New Year’s 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 it. Everyday decisions have suddenly become harder to make. Further, the uncertain and unexpected evoke 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, Covid management is considered an administrative problem. Moreover, the pandemic was declared a Central government responsibility under the National Disaster Management Act in March 2020, and comes under the jurisdiction of the Home Ministry, though the Ministry is not related to the management of the pandemic even remotely.
As a result, we haven’t been able to plan or implement Covid measures properly. For example, less than three months away from our July 2021 vaccination deadline, India has only reached 14% 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 the goal of a Corona-Mukt Bharat for its endurance before the end of this year. For this, India has to vaccinate the entire population aged between 5 to 64. It is feasible, manageable and essential for India’s survival.
The article suggests a mechanism to achieve it.
In mid-March 2021, India believed that it was already past the worst of Covid-19 and the focus had largely shifted from containment to vaccination. The world was looking up to India’s production capacity for a steady supply, especially to 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 middle of a devastating second wave.
Every day since April 25, India has had more than 40% of the global coronavirus cases. On some days, it has crossed the 50% mark as well. India also reported more than 30% 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 the 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, also 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. 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 the pandemic has also hit India’s nascent economic recovery. Till now, there has been no official estimate of the impact of the second wave on the economy. Private forecasters have, however, made assessments of the damage, 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 the second wave. Many states are reporting a shortage of hospital beds, oxygen supply, medicines, and even space in morgues. Further, the prolonged closure of schools due to the pandemic in India may cause a loss of billions of dollars in the country’s future earnings, besides substantial learning losses, according to a World Bank report.
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 — and not just those who are immune. For this, many people are vaccinated to gain immunity against the disease.
Dr Francis Collins, Director of the National Institute of Health, USA, recently said, “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 70-80% of the population needs to be vaccinated in order for it [herd immunity] to happen.”
So far, India has vaccinated 14% of the total population. On the other hand, the UK and USA have vaccinated 56% and 48% of their respective population as on May 20, 2021. The US and UK could reach herd immunity soon, as per Dr Collins. .
In order to achieve herd immunity, India has to vaccinate around 80% of its population. For this, India has to cover the entire population aged 5-64 that is around 112 crore on the priority basis. This includes the working population as well as the school- and college-going population. For the senior population that is 65+ years, it will be optional for the time being. However, a sizable proportion of the senior population has already been vaccinated.
India has already administered over 20 crore coronavirus vaccine doses by May 26, 2021, as per the MOHFW. India, therefore, needs an additional 205 crore doses to fully vaccinate the entire target population — this means around 95 lakh doses every day between June 1 and December 31, 2021. And India has to trace a 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.
The Government of India can increase the supply of vaccines by taking certain steps:
Ask vaccine manufacturers in the country to manufacture the vaccine using the formula developed jointly by Bharat Biotech and ICMR,
- Allow all foreign vaccines to be used in the country,
- The Centre, instead of the states, should buy the vaccines,
- Foreign Covid vaccine manufacturers should be allowed to manufacture vaccines in India, and
- Provide financial and other help to companies in India and outside to make vaccines in India.
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, what may be required in the future and being conscious of what events to anticipate, wrote Aakar Patel, a senior journalist.
Further, the problem of the pandemic cannot be approached through the Central government’s 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, decision-making is often the purview of a few people and sometimes, of just one person.
Vaccinating the target population before the end of the year will require a management approach. For this, creation of a national task force under an eminent epidemiologist in the likes of the US’ Anthony Fauci can prove to 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 10-member national task force headed by a known epidemiologist. Other members may represent disciplines such as management, medical, economics, public administration and sociology, among others. This full-time high powered task force shall take all 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 centre-wise vaccination 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.
Finally, but importantly, all controversial issues like the farmers’ bills and CAA need to be put aside and priority should be 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 power that be).
In sum, recognise that the virus has a long-term survival plan of its own and continues to generate its variants. But it does not mean that one should stop trying to win over the virus. Vaccines may indeed be the miracle weapon that win this battle. So, India must focus on vaccinating the target population on or before the New Year’s to 2022 . And, India can do it.