Double vaccinated and wearing a hazmat suit, Dr Ahmad Syaifuddin had hoped he would be protected from the catastrophic Covid-19 surge sweeping Indonesia, but when the thumping headache hit and he began to cough, he knew the virus had caught up with him.
Fifteen colleagues at the Islamic Hospital of Sunan Kudus, central Java – one of the epicentres of the Southeast Asian nation’s latest outbreak – were also infected as they dealt with scores of patients flooding onto the wards.
“With such a high level of fatigue and almost all of them exposed to Covid, how can we survive this virus?” said Dr Syaifuddin. “The vaccine works to improve immunity, but immunity also depends on the condition of our body. If we are tired or unfit, our immunity will be low.”
Exhaustion and record numbers of patients during Indonesia’s largest Covid-19 wave yet are believed to be factors behind the steady rate of infections and deaths among medical staff, but the heavy toll on frontline workers is also raising questions about the Chinese vaccines they received.
In June, it was reported that more than 350 Indonesian doctors and medical workers had caught the virus despite being vaccinated with China’s Sinovac, with dozens of them hospitalised.
Almost all had received the vaccine developed by Chinese biopharmaceutical company Sinovac, the Indonesian Medical Association (IDI) said. It later revealed that at least 10 of of the 26 doctors who died last month had been given the Chinese-made shot that is widely being used across Asia.
And this week, local media reported that the scientist leading Sinovac vaccine trials in Indonesia died from what is suspected to be Covid.
Novilia Sjafri Bachtiar had headed dozens of clinical trials at a state-owned vaccine manufacturer, BioFarma, which has been producing Sinovac under licence from the Chinese company.
Novilia, who was in her 50s, had been receiving hospital treatment for the virus in the city of Bandung, the capital of Indonesia’s West Java province and the site of a BioFarma manufacturing facility.
State enterprises minister Erick Thohir said he was grieved to hear of the “huge loss”.
“She was lead scientist and head of dozens of clinical trials done by BioFarma, including Covid-19 vaccine clinical trials in cooperation with Sinovac,” he wrote on Instagram.
“It has been produced and injected into tens of millions of people in Indonesia, as part of our effort to be free from this Covid-19 pandemic.”
The Telegraph contacted Sinovac for comment.
Indonesia, the world’s fourth most populous nation, now has a total of 2.3 million confirmed cases and close to 62,000 deaths as the current surge, fuelled by the more transmissible Delta variant, turns into a frightening vertical trajectory.
On Wednesday, it reported another record daily high of 34,379 infections and 1,040 deaths.
Experts have warned the country faces an Indian-style crisis as hospitals on its main island of Java started treating patients in car parks and are running out of medical oxygen supplies. The government has appealed to China, Singapore and other countries for urgent help.
The pandemic has been a brutal period for Indonesian health workers, about 1,000 of whom have died since the first outbreak last year. While deaths have dropped in recent months, public health officials are still concerned about hospitalisations.
A report last month by Project Hope, a charity supporting global healthcare workers, warned that more than 80 per cent of Indonesia medical staff have reported moderate levels of physical and mental exhaustion or burnout due to Covid-19.
It said that after just one month of treating Covid patients, workers are more than five times more likely to experience depression, nearly twice as likely to have anxiety and four times more prone to burnout.
“The pandemic has been so long, and the healthcare system is already distressed,” said Edhie Rahmat, Indonesia executive director of Project Hope.
“There is excessive work, they are already depressed with the situation. They have a high risk of getting sick and infected, and some of them dying. There is also a shortage of supply of personal protective equipment,” he said.
Mr Rahmat said “rocketing numbers”, the lack of personal protective equipment and a high viral load in hospital wards without good ventilation had contributed to the burden on health workers.
But he added: “It is unfortunate for Indonesian healthcare workers that they have received vaccines with low efficacy…compared to mRNA vaccines.”
Mr Rahmat appealed to the government to revaccinate healthcare workers with mRNA vaccines - such as the Pfizer and Moderna jabs - when they arrive in the country later this summer. In trials these vaccines have higher efficacy rates - both over 90 per cent - compared to Sinovac's 51 per cent. However, trials showed it was much better at preventing severe disease and hospitalisation.
“That’s one policy that everyone has to think about because risking healthcare workers means risking the health system,” he said.
In Thailand, a leaked health ministry document this week prompted similar calls for fully vaccinated medical staff to be given a booster of an mRNA vaccine.
According to the Bangkok Post, the document discussed how Pfizer’s vaccine – 1.5 million doses of which are due to arrive this month and 20 million later in the year – should be allocated.
It allegedly admitted that if the Pfizer vaccine was given to healthcare workers as a booster, “it is tantamount to admitting that the Sinovac vaccine offers no protection. This will make it harder to defend it”.
In Indonesia, doctors are struggling to protect themselves and their families as best they can.
“As the head of the emergency department, I have worked round the clock since early last year and have tried to avoid [the virus] as far as I could. But at the end of the day, I got infected anyway,” said Dr Ririek Andry, who works in a hospital in Serang, Java.
He had also been fully vaccinated, but believes he caught the virus before having enough time to develop antibodies. After 14 days he was back at work.
For unvaccinated medical workers, the risk is even more acute.
Dr Ulul Albab, an unvaccinated gynaecologist treating 30-40 patients a day, nearly died after the contracting the virus and ending up on a ventilator.
“Our struggle in this pandemic will continue for the next five years. This is a long-term war, we must not be weak and unaware,” he said.
But he also urged the public to play its part.
“I want them to open their eyes and realise that Covid is really there and exists. This is not a game. The pandemic is real, cruel and getting serious,” he said.
“If you are exposed, we will be busier at work. If we are too busy to help you, our immunity decreases. If our immunity decreases, we are vulnerable to Covid. If there are a lot of sick doctors, we can't help you.”
*Additional reporting by Louise Watt
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