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Indonesia’s New Coronavirus Concern: A Post-Pandemic Baby Boom | Indonesia’s New Coronavirus Concern: A Post-Pandemic Baby Boom |
(about 7 hours later) | |
The government vehicles began appearing in Indonesian towns and cities in May, equipped with loudspeakers blaring a blunt message. | The government vehicles began appearing in Indonesian towns and cities in May, equipped with loudspeakers blaring a blunt message. |
“You can have sex. You can get married. But don’t get pregnant,” health workers read from a script. “Dads, please control yourself. You can get married. You can have sex as long as you use contraception.” | “You can have sex. You can get married. But don’t get pregnant,” health workers read from a script. “Dads, please control yourself. You can get married. You can have sex as long as you use contraception.” |
Indonesian officials are worried about a possible unintended consequence of the country’s coronavirus restrictions: a post-pandemic baby boom. | Indonesian officials are worried about a possible unintended consequence of the country’s coronavirus restrictions: a post-pandemic baby boom. |
In April, as people across Indonesia stayed home, about 10 million married couples stopped using contraception, according to the National Population and Family Planning Agency, which collects data from clinics and hospitals that distribute birth control. | In April, as people across Indonesia stayed home, about 10 million married couples stopped using contraception, according to the National Population and Family Planning Agency, which collects data from clinics and hospitals that distribute birth control. |
Many women couldn’t get access to contraceptives because their health care provider was closed. Others did not want to risk a visit, for fear of catching the virus. Now, officials are expecting a wave of unplanned births next year, many of them to poor families who were already struggling. | Many women couldn’t get access to contraceptives because their health care provider was closed. Others did not want to risk a visit, for fear of catching the virus. Now, officials are expecting a wave of unplanned births next year, many of them to poor families who were already struggling. |
“We are nervous about leaving home, not to mention going to the hospital, which is the source of all diseases,” said Lana Mutisari, 36, a married woman in a suburb of Jakarta, the capital, who has been putting off an appointment to get an IUD. “There are all kinds of viruses there.” | “We are nervous about leaving home, not to mention going to the hospital, which is the source of all diseases,” said Lana Mutisari, 36, a married woman in a suburb of Jakarta, the capital, who has been putting off an appointment to get an IUD. “There are all kinds of viruses there.” |
Hasto Wardoyo, an obstetrician and gynecologist who heads the family planning agency, has estimated that there could be 370,000 to 500,000 extra births early next year, in a country that typically sees about 4.8 million a year. | Hasto Wardoyo, an obstetrician and gynecologist who heads the family planning agency, has estimated that there could be 370,000 to 500,000 extra births early next year, in a country that typically sees about 4.8 million a year. |
That would be a setback for Indonesia’s extensive efforts to promote smaller families, a key aspect of its fight against child malnutrition. President Joko Widodo has made it a national goal to reduce child stunting — impaired development resulting from poor nutrition and other factors — by half within four years. | That would be a setback for Indonesia’s extensive efforts to promote smaller families, a key aspect of its fight against child malnutrition. President Joko Widodo has made it a national goal to reduce child stunting — impaired development resulting from poor nutrition and other factors — by half within four years. |
“There should be no unwanted pregnancy,” said Dr. Hasto. | “There should be no unwanted pregnancy,” said Dr. Hasto. |
Contraception is provided free to Indonesia’s poor, and young married couples of various incomes are visited by government representatives who encourage the use of birth control — often the wife of a neighborhood official, or one of the family planning agency’s 24,000 counselors. | Contraception is provided free to Indonesia’s poor, and young married couples of various incomes are visited by government representatives who encourage the use of birth control — often the wife of a neighborhood official, or one of the family planning agency’s 24,000 counselors. |
According to the agency, half of the Indonesian women who use contraceptives receive hormone injections, which are administered monthly or every three months. Another 20 percent use birth control pills, which women had been required to pick up monthly if they were on government insurance. (Condoms are widely available but unpopular, at least among married couples.) | According to the agency, half of the Indonesian women who use contraceptives receive hormone injections, which are administered monthly or every three months. Another 20 percent use birth control pills, which women had been required to pick up monthly if they were on government insurance. (Condoms are widely available but unpopular, at least among married couples.) |
Those regular clinic visits were largely disrupted by the coronavirus, which in Indonesia has caused more than 34,000 infections and nearly 1,900 deaths. In Jakarta, the country’s first epicenter, new infections had been on the decline, and mosques, malls and offices have been gradually reopening this month. But cases are rising in other parts of Indonesia, including the provinces of East Java and Papua. | Those regular clinic visits were largely disrupted by the coronavirus, which in Indonesia has caused more than 34,000 infections and nearly 1,900 deaths. In Jakarta, the country’s first epicenter, new infections had been on the decline, and mosques, malls and offices have been gradually reopening this month. But cases are rising in other parts of Indonesia, including the provinces of East Java and Papua. |
Dr. Hasto, the family planning chief, said his estimate of up to half a million unplanned births was a conservative one. But he said he was confident that changes his agency had begun making could prevent a much larger baby boom. | Dr. Hasto, the family planning chief, said his estimate of up to half a million unplanned births was a conservative one. But he said he was confident that changes his agency had begun making could prevent a much larger baby boom. |
Regulations have been revised to allow for home delivery of contraceptives, and to let women obtain more than a month’s supply of birth control pills at a time. In April, the government began delivering contraceptives along with the emergency food supplies that many families were receiving because of the pandemic. | Regulations have been revised to allow for home delivery of contraceptives, and to let women obtain more than a month’s supply of birth control pills at a time. In April, the government began delivering contraceptives along with the emergency food supplies that many families were receiving because of the pandemic. |
“We conduct door-to-door distribution while handing out staple food packages,” Dr. Hasto said. “We give free injections. We also bring birth control pills.” | “We conduct door-to-door distribution while handing out staple food packages,” Dr. Hasto said. “We give free injections. We also bring birth control pills.” |
The agency has also ramped up its promotional efforts — involving radio pitches and social media, as well as loudspeaker trucks — to encourage couples to put off getting pregnant until the Covid-19 crisis is over. | The agency has also ramped up its promotional efforts — involving radio pitches and social media, as well as loudspeaker trucks — to encourage couples to put off getting pregnant until the Covid-19 crisis is over. |
In the city of Semarang, one female health worker’s direct talk about contraception over a loudspeaker briefly became a national controversy, with some saying the language was inappropriate. But the attention helped to spread the message. | In the city of Semarang, one female health worker’s direct talk about contraception over a loudspeaker briefly became a national controversy, with some saying the language was inappropriate. But the attention helped to spread the message. |
Novita Saputri, 28, a secretary for a foreign trading company in Jakarta who has been married for 18 months, wants to have a baby, but not until the pandemic ends. Her doctor’s office is at a nearby hospital, and she does not want to risk the monthly visits she would need if she became pregnant now. | Novita Saputri, 28, a secretary for a foreign trading company in Jakarta who has been married for 18 months, wants to have a baby, but not until the pandemic ends. Her doctor’s office is at a nearby hospital, and she does not want to risk the monthly visits she would need if she became pregnant now. |
“If I go to the hospital, the risk of getting the virus is higher,” she said. | “If I go to the hospital, the risk of getting the virus is higher,” she said. |
But she prefers not to use birth control pills or injections, worrying that she might gain weight. Instead, she and her husband, who have been mostly housebound for three months, are using condoms occasionally and having sex less often. (His video game habit helps, she joked.) | But she prefers not to use birth control pills or injections, worrying that she might gain weight. Instead, she and her husband, who have been mostly housebound for three months, are using condoms occasionally and having sex less often. (His video game habit helps, she joked.) |
Updated June 24, 2020 | |
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles. | |
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. |
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. |
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
The Indonesian authorities' involvement in family planning dates to 1970, when the country was under a military dictatorship run by President Suharto. Soldiers promoted the use of contraception, and army doctors performed vasectomies and tubal ligations, according to the family planning agency. | The Indonesian authorities' involvement in family planning dates to 1970, when the country was under a military dictatorship run by President Suharto. Soldiers promoted the use of contraception, and army doctors performed vasectomies and tubal ligations, according to the family planning agency. |
The agency still works with the military and the police, who have been involved in the recent home delivery of contraceptives. Dr. Hasto said the agency would observe National Family Day on June 29 by mobilizing teams to hand out contraceptives to a million people. | The agency still works with the military and the police, who have been involved in the recent home delivery of contraceptives. Dr. Hasto said the agency would observe National Family Day on June 29 by mobilizing teams to hand out contraceptives to a million people. |
Ms. Lana, the suburban Jakarta resident, has a 2-year-old daughter and said she would like to wait two years before having another child. But fear of Covid-19 has her reluctant to schedule an appointment to get an IUD. | Ms. Lana, the suburban Jakarta resident, has a 2-year-old daughter and said she would like to wait two years before having another child. But fear of Covid-19 has her reluctant to schedule an appointment to get an IUD. |
“People think that when we are working from home, we always make a baby,” said Ms. Lana, a researcher for Gojek, a well-known Indonesian ride-hailing company. “There are two nannies at home. My child is active. Our home is lively. It is not a romantic environment.” | “People think that when we are working from home, we always make a baby,” said Ms. Lana, a researcher for Gojek, a well-known Indonesian ride-hailing company. “There are two nannies at home. My child is active. Our home is lively. It is not a romantic environment.” |
Still, she admitted, anything could happen, especially if their home confinement continues. | Still, she admitted, anything could happen, especially if their home confinement continues. |
“We could have a baby sooner than we plan,” she said with a laugh. “There is always a risk in life.” | “We could have a baby sooner than we plan,” she said with a laugh. “There is always a risk in life.” |