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India’s anti–Covid vaccination drive

For the last few days, there have been a lot of discussions on the shortage of COVID-19 vaccines and the need for opening up vaccination for all. Both issues are being politicized and the saner voices of experts tend to get drowned in the loud political rhetoric. One wonders if these politicians understand that in the present scenario, the two issues are contradicting in nature. If there is a shortage, then opening up vaccination for all will make the situation worse and vice versa.

Critics notwithstanding, the Indian vaccination program that was launched on 16 January has been executed very efficiently and the authorities concerned deserve a pat for the same. Just for the record, in a 24 four-hour period starting on 05 April, over 4.3 million doses were administered. The highest daily figure reported in the USA is about 3.6 million doses. This is no mean feat considering India’s geographical spread, existing logistical infrastructure, and the ever-present inefficiencies in the system. India’s monthly production capacity is about 100 million doses of COVISHIELD at Serum Institute in Pune and about 4.5 million of COVAXIN at Bharat Biotech in Hyderabad. Both are expected to ramp up further in the next six to eight weeks.

As of date, there have been no shortages of vaccines across the country. If any particular point of administration of vaccine did run short in any state, it must be either due to a local logistics failure or a planning glitch. Today, most states have 3 to 7 days stocks apart from another week’s quota in the pipeline. At an average current rate of 3.5 million doses per day, India’s monthly requirement is about 105 million doses and the productions just about meet the same with a few million doses to spare to meet international obligations. 

The problem will come in case daily requirement rises sharply to five to six million doses. It is important to remember that while COVAXIN is an Indian effort and full production can be diverted for local usage, COVISHIELD production is under license and therefore some restrictions will apply. Additionally, under the WHO-sponsored COVAX global initiative, vaccine-producing nations have to meet some export obligations. After all, the vaccine is just being produced in a handful of countries but the requirement exists in every nation of the world. Some short-sighted and unaware politicians have demanded a complete ban on the export of the vaccine. They are oblivious to how governments function on the principle of ‘give and take’ apart from the humanitarian issues involved. 

The other point that is often discussed is about the delay in not scaling up the vaccine production in the last few months. One may recall that the two vaccines in India received approval for emergency usage only in the middle of January 2021. It is unlikely that any government or industry would scale up production at such a nascent stage of a critical drug. If that was possible, one wonders why America and Europe are struggling to meet the vaccine demand? 

By all counts, India’ has done better than most nations in the world. The same people, who are now asking why the production was not scaled up in the last two months, were critical of the government’s decision and accused it of being hasty and short-circuiting required protocols. Some had been dismissive of COVAXIN as they showed an utter lack of confidence in the Indian vaccine. A lot of water has since flown down the Yamuna Bridge and the decision to ramp up production has already been taken and the results may be visible by June 2021.

The other issue that is grabbing the headlines is about opening up the vaccination for all. In principle, this does sound fine but considering the numbers involved, availability of the vaccine, logistics involved, and the requirement of trained effort to vaccinate such large numbers, it does not seem to be a very practical approach. Initial reports across the world were that the virus was deadly for senior citizens and those with comorbidities. Therefore, the world over the vaccine was administrated to this segment first followed by those over 45 years of age, and India was no exception. 

There have been enough reports and discussions to suggest that the current vaccines were not suited for children below sixteen years of age. Research and development work for a suitable vaccine for children is already being done on priority. The efficacy of current vaccines for children is yet to be established and that has to be understood.

More than 74% of India’s population is above the age of fourteen years that includes nearly 6.4% who are above 65 years. Administratively it will be a nightmare to open the current vaccination program for all above this age. It should not be forgotten that the bulk of the effort involved in vaccinating people comes from the same health care staff that is also responsible to treat and fight the virus. So, if the vaccination has to be ramped up overnight, this effort also needs to be increased. In the real world, it will be impossible to do both overnight. It will have to be done in a planned manner in a realistic time frame. 

In such a scenario can the country do something differently? Perhaps it can and the list below can be considered to help in fighting the recent spike in cases that are being termed as a second wave:

1. Intensify vaccination in large cities like Mumbai, Delhi, Pune, and others. Allocate more doses to achieve herd immunity in such areas by reaching a vaccination figure of about 30% at the earliest. States must redeploy their existing resources within their respective states to make this a success. Health is a state subject and the onus lies on the states.

2.States must not dither on taking tough decisions when it comes to implementing restrictions in hot spots. 

3.While industry, offices, and markets have to continue functioning, restrictions must be imposed on places like theatres, places of worship, and social gatherings. Educational institutions must continue to remain closed and instead conduct online learning.

4.The biggest challenge is how to limit and control election campaigning and crowds that throng the rallies. One has to wait and watch to see how the states of Bengal, Kerala, Tamil Nadu, and Assam fare in the next few weeks once elections are over. Chances are there will be spikes in many places in the number of virus-positive cases.

5.Stop reverse migration of labour from cities and agriculture-dominated areas. The employers and state authorities must chip in with resources to ensure the wellbeing of such migrant labour. 

6.Strict control and limiting the number of commuters in public transport at any one time. 

7.Encouraging manpower-heavy offices (like call centers, IT offices) to work with 30-50% strength while the rest works from home.

8.Testing must be ramped up, including checking for the new strains of the virus, to control its spread. Tracing of contacts of positive cases seems to have declined sharply. This needs to be corrected.

9.Vaccination drive must be ramped up continually. Early approval for the Russian Sputnik vaccine will be an important step in this regard.

10.Identify more groups of people to be included as vulnerable for priority vaccination. These could include industrial workers, delivery/courier services, staff at shopping establishments, construction workers, etc. 

There is an imperative need to relaunch a public awareness campaign highlighting the longevity of the virus and the need to take all recommended precautionary measures as part of daily life. The laxity that seems to have crept up in this regard needs to be corrected on priority. The onus for this lies on the state and local city/town administrations. Here administration also includes locally elected politicians from Panchayat members to Members of Parliament. It is time they contribute to this public awareness campaign instead of just finding faults with the system. After all, they are paid by taxpayers’ hard-earned money.

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Disclaimer

Views expressed above are the author’s own.



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