Amidst shortages in India unplanned Vaccine Plan stumbles

covid vaccine

The  second wave of COVID-19 pandemic  situation across the country is becoming alarming. With  nearly 1.52 lakh new cases  being reported daily (as on 10th April)  and  the  mounting death toll a calamitous health situation is emerging. Amidst this, various states reported vaccine shortages and   people are being sent home at the vacination centers. With  spike in  infections people started thronging vaccination centers and suddenly the demand soared. The two vaccine producers  viz. Serum Institute (Pune) and Bharat Biotech (Hyderabad)  are  struggling to meet the demand. This  clearly shows failure of  government’s lack of planning. Ironically the Centre seems to be in total denial about vaccine shortages in the country, and is blaming the states for mismanaging available stocks.

Sequencing of SARS COVID.2 virus  samples collected from patients revealed that  presently three  new strains are in  circulation among population- South African (B.1.351), Brazilian (P.1) and  double mutated (E4 84Q and L452R) Indian mutation. Spike Genes on the surface of the SARs  COVID viral surface  change their  behavior 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 Maharastra are infected by  double mutated Indian strain. However the second wave of pandemic is caused by the  last year’s same COVID 2 strain only. He attributes  alarming second wave  of infection is the  result of negligence and flaunting  recommended COVID  discipline in public places.

The fact is total production capacity of the manufacturers of Covishield and Covaxin,is is nearly 24 lakh vaccines a day. The current demand is 37 lakh vaccines a day. Daily shortage is already huge  touching 15 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 population  must be vaccinated. Till  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  times ahead precarious  with  subsequent waves of pandemic emerging from time to time with  appearance of new  mutant strains. Despite,  the government  appears to be complacent and in a denial mood  serious vaccine shortages. Instead of resorting steps to  ramp up  production of doses, union  ministers  started  blaming the  non BJP ruled state governments for mismanagement of stocks. Even the health ministry Refuses to share Information on rollout process of COVID-19 vaccines.

In the recent  virtual online meeting, chief ministers of some states complained about  serious  shortage of vaccines in  several districts across the nation  and they are forced to close  vaccination centers 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 invocated  “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 gulf between words our  ruling party leaders especially  Prime minister and Amit Shaw  preach to people and what they practice in real world. Despite the loud talk  of  Covid  behavioral discipline  both Prime minster and home minister addressed more than 35 election rallies  during the  ongoing state elections. Ironically  they were never seen  wearing masks, maintaining  physical distance. Added to this  neither election commission nor  home ministry  took note of  prolonged election campaign,  especially  spanning  6 weeks of   eight phased polling in West Bengal nor kumbha melas, cricket matches, opening up of bars and cinema halls  overlooking the  Covid threat. Instead,  prime minister became so complecent  with decline of cases in January this year and  boasted India’s victory over COVID, a model   for entire world.  Ultimately people  get the message and emulate the   political leaders and thus  public  adapted negligent  Covid  behaviour resulting in   alarming second wave of infection.

Recent 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  no single rupee was allocated in union budget  for  increasing hospital beds, ICU wards equipped with ventilators and oxygen supply, improvement of facilities in rural primery health centres. In the words of  Dr. Kafeel kKhan of Childrens hospital, Gorkpur ( who tried to save lives of hundreds of infants but instead   falsely imprisoned by U.P state government) ” 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”.

As the  recent data shows a vast majority of infected patients are in the age group of 18 to  45. Incidentally this is the working age  population  and constitute nearly 75 percent of 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  present vaccination drive must be extended immediately to this  younger working age gropu.

Fact is  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 accute as a  group of bureaucrats at the  PMO  have been put in charge of decision-making on production and distribution capacity across the country. On the one hand,  all the Union ministers ( honorable Health minister rarely speaks while all othe rministers   interfere) for the last   four months are actively engaged in electioneering in different  states.

Presently , Serum Institute shoulders nearly 90% of the vaccine supply and the rest  by Bharat Biotech. There is an urgent need to  ramp up production capacity   with both the  vaccine producers. They should be provided  special grants  and  other  tax benefits  to expand production  capacity to for  increased  supply of doses.  Government  should immediately negotiate and import  other vaccines from Russia (Sputnik), Pfizer, Moderna and Hohnson & Johnson.   Time is running out,  keep aside  boasting about  vaccine nationalism, vaccine diplomacy and  nothing is  important than  averting a  huge humanitarian disaster and saving 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 minster should immediately  invite   a meeting of all political parties, scientists, doctors  and  discuss the ways to  come out of the  Pandemic crisis.

 Dr Soma Marla,Principal Scientist, Genomics division, ICAR, New Delhi


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