaths, 981 were listed as coming from the Greater Jakarta area. I compared this with data from the website of the Greater Jakarta regional government, which (up to 16 August) details 995 confirmed cases (i.e. those who received positive tests), plus 874 ‘probable’ and 2,267 ‘suspect’ cases. On this basis, it seems the central government’s statistics may only be catching about a quarter of Covid-19 deaths (based on a broad definition).

In this context it is not surprising that Dr Pandu Riono, an epidemiologist from the University of Indonesia has said that ‘we estimate maybe the real death [count] is four or five times… the [figures] reported [by central government]’. That would put the current total deaths at roughly 25,000-30,000.