Dr. Devendra Kothari
Population and Development Analyst
Forum for Population Action
The New Year is a great time to give up anything that’s holding you back; unpacking a little emotional baggage is a great way to celebrate it. The Covid-19 pandemic has affected our lives, and how we live them. Everyday decisions have suddenly become harder to make. Further, the uncertain and unexpected evokes pronounced fear and stress.
So when the Union Health
Minister said that India would be in a position to vaccinate at least all of
its adult population by the end of 2021,
it was a great sign of relief for everyone; however, he could not elaborate as
to how India is going to achieve it.
India is in desperate need of expert disaster management to achieve this target. Currently, the corona management is considered as an administrative problem. Further, pandemic is a Central government responsibility under National Disaster Management Act since March 2020, and it comes under the jurisdiction of Home Ministry, though the Ministry is not related to the management of the pandemic even remotely. As a result, we are not able to plan properly. For example, less than three months to its July 2021 vaccination deadline India has only reached 25% of its target. Due to the shortage in the vaccine, inoculation dropped from 35 lakh each day in the first week of April to 21 lakh in the last week of April. In May the daily average dropped further to 16 lakh doses being administered per day.
That’s why it’s important to sit down, set a goal, and put a plan in place to start crushing the goal. And, this requires professional inputs.
India has to achieve ‘Corona-Mukt Bharat’ for its endurance
before the end of the year. For this, India has to vaccinate the entire
population aged 5 to 64? It is feasible, manageable and essential for the
survival of India.
The article suggests a mechanism to achieve it.
In mid-March, 2021, India believed that the worst of Covid-19 was already behind; and the focus had largely shifted from containment to vaccinations. And the world was looking up to India's production capacity for a steady supply, especially to the poorer countries. By mid-March, India had exported over twice the number of doses it had administered at home. But then the story changed suddenly. The daily infection rate that was on a steady decline took a reverse turn, almost with a vengeance. And the country found itself in the devastating second wave.
Every day since April 25, India has had more than 40 per cent of the global coronavirus cases. On some days it has crossed the 50 per cent mark. India also reported more than 30 per cent of the total global Covid deaths. These are only the reported official cases and deaths. Many experts say the real numbers are much –much higher.
Experts are a little uncertain about why there’s been a surge in coronavirus cases, as there hasn’t been one answer to explain the spike. It’s happened so fast that there hasn’t been a chance for massive research.
A variant of
SARS-CoV-2 known as B.1.617 is widely suspected to have played a big part in
the disastrous spread of covid-19 across India in recent months, as
per the WHO.[1]
In addition, it has been pushed by certain man-made decisions/actions and over
confidence. The government took little steps to build India’s health
infrastructure after the first wave, declared a false victory over
the virus, celebrated Kumbh and went ahead with election
rallies when the disease was spreading fast. In
short, the laxity in preventive measures, coupled with the presence of new
variants, has resulted in a nationwide crisis.
The second wave of Covid-19
pandemic has hit India’s nascent economic recovery. Till now, there is no
official estimate of its impact on the economy. Private forecasters have,
however, made assessments of the damage caused by the second wave, which is
still unfolding. It may take years to reach pre-pandemic
levels.
Also, the national health and education systems have buckled under the strain of Covid-19’s second wave. Many states are reporting shortages of hospital beds, oxygen supply, medicines, even space in morgues. Further, the prolonged closure of schools due to the COVID-19 pandemic in India may cause a loss of over billions of dollars in the country's future earnings, besides substantial learning losses, according to a World Bank report. [2]
Available data indicate that the young and economically active populace is getting more infected in the new wave. “Children are definitely more symptomatic now than what we saw in the first wave,” said Tanu Singhal, a paediatrician and infectious disease specialist at Mumbai’s Ambani Hospital. So India has to FOCUS on a young and economically active population.
What should India be doing? Here the concept of herd immunity could help. Herd immunity occurs when a large portion of a community (the herd) becomes immune to a disease, making the spread of disease from person to person unlikely. As a result, the whole community becomes protected —not just those who are immune. For this many people are vaccinated against the disease to achieve immunity.
Dr.
Francis Collins, Director of the National Institute of Health, USA, recently
said that “we don’t really quite know how many people need to be vaccinated
against Covid-19 to hit herd immunity, but there has been a long-standing
belief that 70% to 80% of the population needs to be vaccinated in order for it to happen”. [3]
So far, India has vaccinated
10 per cent of the total population. On the other hand, the UK and USA have
vaccinated 56 per cent and 48 per cent of their population, respectively, as on
May 20, 2021. The U.S. and UK could reach herd immunity soon, as per Dr.
Collins. .
For this, India has to cover the entire population aged 5 to 64 that is around 112 crore on the priority basis, this includes the working and school and college going population. For the senior population 65+ it will be optional for a time being. However, a sizable proportion of the senior population has already been vaccinated.
India has already administered over 18 crore coronavirus vaccine doses by May 20, 2021, as per MOHFW. India, therefore, needs additional 205 crore doses to fully vaccinate the entire target population. It means around 95 lakh doses every day between june1 to December 31, 2021. And, India has to plan for this.
But a severe vaccine shortage has derailed India's vaccination drive. With a steady supply, we could have vaccinated half the adult population by now. It is clear the current production capacity is inadequate to meet the demand. India needs around 2.05 billion doses to fully vaccinate the target population.
Vaccinating the entire target population in 214 days is a herculean
task. But it can be achieved with proper planning and management. The reason we don’t have enough vaccines is that we
did not order them at the right time because we didn’t think we needed them. In
other words, the Government didn’t have a ‘grip’ over the problem. This
is the faculty of being aware of the situation, being knowledgeable about what
resources are at hand and what may be required in the future and being
conscious of what events to anticipate, writes
Aakar Patel, a senior journalist [4]
Further, the problem of the Covid-19 pandemic cannot be approached through the Central government interventions and guidelines alone. It needs the States to be aware of the situation, be knowledgeable about what resources are at hand and what may be required in future and be conscious of what events to anticipate. In a centralised system, as has been followed so far, where decision making is often the purview of a few people and sometimes that only of one person.
Vaccinating the target population on or before the end of the year will require a management approach. For this, creation of a national task force under an eminent epidemiologist like Anthony Fauci of the USA could be a sound move. (Epidemiology aims to solve or control health problems. It integrates experiments, risk assessment, statistical analysis, and surveys to study disease patterns.)
At the central level, the mass vaccination programme should be managed by a ten member National Task-Force headed by a known epidemiologist. Other members may represent disciplines like management, medical, economics, public administration and sociology among others. This full-time high powered Task-Force will take all the technical and management decisions as to how to achieve the target. The procurement and supply of vaccines will be the responsibility of this task-force. It will be a powerful committee reporting directly to the Prime Minister of India.
The Task-force will ask states and UTs to prepare district-wise and vaccination centre-wise plans. The move is aimed at enabling “efficient and judicious” utilisation of available doses for smooth implementation of the national vaccination programme.
The programme implementation will be the
responsibility of states and union territories. They will prepare
the plans of action district wise and that will be submitted to the National
Task-force for approval and monitoring. Also,
states and private vaccination centres will publish their vaccination calendar
on Co-Win digital platform in advance, while desisting from publishing single
day vaccination calendars.
The proposed vaccination exercise will be regularly reviewed and monitored by the Task-Force.
In the last, but very important, all the controversial issues like farmers’ bills and CAA need to be put aside and priority given to procure and vaccinate on a war footing. No doubt, rapid vaccination will bring down the curve. However, it's important that the public follows all the laid down Covid Protocol (and if not followed, enforced by the powers that be).
In sum, recognise that the virus has a long-term survival plan of its own, and is still generating variants. But it does not mean that one should stop trying to win over the virus. Vaccines may indeed be the miracle weapon that may win this battle. So India must focus on vaccinating the target population on or before the New Year.
[1] The Economist, May 14, 2021. How much should you worry about the “Indian variant”? at https://mail.google.com/mail/u/0/?hl=en&tab=wm#inbox/FMfcgzGkXSVlxKjsmMXzFRQGbgnkkHph
[2] https://www.ndtv.com/india-news/covid-19-school-closure-may-cost-over-usd-400-billion-to-india-world-bank-2308868
[3] Read more at:https://www.deseret.com/coronavirus/2021/4/26/22403505/us-covid-herd-immunity-timeline
[4]Read more at:
https://www.asianage.com/opinion/columnists/180521/aakar-patel-govt-needed-to-have-grip-over-covid-that-is-what-pm-lacks.html
