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