PPKM Level 4 Decided Today, Former WHO Director Names 3 Possibilities
Prof. dr Tjandra Yoga Aditama, SpP(K), MARS, DTM&H, DTCE, Head of the Health Research and Development Agency of the Indonesian Ministry of Health. Special
TEMPO.CO, Jakarta - Pulmonologist and Respiratory Medicine Expert, Faculty of Medicine, University of Indonesia, Tjandra Yoga Aditama, revealed that there are three things that can be considered regarding the decision to impose restrictions on community activities or PPKM Level 4 which will end tonight.
First, Tjandra believes that there is a real improvement in the hospital burden because it is easier for people to seek medical help. Regarding national epidemiological indicators, some may show improvement and some may not, depending on how it is assessed.
The WHO situation analysis on July 28, 2021 stated that there was still very high transmission in the community and it was recommended that efforts to suppress transmission through strict implementation of "public health and social measures (PHSM)" should be continued and strengthened.
"If there is a plan to continue the PPKM which is currently running, then social assistance insurance needs to be provided for all those affected," said Tjandra in his statement, Monday, August 2, 2021.
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By continuing the PPKM, Tjandra estimates that the situation that has begun to improve will become more controlled and well maintained so that it does not escalate again.
The second consideration is the possibility of providing some additional easing, with the consequence of the possibility that Covid-19 cases will increase and hospitals will be full again. For this reason, said Tjandra, if the second possibility is to be carried out, the selection of easing needs to be done very carefully.
Easing should be gradual and can be adjusted from time to time if necessary. On the other hand, this FKUI Professor said that activities that still had to carry out social restrictions had to be carried out strictly and should not be carried away too loosely.
The third possibility is a policy based on regional data, such as districts/cities or agglomeration areas. Tjandra considered that an in-depth analysis of the epidemiological situation of the area and the existing response capacity should be carried out. The data must be very detailed and accurate at the level of each region.
On June 14, 2021, WHO has published the document Considerations for Implementing and Adjusting Public Health and Social Measures in the Context of Covid-19 , which is an improvement from the previous edition.
Transmission in the community is divided into 7 categories, starting from no cases, only sporadic cases, starting with clusters and then transmission in the community to degrees one, two, three, and four. Meanwhile, the health response capacity is divided into adequate, moderate or limited.
And by combining these two things, it is determined five state level ( situation level ), from zero, one, two, three, and four. Level four is a composite of circumstances where community transmission is at degree four and response capacity is limited.
By definition, Tjandra Yoga said that level 4 is an uncontrolled outbreak with limited or inadequate health response capacity. Thus, it requires extensive efforts to avoid significant increases in morbidity and mortality due to overstretched health services.
"It would be very good if we had this detailed data for each district/city and agglomeration area, so that any decisions that will be taken are really based on scientific data, an evidence-based decision making process ," said the former Director of the World Health Organization ( WHO ) Asia. Southeast Asia is about the PPKM Level 4 policy.

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