Vaccinating the Worst-Hit Southeast Asian Country

But first, here's what happened in virus news today. The rolling average of US coronavirus cases edged up in the past week and is on a path to break records again any day. Today, thirty two states reported seven day case averages substantially rising over the prior week, with some of the steepest rises in Kansas and Arizona. That's a sharp turnaround from mid December, when thirty eight states reported

cases flat or falling. Meanwhile, an easier to spread variant of COVID nineteen was detected in three U s states last week, though health officials don't know how much farther it may have spread. That could intensify the virus's search if it hasn't already. Boosting the urgency for a speedier, more effective vaccine push. Israel plans to vaccinate seventy of its population by April or May. That's according to Health

Minister Julie Ethelstein. The country is moving faster to inoculate people than any other country in the world on a per capita basis. Israel has already administered first doses of the fiser shot to about one point two million residents,

or more than twelve percent of the population. Officials from Operation Warp Speed, the US government's vaccine drive, are asking Moderna and the Food and Drug Administration to cut in half the dose of the company's COVID nineteen vaccination for people ages eighteen to fifty five after finding that it induces the same immune response. That's according to Chief Scientific Advisor Monsef Slowly, who spoke on CBS's Face the Nation

on Sunday and Now for today's main story. Indonesia had planned to prioritize its working age population for its COVID nineteen vaccine rollout, but they recently announced a change of plans. The inoculation program would instead start with healthcare workers, civil servants, and the elder The government didn't give a reason for the change, but the shifting procedures show some of the difficulties in coordinating a vaccine rollout for a massive nation

spread across a string of islands. I spoke to Jacarta Bureau chief, you toith Hoe about how hard it's been to secure enough doses for the fourth largest country in the world. What has COVID nineteens effect been thus far in Indonesia? How is the country been hit by the pandemic? So Indonesia, it's actually suffering the worst cornavirus outbreak right now in Southeast Asia, and that's in terms of the

number of infections and also the number of deaths. I think part of that is because it really hasn't resorted to any form of luckdown because Bretnao we don't know actually said that that's against h culture of the country. So what they've done and said is just um calling

for people to follow health protocols. That's become a lot worse coming up to the holiday season because after a whole year of people saying put in their homes, I think there are a lot of people taking this chance to go on holidays or gather with families, and especially coming up to the new year, there's been a lot of warnings from the government to say they are expecting a spike embarrassing inspections UM, and they're really calling for

people to be careful, but they really haven't resorted to any um of those strict lockdowns that you've seen any elsewhere in Asia. And as we move into the new year, what is Indonesia's plans in terms of vaccination. So Indonesia might be UM one of the country's most reliant on vaccines. It's basically been signing deals left and right with Western producers and also UM, the Chinese producer for vaccines UM.

It's really banking on Sinovac especially. The country has actually been partnering with no back to do UM joint trial UM in the city south of Jakarta, and that trial is coming up to the conclusion now. And what's pending before I can actually start this vaccination program is this emergency use authorization from the local drug regulator that is

expected sometime in January one. That's out The president himself, Joco Ridoto, is actually going to be the first one to take the vaccine and he said that the reason why he's doing this is to make sure that people feel secure in the safety of the vaccine, especially considering the lack of transparency in how um the trials for THEO back vaccines have been conducted. And maybe you could just talk a little bit about the Sinovack vaccine in terms of how does it differ from say those developed

by MODERNA or FIGHTSER. I think what's been really interesting with modern and Fightser is they're actually using new technology with the m m R n A vaccines, whereas assino vac one is I would say pretty old school. They are using inactivated viruses UM to create these vaccines. But and because of that, actually it might work better for Indonesia considering the country is spread across the world's biggest archipelago, so it becomes more difficult to transport um vaccines that

require very cold temperatures. Sinovac vaccines actually only required to to four degrees celsius, which means normal refrigeration will be okay. And that's why Indonesia is I think, relying on vaccino back for about half of its vaccine needs. And and you raise a great point there. So many countries now are are very much focused on acquiring enough doses of vaccines. So in total, between cinovac and perhaps other vaccines it's acquired or at least put on order. How many doses

has Indonesia security for its population? So in Aonesia, the last number they gave was that they're close to acquiring four hundred million doses, and that is actually still not enough to cover the whole population, because the whole population would amount to about seventy million, and they're also taking into account any vaccines that might turn out to be ineffective or any vaccines that might be damaged in the process.

So the last number they gave was that they need four hundred twenty seven million that they're aiming to get. Um but that's still not going to cover the whole population. Um I think they're right now they actually increase their target for her community from about only of the population to about six If there's also an Indonesian vaccine that it's in development, um I was wondering if you might tell us just a bit about that. So Indonesia is

also trying to develop his phone vaccine. This one is being developed by its they downed U pharmaceutical company is also named Meraputi, which that basically says it and White, which is the colors of the nation's flag. The vaccine itself. That's actually Celindary early trials. Um. The last update they gave us was that they're still conducting animal trials, so

it's pretty slow going. UM. But I think the reasoning behind that is considering all the race for vaccines all over the world, Indonitia is trying to make sure that if even if nothing else works out in terms of overseas deals, it actually still has this one local producer going for them. Um. From what we know, the Maraputi vaccine is also relying on the inactivated virus um sort of technology. Now, let's move on to the actual rollout

of the vaccination program. Indonesia recently announced a change to who would be receiving a COVID vaccine first in the country. What exactly was this change? So previously Indonesia wanted to vaccinate the younger people first, and that would be the working age who are aged between eighteen to fifteen nine years old. UM. That is, that was after the health care workers. But recently they've announced a new vaccination program and that one actually starts with healthcare workers civil servants,

followed by the elderly. Uh. Those would be people six

years old and above. Indonesia's difficulty in trying to get enough vaccines to cover the whole population and actually a big factor in why they want to vaccinate the young people first, because the idea is if the younger people who are having to go out to work UM and having to move around in the economy, UM, if they're vaccinated, then they might not actually come home and like bring the virus to people who are older or maybe their children.

So they're really trying to use the vaccine not only to protect people from UM developing a more severe case of COVID, but they're actually trying to use the various basically as their front line in trying to prevent wider spread of the virus. The government hasn't actually given us a very clear reason for the change, other than the fact that President Jacoby Dodo said that the government is

actually going to provide free vaccines for everyone. And what that means is the government has to actually procure more vaccines than before. Whereas before they've signed on to sinovac Um to also produce the doses locally. Now they actually

stepped up the hunt for vaccines. In December, they've actually signed another fifty million doses purchased from Azardenca, and then in January they're expected to sign another fifty million from Fiser, So it seems like that might be one of the reasons why they're recalibrating how they're doing the telectation program after Jacoby said that he wants to make sure everybody

gets vaccines for free. And are there any other factors that the country is taking into account prioritizing those who would be most likely to spread it and trying to protect more vulnerable populations. Are there any other demographics that fall into that vulnerable population that may not receive the

vaccine first. Because the country is so huge and it's spread out across very remote islands, sometimes it's um it can be difficult for the government to actually get the vaccines to where they need to be um and that's

actually played out in the government's fascination program. They're actually saying that they want to prioritize the places that are most impacted by the virus and those happened to be in the Jab Island, which is the most populous and the most developed, But in doing so, that might actually leave out the more remote places who are also whose

health facilities might actually be under strained as well. We the government has not actually given a very detailed plan of how they're actually getting the going to get the vaccine from Jackard to where it's just where it's likely to land to all these remote islands. What they have said is they're going to make use of these states public clinics called postcus mass. These are actually very small clinics. They're very sparsely um UM equipped, but they are spread

out basically in every regency. You need to have at least one postcast man, so at least they do have the framework or by the government can actually uh contact all these this network that they already have of state health clinics and they can just just do with the vaccines that way. UM. And I think the other difficulty is once you actually have people getting their prostoses, how are you going to make sure that they are actually going to get the necessary second dose. I think that's

the challenge that the government hasn't actually spoken about. They been taking the matter basically step by step. Right now, they're focused on securing the deals and getting the emergency use authorization and they keep telling us, um, once we have the vaccines, and will tell you how we're going to distribute it. You know. The other thing that's on a lot of people's minds right now is, of course, the timeline of when will I be able to receive

my vaccine? Has the government mentioned anything in terms of a timeline and when it hopes to have the majority of say the working age population vaccinated, even in an ideal world or an ideal timeframe. There have been a

couple of timelines that they have discussed. I think the latest one stretches until the bid of twenty twenty two, and I think that would be the ideal scenario, is for them to actually get the vaccines approved for use and go through the whole population until the middle of two. They have actually said that they're planning to vaccinate a

hundred six million people a year. That actually doesn't really work out with their middle of two timeline either, So there's a lot of questions around that, and I think again the government is not setting a fixed time line as much as they're kind of pushing back the timeline as thanks to a pop or as new vaccine supply becomes available to them. That was Edith Hoe, and that's

it for our show today. For coverage of the outbreak from one bureaus around the world, Visit bloomberg dot com slash coronavirus and if you like the show, please leave us a review and a rating on Apple Podcasts or Spotify. It's the best way to help more listeners find our global reporting. The Prognosis Daily edition is produced by Top for foreheads Magnus Henrickson and me Laura Carlson. Today's main story was reported by Edith Hoe. Original music by Leo Sidrin.

Our editors are Rick Shine and Francesca Levi. Francesco Levi is Bloomberg's head of podcasts. Thanks for listening. No