Shri Rajesh Bhushan
Union Health Secretary

Dear Shri Bhushan,

While we are about to conclude that we longer have to feel concerned about a Covid surge for the third time, the discovery of Omicron and its own mutants with high rates of transmission in many parts of the world has put to rest any such feeling of comfort. Are we taking the necessary preemptive measures to make sure that this variant, and similar other variants which may evolve in due course, do not create a crisis situation once again?

There are a few aspects of Covid management in India that cause concern.

While a fairly large proportion of the adult population(80%) in the country has been covered with the first dose of vaccination, the proportion covered with both the doses is only 38%, a gap as wide as 2.1, compared to much lesser gaps in the case of several other countries. This implies that 62% of the adult population in our case stand exposed to getting infected. This leaves out persons less than 18 years old, pregnant women and children who will remain more all the more vulnerable. By the time the new virus mutants infect the population, the resistance acquired by some through the first dose may have worn off. Had we planned vaccine procurement well in advance, the situation would have been far more comfortable.

The policy adopted by the Centre to allot 50% of the vaccine doses in the first instance to the private sector for distribution, later reduced to 25%, not only created an avoidable price barrier for the poor but also allowed the private hospitals to hoard the vaccine doses, indirectly depriving a corresponding number of the people not being able to benefit from the vaccine. While most other countries are vaccinating the people free of cost, in India, even poor people are forced to pay for the vaccine provided by private hospitals.

I understand that despite the best efforts of INSACOG to ramp up the genome sequencing of virus samples, less than 1% of the samples collected during testing in India have been subject to genome sequencing. Considering that the sample size is far too small, the confidence levels at which we can detect the new variants remain low, a situation that should cause public concern. Covid has been with us for more than one and a half years and your Ministry, in close consultation with the Department of Biotechnology, could have ramped up the capacity for genome sequencing levels that match the requirement. Such capacity building would not go waste, as genome sequencing is necessary for a wide range of viruses.

Even though RT-PCR testing is the most accurate among the tests available today, the fact that its accuracy is still around 70-80% implies that many infected cases could slip out undetected even through the RT-PCR screen. Added to this is the low proportion of the samples put to genome sequencing and the large proportion of the adult population standing exposed to the virus. As a result, the probability of the new mutants appearing undetected and then spreading rapidly in the country seems to be high.

Against the above background, there is no escape from reimposing severe restrictions on international passengers entering India, especially from the African countries, UK, Israel, Singapore, Hongkong, Australia and possibly a few more countries where Omicron has appeared. RT-PCR testing and quarantine may have to be made mandatory for travellers who have touched base with those countries recently.

Within the country, it is disturbing to see large public gatherings all over the country, especially pre-poll rallies and public events often attended by very senior public functionaries, unmindful of the Covid precautions.Such public figures should know that they are endangering the lives of thousands of people. From the public interest point of view, your Ministry should ask the Union Home Ministry to invoke the provisions of the disaster management law and restore some order to prevent the people from being once again exposed to a possible Covid surge.

Also, it is imperative that the government mobilises all its resources to enhance the domestic genome sequencing capacity to make sure that we do not miss detecting the new mutants and understand their transmissibility.

During the second wave, while the government hospitals were overcrowded, it was the private corporate hospitals that exploited the crisis and fleeced the poor and the rich alike. Your Ministry, in consultation with the States, should bring in stringent regulation of the amounts charged by the private hospitals for medicines and treatment. This is an emergency situation and such regulation cannot be avoided.

I request you to take these measures at the earliest so that we may not witness the kind of chaos that was seen during the second wave.


Yours sincerely,

(Former Secretary to Government of India)

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