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Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day two nine

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Speaker 1: since coronavirus was declared a global pandemic. Today's main story,

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Speaker 1: how difficult is it to create a vaccination program for

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Speaker 1: a massive country that's spread across several islands and happens

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Speaker 1: to be the worst hit in its region. Our Jakarta

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Speaker 1: Bureau chief explains why Indonesia's vaccine rollout plan keeps changing.

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Speaker 1: But first, here's what happened in virus news today. The

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Speaker 1: rolling average of US coronavirus cases edged up in the

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Speaker 1: past week and is on a path to break records

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Speaker 1: again any day. Today, thirty two states reported seven day

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Speaker 1: case averages substantially rising over the prior week, with some

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Speaker 1: of the steepest rises in Kansas and Arizona. That's a

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Speaker 1: sharp turnaround from mid December, when thirty eight states reported

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Speaker 1: cases flat or falling. Meanwhile, an easier to spread variant

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Speaker 1: of COVID nineteen was detected in three U s states

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Speaker 1: last week, though health officials don't know how much farther

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Speaker 1: it may have spread. That could intensify the virus's search

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Speaker 1: if it hasn't already. Boosting the urgency for a speedier,

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Speaker 1: more effective vaccine push. Israel plans to vaccinate seventy of

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Speaker 1: its population by April or May. That's according to Health

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Speaker 1: Minister Julie Ethelstein. The country is moving faster to inoculate

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Speaker 1: people than any other country in the world on a

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Speaker 1: per capita basis. Israel has already administered first doses of

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Speaker 1: the fiser shot to about one point two million residents,

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Speaker 1: or more than twelve percent of the population. Officials from

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Speaker 1: Operation Warp Speed, the US government's vaccine drive, are asking

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Speaker 1: Moderna and the Food and Drug Administration to cut in

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Speaker 1: half the dose of the company's COVID nineteen vaccination for

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Speaker 1: people ages eighteen to fifty five after finding that it

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Speaker 1: induces the same immune response. That's according to Chief Scientific

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Speaker 1: Advisor Monsef Slowly, who spoke on CBS's Face the Nation

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Speaker 1: on Sunday and Now for today's main story. Indonesia had

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Speaker 1: planned to prioritize its working age population for its COVID

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Speaker 1: nineteen vaccine rollout, but they recently announced a change of plans.

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Speaker 1: The inoculation program would instead start with healthcare workers, civil servants,

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Speaker 1: and the elder The government didn't give a reason for

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Speaker 1: the change, but the shifting procedures show some of the

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Speaker 1: difficulties in coordinating a vaccine rollout for a massive nation

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Speaker 1: spread across a string of islands. I spoke to Jacarta

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Speaker 1: Bureau chief, you toith Hoe about how hard it's been

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Speaker 1: to secure enough doses for the fourth largest country in

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Speaker 1: the world. What has COVID nineteens effect been thus far

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Speaker 1: in Indonesia? How is the country been hit by the pandemic?

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Speaker 1: So Indonesia, it's actually suffering the worst cornavirus outbreak right

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Speaker 1: now in Southeast Asia, and that's in terms of the

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Speaker 1: number of infections and also the number of deaths. I

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Speaker 1: think part of that is because it really hasn't resorted

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Speaker 1: to any form of luckdown because Bretnao we don't know

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Speaker 1: actually said that that's against h culture of the country.

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Speaker 1: So what they've done and said is just um calling

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Speaker 1: for people to follow health protocols. That's become a lot

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Speaker 1: worse coming up to the holiday season because after a

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Speaker 1: whole year of people saying put in their homes, I

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Speaker 1: think there are a lot of people taking this chance

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Speaker 1: to go on holidays or gather with families, and especially

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Speaker 1: coming up to the new year, there's been a lot

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Speaker 1: of warnings from the government to say they are expecting

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Speaker 1: a spike embarrassing inspections UM, and they're really calling for

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Speaker 1: people to be careful, but they really haven't resorted to

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Speaker 1: any um of those strict lockdowns that you've seen any

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Speaker 1: elsewhere in Asia. And as we move into the new year,

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Speaker 1: what is Indonesia's plans in terms of vaccination. So Indonesia

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Speaker 1: might be UM one of the country's most reliant on vaccines.

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Speaker 1: It's basically been signing deals left and right with Western

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Speaker 1: producers and also UM, the Chinese producer for vaccines UM.

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Speaker 1: It's really banking on Sinovac especially. The country has actually

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Speaker 1: been partnering with no back to do UM joint trial

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Speaker 1: UM in the city south of Jakarta, and that trial

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Speaker 1: is coming up to the conclusion now. And what's pending

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Speaker 1: before I can actually start this vaccination program is this

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Speaker 1: emergency use authorization from the local drug regulator that is

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Speaker 1: expected sometime in January one. That's out The president himself,

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Speaker 1: Joco Ridoto, is actually going to be the first one

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Speaker 1: to take the vaccine and he said that the reason

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Speaker 1: why he's doing this is to make sure that people

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Speaker 1: feel secure in the safety of the vaccine, especially considering

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Speaker 1: the lack of transparency in how um the trials for

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Speaker 1: THEO back vaccines have been conducted. And maybe you could

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Speaker 1: just talk a little bit about the Sinovack vaccine in

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Speaker 1: terms of how does it differ from say those developed

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Speaker 1: by MODERNA or FIGHTSER. I think what's been really interesting

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Speaker 1: with modern and Fightser is they're actually using new technology

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Speaker 1: with the m m R n A vaccines, whereas assino

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Speaker 1: vac one is I would say pretty old school. They

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Speaker 1: are using inactivated viruses UM to create these vaccines. But

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Speaker 1: and because of that, actually it might work better for

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Speaker 1: Indonesia considering the country is spread across the world's biggest archipelago,

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Speaker 1: so it becomes more difficult to transport um vaccines that

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Speaker 1: require very cold temperatures. Sinovac vaccines actually only required to

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Speaker 1: to four degrees celsius, which means normal refrigeration will be okay.

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Speaker 1: And that's why Indonesia is I think, relying on vaccino

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Speaker 1: back for about half of its vaccine needs. And and

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Speaker 1: you raise a great point there. So many countries now

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Speaker 1: are are very much focused on acquiring enough doses of vaccines.

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Speaker 1: So in total, between cinovac and perhaps other vaccines it's

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Speaker 1: acquired or at least put on order. How many doses

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Speaker 1: has Indonesia security for its population? So in Aonesia, the

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Speaker 1: last number they gave was that they're close to acquiring

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Speaker 1: four hundred million doses, and that is actually still not

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Speaker 1: enough to cover the whole population, because the whole population

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Speaker 1: would amount to about seventy million, and they're also taking

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Speaker 1: into account any vaccines that might turn out to be

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Speaker 1: ineffective or any vaccines that might be damaged in the process.

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Speaker 1: So the last number they gave was that they need

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Speaker 1: four hundred twenty seven million that they're aiming to get.

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Speaker 1: Um but that's still not going to cover the whole population.

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Speaker 1: Um I think they're right now they actually increase their

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Speaker 1: target for her community from about only of the population

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Speaker 1: to about six If there's also an Indonesian vaccine that

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Speaker 1: it's in development, um I was wondering if you might

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Speaker 1: tell us just a bit about that. So Indonesia is

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Speaker 1: also trying to develop his phone vaccine. This one is

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Speaker 1: being developed by its they downed U pharmaceutical company is

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Speaker 1: also named Meraputi, which that basically says it and White,

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Speaker 1: which is the colors of the nation's flag. The vaccine itself.

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Speaker 1: That's actually Celindary early trials. Um. The last update they

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Speaker 1: gave us was that they're still conducting animal trials, so

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Speaker 1: it's pretty slow going. UM. But I think the reasoning

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Speaker 1: behind that is considering all the race for vaccines all

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Speaker 1: over the world, Indonitia is trying to make sure that

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Speaker 1: if even if nothing else works out in terms of

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Speaker 1: overseas deals, it actually still has this one local producer

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Speaker 1: going for them. Um. From what we know, the Maraputi

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Speaker 1: vaccine is also relying on the inactivated virus um sort

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Speaker 1: of technology. Now, let's move on to the actual rollout

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Speaker 1: of the vaccination program. Indonesia recently announced a change to

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Speaker 1: who would be receiving a COVID vaccine first in the country.

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Speaker 1: What exactly was this change? So previously Indonesia wanted to

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Speaker 1: vaccinate the younger people first, and that would be the

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Speaker 1: working age who are aged between eighteen to fifteen nine

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Speaker 1: years old. UM. That is, that was after the health

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Speaker 1: care workers. But recently they've announced a new vaccination program

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Speaker 1: and that one actually starts with healthcare workers civil servants,

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Speaker 1: followed by the elderly. Uh. Those would be people six

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Speaker 1: years old and above. Indonesia's difficulty in trying to get

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Speaker 1: enough vaccines to cover the whole population and actually a

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Speaker 1: big factor in why they want to vaccinate the young

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Speaker 1: people first, because the idea is if the younger people

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Speaker 1: who are having to go out to work UM and

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Speaker 1: having to move around in the economy, UM, if they're vaccinated,

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Speaker 1: then they might not actually come home and like bring

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Speaker 1: the virus to people who are older or maybe their children.

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Speaker 1: So they're really trying to use the vaccine not only

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Speaker 1: to protect people from UM developing a more severe case

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Speaker 1: of COVID, but they're actually trying to use the various

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Speaker 1: basically as their front line in trying to prevent wider

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Speaker 1: spread of the virus. The government hasn't actually given us

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Speaker 1: a very clear reason for the change, other than the

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Speaker 1: fact that President Jacoby Dodo said that the government is

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Speaker 1: actually going to provide free vaccines for everyone. And what

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Speaker 1: that means is the government has to actually procure more

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Speaker 1: vaccines than before. Whereas before they've signed on to sinovac

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Speaker 1: Um to also produce the doses locally. Now they actually

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Speaker 1: stepped up the hunt for vaccines. In December, they've actually

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Speaker 1: signed another fifty million doses purchased from Azardenca, and then

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Speaker 1: in January they're expected to sign another fifty million from Fiser,

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Speaker 1: So it seems like that might be one of the

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Speaker 1: reasons why they're recalibrating how they're doing the telectation program

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Speaker 1: after Jacoby said that he wants to make sure everybody

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Speaker 1: gets vaccines for free. And are there any other factors

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Speaker 1: that the country is taking into account prioritizing those who

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Speaker 1: would be most likely to spread it and trying to

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Speaker 1: protect more vulnerable populations. Are there any other demographics that

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Speaker 1: fall into that vulnerable population that may not receive the

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Speaker 1: vaccine first. Because the country is so huge and it's

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Speaker 1: spread out across very remote islands, sometimes it's um it

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Speaker 1: can be difficult for the government to actually get the

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Speaker 1: vaccines to where they need to be um and that's

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Speaker 1: actually played out in the government's fascination program. They're actually

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Speaker 1: saying that they want to prioritize the places that are

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Speaker 1: most impacted by the virus and those happened to be

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Speaker 1: in the Jab Island, which is the most populous and

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Speaker 1: the most developed, But in doing so, that might actually

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Speaker 1: leave out the more remote places who are also whose

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Speaker 1: health facilities might actually be under strained as well. We

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Speaker 1: the government has not actually given a very detailed plan

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Speaker 1: of how they're actually getting the going to get the

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Speaker 1: vaccine from Jackard to where it's just where it's likely

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Speaker 1: to land to all these remote islands. What they have

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Speaker 1: said is they're going to make use of these states

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Speaker 1: public clinics called postcus mass. These are actually very small clinics.

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Speaker 1: They're very sparsely um UM equipped, but they are spread

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Speaker 1: out basically in every regency. You need to have at

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Speaker 1: least one postcast man, so at least they do have

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Speaker 1: the framework or by the government can actually uh contact

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Speaker 1: all these this network that they already have of state

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Speaker 1: health clinics and they can just just do with the

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Speaker 1: vaccines that way. UM. And I think the other difficulty

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Speaker 1: is once you actually have people getting their prostoses, how

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Speaker 1: are you going to make sure that they are actually

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Speaker 1: going to get the necessary second dose. I think that's

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Speaker 1: the challenge that the government hasn't actually spoken about. They

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Speaker 1: been taking the matter basically step by step. Right now,

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Speaker 1: they're focused on securing the deals and getting the emergency

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Speaker 1: use authorization and they keep telling us, um, once we

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Speaker 1: have the vaccines, and will tell you how we're going

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Speaker 1: to distribute it. You know. The other thing that's on

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Speaker 1: a lot of people's minds right now is, of course,

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Speaker 1: the timeline of when will I be able to receive

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Speaker 1: my vaccine? Has the government mentioned anything in terms of

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Speaker 1: a timeline and when it hopes to have the majority

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Speaker 1: of say the working age population vaccinated, even in an

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Speaker 1: ideal world or an ideal timeframe. There have been a

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Speaker 1: couple of timelines that they have discussed. I think the

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Speaker 1: latest one stretches until the bid of twenty twenty two,

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Speaker 1: and I think that would be the ideal scenario, is

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Speaker 1: for them to actually get the vaccines approved for use

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Speaker 1: and go through the whole population until the middle of two.

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Speaker 1: They have actually said that they're planning to vaccinate a

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Speaker 1: hundred six million people a year. That actually doesn't really

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Speaker 1: work out with their middle of two timeline either, So

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Speaker 1: there's a lot of questions around that, and I think

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Speaker 1: again the government is not setting a fixed time line

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Speaker 1: as much as they're kind of pushing back the timeline

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Speaker 1: as thanks to a pop or as new vaccine supply

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Speaker 1: becomes available to them. That was Edith Hoe, and that's

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Speaker 1: it for our show today. For coverage of the outbreak

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Speaker 1: from one bureaus around the world, Visit bloomberg dot com

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Speaker 1: global reporting. The Prognosis Daily edition is produced by Top

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Speaker 1: for foreheads Magnus Henrickson and me Laura Carlson. Today's main

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Speaker 1: story was reported by Edith Hoe. Original music by Leo Sidrin.

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Speaker 1: Our editors are Rick Shine and Francesca Levi. Francesco Levi

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Speaker 1: is Bloomberg's head of podcasts. Thanks for listening. No