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Bracing for impact: Strategically battling the second wave of infections

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Vaccine manufacturing is a complex process that needs high-quality assurance and tests for every batch.

By Amitabh Kant

With over 1.6 lakh new Covid-19 cases on April 12, India is witnessing a sharp surge in infections, which is greater in magnitude than what we had faced last year. Despite this, we have been able to control mortality. Our deaths per million remain among the lowest in the world—well below that in the UK, in the US, Mexico and Brazil. Even India’s cases per million population are among the lowest in the world. Our successful response to the first wave also gives us the confidence that if we come together as a country, we can stem the impact of Covid-19 on the health of our people and the economy.

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There is, however, an urgent need for renewed commitment, as states such as Chhattisgarh, Karnataka, Delhi, Tamil Nadu, Gujarat and Maharashtra cross historical highs in terms of daily cases. Both the central and state governments are working tirelessly, in partnership with the public and private sectors, to ramp up testing to at least 20 lakh tests daily and expand healthcare infrastructure—including beds, oxygen supplies, ICU facilities and critical therapeutics.

Alongside the surge in cases, we have also entered the third phase of our Covid-19 vaccination drive, with two approved vaccines: Covaxin and Covishield, and others in various stages of trials such as those by Gennova, Biological E and Zydus Cadila, which are awaiting approval, and Sputnik V, cleared by experts for use in India. In scale and scope, India’s immunisation drive is unprecedented in human history—we plan to vaccinate nearly 35 crore people by August 2021. Since the launch of the campaign on January 16, we have steadily ramped up coverage—with priority groups defined on the basis of needs and criticality—and on April 10 India became the fastest country to deliver 100 million doses.

Undoubtedly, our scientific and technical expertise, combined with our strong delivery capabilities—honed by the highly successful Universal Immunisation Programme (UIP)—across diverse geographical conditions, has enabled the successful engineering of the vaccination drive. Through the CoWIN platform, digital vaccination certificates are being delivered in real time on a scale unparalleled in the world.

Already, our national vaccination campaign is delivering an average of 40 lakh doses per day, the highest in the world, ahead of the US, even though our drive began a month later. To date, India has administered over 10 crore doses, of which over 6 crore people above the age of 45 have received at least one dose, 89 lakh healthcare workers have received at least one dose, and 98 lakh frontline workers have received at least one dose of the vaccine.

Our current policy to immunise those over 45 covers the age segments contributing to nearly 70% of Covid-19 mortality in India. As mentioned earlier, our pandemic control strategy is targeted at limiting severe disease and death, and is based on rigorous analysis of disease patterns in India. Our ability to vaccinate those who are more likely to be severely affected by the virus will also reduce the burden on the healthcare infrastructure, by potentially bringing down hospital admissions.

The priority groups identified in India’s vaccination drive are consistent with the World Health Organisation’s recommendations and the approach adopted by other nations, including the UK, the US and France. At the same time, we are also working towards expanding our vaccine manufacturing capacity to cover the populations at lower risk.

Vaccine manufacturing is a complex process that needs high-quality assurance and tests for every batch. Therefore, scale-up requires careful planning and execution to ensure that every dose is safe and effective. This is not an overnight effort. However, given the country’s vaccine manufacturing capabilities, we are well-equipped to increase production consistent with our immunisation objectives. The central government has focused on ensuring proper stocks and distribution of vaccines to all the states. It has also directed states and Union territories to bring down the vaccine wastage rate from the current 6% to 1%.

It is critical to understand that a vaccine is not an instant cure, and therefore it will not produce immediate results in the midst of a surge of cases; the effects of the vaccine are lagged in nature, and therefore citizens must understand that the vaccine has to be accompanied by Covid-appropriate behaviour for impactful results. As we wait for the vaccination drive to cover other segments of our population, we can effectively tackle the ongoing surge via other means—by increasing testing, ensuring stringent and efficient tracing, containment and surveillance, and focusing on promoting Covid-appropriate behaviours, such as mask-wearing and hand-washing. Masks are a social vaccine, which is available to all. They have been proven to work effectively to curb the transmission of the coronavirus. It is important to ensure that the mask-wearing mandate remains in place, along with other social distancing and hygiene norms.

In order to defeat adversaries, it is important to know them well, particularly how they behave. When it comes to a powerful adversary such as Covid-19, we need to deepen our understanding of how the virus behaves, for this holds the key to battling it effectively. This can be achieved through genome sequencing, which studies the changes in the structure of the virus over time. This will better enable us to understand the different mutations, their impact and how our strategies to control the pandemic, right from diagnostics to treatment, need to be adjusted and realigned to better tackle the spread of the virus.

Our immunisation drive aims to achieve herd immunity and until we reach that stage, we cannot afford to let our guard down in this fight. The next four to six weeks will be pivotal in India’s battle against Covid-19. All Indians who are eligible must get vaccinated at the earliest and adhere to Covid-safe behaviours. Together, we can cut the transmission of the virus. Together, we can win. We owe it to each and every Indian.

The author is CEO, NITI Aayog. Views are personal

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