By Dr. Somu
The second wave of COVID-19 pandemic situations across the country is becoming alarming. With nearly 1.52 lakh new cases being reported daily (as on April 10) and the death toll mounting, the health situation takes a turn for the worse. Amidst the deadly chaos, various states report vaccine shortages and people being sent home from the vaccination centres. With a spike in infections people have started thronging vaccination centres as the demand has suddenly soared.
The two vaccine producers, Serum Institute (Pune) and Bharat Biotech (Hyderabad) are struggling to meet the demand. This clearly shows the failure of the government in planning properly. Ironically Centre seems to be in total denial about vaccine shortages in the country, and is blaming the states for mismanaging available stocks. Realizing the severity of fast spreading pandemic and mounting death toll during the last one week, the government has finally approved the SPUTNIK V COVID vaccine from Russia to supplement the doses and fight shortages. It should have been approved in January when Russian government was ready to negotiate at much lower prices.
Sequencing of SARS COVID.2 virus samples collected from patients revealed that presently four new strains are in circulation among the population- South African (B.1.351), Brazilian (P.1), UK and double mutated (E4 84Q and L452R) Indian mutation. Spike Genes on the surface of the SARs COVID viral surface change their behaviour and increasingly become aggressive while attacking the human body cells.
According to Dr. Rakesh Mishra, Director, Hyderabad based CCMB says nearly 20 percent of patients in Maharashtra are infected by double mutated Indian strain. Just in a week’s time number of cases have doubled and by April 15, they are to reach as high as 1.8 Lakh cases. However the second wave of pandemic is caused by the last year’s same COVID 2 strain only. Dr Rahul Pandit, member, Task Force, Maharashtra attributes rapid rise to Indian double mutants (up to nearly 60 percent)is alarming in the second wave of infection mainly the result of negligence and flaunting recommended COVID discipline in public places.
The fact is the total production capacity of the manufacturers of Covishield and Covaxin, is nearly 24 lakh vaccines a day. The current demand is 37 lakh vaccines a day. Daily shortage is already huge touching15 to 20 lakh vaccines a day, government failed to anticipate higher vaccination demand with starting the 45-plus age group. This will become more acute in the weeks to come as production capacity increase will take time. To break the infection chain at least 70 percent of the population must be vaccinated. Till the second week of April only eight and half crore population is vaccinated during the last two months. At this slow pace it might take nearly one and half years to reach the set goal to vaccinate and reach herd immunity. This may turn the coming days precarious with subsequent waves of pandemic emerging occasionally with the appearance of new mutant strains. In the face of these critical times, the government appears to be complacent and in a denial mode refuting serious vaccine shortages.
Instead of acting fast to speed up production of doses, Union ministers have started blaming the non- BJP ruled state governments for mismanagement of stocks. Even the health ministry refuses to share information on the rollout process of COVID-19vaccines.
In the recent virtual online meeting, chief ministers of some states complained about a serious shortage of vaccines in several districts across the nation and they are forced to close vaccination centres temporarily. Ironically ignoring the looming shortages, prime minister blamed the states for mismanagement of vaccine stocks and urged the public to strictly adhere to COVID discipline. He even tried to give it a joyous colour calling it “festival of vaccinations” rather than focusing on how fast the production of vaccines by the Serum Institute of India and Bharat Biotech can be scaled up from present levels to meet the existing gap between supply and demand in districts.
There is a huge gap between the words our ruling party leaders, especially the Prime Minister and Amit Shah, preach to people and what they practice. Despite the loud talk of Covid behavioural discipline, both prime minister and home minister addressed more than 35 election rallies during the ongoing state elections, with neither wearing masks, nor maintaining physical distance. Added to this neither election commission nor home ministry took note of prolonged election campaign, especially spanning six weeks of eight phased polling in West Bengal nor the Kumbh mela, cricket matches, opening up of bars and cinema halls despite the Covid threat looming large. Instead, the prime minister became so complacent that he never acknowledged the fast rising death rate. With decline of cases in January this year and boasting India’s victory over COVID as a great accomplishment, he kept stressing on it to the entire world. Ultimately people got the message and started emulating the political leaders. Thus, the negligent attitude became public and the neglect of Covid cautions resulted in an alarming second wave of infection.
2021-22 budget made tall claims of unprecedented 137 percent hike in allocations for the health sector when in actual terms the budgetary provision for 2021-22 for the Union Ministry of Health and Family Welfare shows a 9.6 percent decrease over the actual expenditure incurred in 2020-21.Seeing the resurgence of second wave of infection in Spain, Germany, France and U.K our government should have invested on strengthening health care infrastructure. Ironically not a single rupee was allocated in the Union budget for increasing hospital beds, ICU wards equipped with ventilators and oxygen supply, improvement of facilities in rural primary health centres. In the words of a renowned child specialist, the biggest lessons to learn from the pandemic raging in India is to create a robust healthcare system. Bold healthcare reforms have to be introduced as cosmetic changes will not help. There has to be a sustained campaign to deliver healthcare to rural India, he observed.
As the recent data shows a vast majority of infected patients are in the age group of 18 to 45.Incidentally this age group belongs to the earning sections, toiling to live and sustain the dependents. They constitute nearly 75 percent of the population in India. Being young they do not exhibit symptoms and act as active vectors to spread the infection. So as to break the chain and attain herd immunity, the present vaccination drive must be extended immediately to the younger working masses.
The present government is very slow in anticipating the need for capacity expansion to deal with a second surge of infections, which would require a much higher level of vaccination. The problem turned acute as a group of bureaucrats at the PMO have been put in charge of decision-making on production and distribution capacity across the country. It is also a fact that all the Union ministers (honourable health minister rarely speaks while all other ministers interfere)for the last four months have been actively engaged in electioneering in different states.
Presently, Serum Institute shoulders nearly90 percent of the vaccine supply and the rest by Bharat Biotech. There is an urgent need to speed up production of both the vaccine products. The producers should be provided with special grants and other tax benefits to expand production capacity for increased supply of doses. Government should immediately negotiate and import other vaccines from Russia(Sputnik), Pfizer, Moderna and Johnson &Johnson.
Time is running out, keep aside boasting about vaccine nationalism, vaccine diplomacy. Nothing is more important than averting a huge humanitarian disaster and saving the lives of fellow Indians. The Serum Institute has the capacity to produce 60 million doses a month and its promoter, Adar Poonawala, has been seeking bridge finance from the government to enhance capacity to produce 100 million doses to meet the growing demand. At present, the Serum Institute cannot meet even its current export commitment of over 60 million doses.
Prime minister should immediately invite a meeting of all political parties, scientists, doctors and discuss ways to come out of the Pandemic crisis. (IPA Service)