From the beginning of the COVID time it was apparent, that the only sustainable check would be vaccine induced protection. Unfortunately the GOI bungled big time, as demonstrated in the following timeline of events.
No orders were placed with any of the companies who had demonstrable results in Phase 1 & 2 trials by August ’20. Instead the ICMR partnered with Bharat Biotech, a manufacturer with a limited capacity of under 50 lakh doses per month whereas demand, at 100% coverage of the 18+ population, is 200 cr shots. The largest vaccine manufacturer in the world is Serum Institute and they tied up with Astra Zeneca to develop, test and produce, a yet to be proven COVID vaccine using their own funds and funds from GAVI, an international consortium,
By November’20, four vaccines (Moderna, Pfizer, Astra Zeneca and Sputnik 5), had completed Phase 3 trials with encouraging results. It was quite clear that vaccination would start in December’20.
Switch now to the prevailing scene in Bharat with the yet-to-be-titled ‘Vishwa Guru’, the Supreme Leader (‘SL’ in short), at the helm…..
In the first week of December ’20, both Pfizer and Astra Zeneca (Covishield) applied for emergency use approvals. Pfizer’s application was discarded rather hastily on the grounds that there had been no trials conducted in India. The fact that millions of people in other parts of the world were going to receive this vaccine was not good enough for us …the babu and our SL really had it in for the ‘white man’ for getting ahead!
Serum Institute announced that they had stockpiled enough vaccine raw material to produce 5-6 cr doses and could produce 5 cr per month. We could have started our vaccination drive by mid-December ’20 but emergency approval for Covishield came only on Jan1st. In a master stroke by Atmanirbhar Bharat, approval was given to Bharat Biotech’s Covaxin vaccine despite only Phase1& 2 trials having been completed on it. The drive started on January 16th targeting 3 cr frontline workers.
At this stage there was a convergence of several factors that resulted in the ’perfect storm’….
# On Jan 21st. the SL announced, at no less a forum than the WEF at Davos, that we had defeated Covid! In early March the Union Health Minister, a doctor himself, declared that ‘we are in the endgame of the COVID-19 pandemic in India’. Simultaneous to all this macho ‘ 56” chest beating’, our SL decided it was the ideal time to substitute hugaloo diplomacy with Vaccine Maitri (friendship). 6.6 cr doses were exported and 90 countries received this friendly jab from us
#Sometime in Feb, research from the inventors of Covishield indicated that there was a significant increase in efficacy if the duration between the two doses was increased from 4-6 weeks to 10-12 weeks. Our masterminds decided to stick with the 4-6 week gap recommendation.
Unfortunately, with the rapid spread of a virulent UK variant coupled with our home grown B.1.617 strain dark clouds were clearly visible for those with their eyes open. The SL and his cohorts were still in a state of euphoria over the great ‘victory’ so all energy was spent on politicking…. promoting large scale religious gatherings instead of gearing up production of the vaccine and the vaccination drive. In mid-March, both vaccine producers asked for funding to ramp up production but this was sanctioned only in end April in the form of an advance for only 16 cr doses, the anticipated order for May, June and July. Why not five times this amount so that the manufacturers could really start expediting production?
# The MASTERSTROKE …..
By mid-April the Indian variant (B.1.617), had spread exponentially in the country leaving a devastating trail of deaths. There was an inexcusable collapse of medical facilities and supplies in most major urban centres leading to many more people now seeking and accepting the vaccine as a necessary protection.
In early April, with the 45+ now eligible, the daily vaccination rate went up to 35 lakhs per day. For a person with any intelligence it would be apparent that if one just followed this current rate the demand would be 50% more than supply. So what do the geni-asses in charge of our programme announce…..the opening up of vaccinations to all 18+ citizens!!
Free vaccination was to be limited to the 45+ even though the budgetary allocation of Rs. 35,000 cr would leave a surplus of Rs. 9000 cr if all 90 cr were covered.
Furthermore, the Centre ordains that each State has to buy/procure their requirements directly from the manufacturers at whatever price they can negotiate as they compete with each other. Also, they decided to remove the condition of testing in India for allowing ‘foreign’ vaccines to be used on our great Atmanirbhar populace. However, not unsurprisingly, there are almost no vaccines available in quantity till the end of the year!
.It is entirely possible that both manufacturers are honorable men but as entrepreneurs if you have orders at different price points and quantities, you have the power to pick and choose. Obviously all private sector orders would get preference and after that, they can ‘play god’ with the States.
Confusion has been further confounded by directions to the States to concentrate on coverage of the 45+ (who measure only 30% for the 18-45 population). This has been followed by the ‘advice’ that now the gap between Covishield shots must be 12-16 weeks.
THE WAY FORWARD
Remove all officials/politicians who have been associated with this botched mission, particularly all those responsible for the lack of oxygen and other medical facilities.
Reprioritize the vaccination drive. Assess whether the 12-16 week gap is appropiate as the UK has REDUCED the gap to 8 weeks in view of the virulence of the B.1.617 variant. Complete the 45+ group with the gap increased to 8 weeks..
A new priority list must include all shopkeepers, drivers, sales persons, delivery staff, domestic workers, post and bank staff and others whose work involves public contact.
GOI must procure and distribute the vaccine free to all States.
Immediately revamp the entire process of administering the vaccination. The Cowin app is completely elitist and not suitable for at least 70% of our people who do not have a smartphone and are not net savvy. To add insult to injury the app is in English only ……to be Atmanirbhar it has to be available in at least eight regional languages. .
Allow 1000 registrations per mobile number instead of the current four. This will allow a single person to assist a whole community. Simultaneously allow on-the-spot registration at the vaccination centre.
Currently we have a supply problem but anecdotal evidence from slum dwellers and rural people in the hinterland indicate that awareness of the vaccine is low, and many are afraid to take the shot because of unfounded rumors. An intensive communication campaign to allay fears and emphasize the benefits, needs to launch in the next 4-6 weeks so that the marginalised communities are not left out once again.
It is also evident that a booster shot will be required more sooner than later and this has to be part of our calculations.
We need to plan for the approximately 40cr doses for 2+ year-old children of our nation so that we are not caught completely exposed and vulnerable a second time around.
Koko Singh is associated with Atmashakti Trust, a NGO working with tribals and Dalits in Odisha
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