In Indonesia social restrictions will continue until the end of May. But the government has said that workers under the age of 45 in some sectors can return to work before then. If this happens it risks undoing much of the progress made in April/May in suppressing the SARS-CoV-2 coronavirus and could lead to a second wave pandemic.
The reasons given by the government are flawed and contradictory.
The head of the coronavirus task force Doni Monardo is quoted as saying that younger workers under 45 are prioritized “…due to the fact that those aged 60 and above have the highest mortality rate”. The ministry of health spokesperson said Yurianto said: “We realise very well that the group of 45 years and below are productive forces who have a high immunity to withstand this disease.”
It’s true that those aged 60 and above have the highest mortality rates. That is because there is usually a higher incidence of underlying medical conditions, respiratory problems, diabetes, their immune system is less resilient, etc. Talking only about mortality rates misses the point.
Social restrictions are designed to suppress the COVID-19 pandemic, stopping the spread of the coronavirus. Young people stay at home to protect everyone else, not just themselves. The government announcement makes it sound as though the social restrictions are only to protect your own health. Everyone and anyone can be infected with and spread the coronavirus regardless of age. So workers under 45 returning to work now gives SARS-CoV-2 an opportunity to infect more people and spread in the community. It’s a second chance for the coronavirus.
Younger people with COVID-19 can still suffer a very serious form of COVID-19 disease, especially if they have underlying health conditions, smoke, or have diabetes, etc. The rate of smoking among men under 45 is high, as is the incidence of diabetes.
We also have to consider the capacity of hospitals to handle more cases and provide treatment. The lower incidence of death among younger people is because they can recover with treatment at hospital. But hospitals are overwhelmed now and it’s possible the death rate among younger people will rise if they cannot receive timely medical treatment.
The ministry of health reference to “high immunity” is dangerously confusing. Younger people are not immune to the SARS-CoV-2 coronavirus. They generally suffer a less severe form of the COVID-19 disease and sometimes are asymptomatic (showing no symptoms). But that is not the same as immunity. You can still be infected, appear healthy, and infect others.
Even those who recovered from COVID-19 are not necessarily immune. Cases of re-infection are reported in China and South Korea. Medical experts are now saying that most likely people who recovered from COVID-19 have enough antibodies to be immune. That’s good news but it is still unclear why some people were not immune.
We have to assume the ministry of health doesn’t mean immunity, but a healthier immune system (to survive COVID-19 if infected).
So the correct explanation of the return to work for people under 45 is that it is for economic reasons. Reopening businesses needs more people back at work . So this should be explained as a decision based on business, not science. So those who are under 45 and who …
- are healthy;
- don’t have a compromised immune system;
- don’t have any underlying medical conditions or illness;
- are able to gain immediate access to medical treatment at a hospital equipped to handle COVID-19 patients if infected with the coronavirus;
- can isolate themselves from family members when they go home each day;
- can maintain physical distancing going to and from work;
- can maintain physical distancing at work;
- will wash their hands thoroughly throughout the day;
- will wear masks going to and from work and a different mask at work;
… can indeed return to work. In fact anyone at any age this healthy and maintaining safety protocols in a safe work environment can probably return to work. Someone just needs to explain all this to the coronavirus.
12 May 2020