India has hit a new high in terms of the rising viral caseload and with new variants and double mutations of the virus occurring, the hope seems only now on a much more speeded up vaccination drive and more stricter adherence to safety protocols. In about 80 days now since Indian embarked on its vaccination drive, nearly 80 million doses have been administered so far though the rate per day has been increasing with time, the expert view seems to be that we still have some distance to cover before we can take comfort. “India needs to vaccinate four to five times what is being done currently because we have a very large population. If the US is administering 3 million COVID vaccines a day, India should be doing 10 million a day if we have any hope of reaching people as quickly as possible,” says Dr Gagandeep Kang, a highly regarded medical scientist and the professor at the Christian Medical College, Vellore. She however is also very quick to remind that vaccination drive is just one factor to deal with the spreading virus, what is equally important, if not more, is people getting more responsible in adhering to the non-pharmaceutical interventions – the basic safety protocols of wearing face-masks and keeping physical distance. While she has been maintaining this consistently and emphasizing each time, there seems failures in practicing that seems to have triggered the current upsurge. What has complicated matters apparently is that this has happened at a time when the new variants have entered India and local variants are emerging leading to a further spiralling of the viral caseload. Now, with over 1 lakh new cases a day, the country has now been witness to the biggest-ever upsurge thus far.
What we need to do other than maintaining the safety protocols? Focus on vaccination drive and distribution and building the vaccine delivery infrastructure. It is not as if there are supply challenges, at least at the moment. Consider this: Serum Institute of India, which has been supplying Covishield vaccine, has till date manufactured about 210 million doses and of this, 91 million doses have been supplied to the Indian government and another 10 million under the WHO-GAVI initiative of COVAX. Apart from this, the company has supplied 64 million doses for exports. All of that still leaves the company with 45 million doses in stock / under testing. What is also important, the company intends to start making 100 million doses a month soon but by the time it comes into supplies it will be end of June and early July. Such data from Bharat Biotech is however still unclear and sketchy.
Lessons from Maharashtra
What seems to have triggered the developments in Maharashtra seems a combination of a presence of variants that are more transmissible than the ancestral strains and laxity in adherence to safety precautions, feels Dr Kang. She says “we still are unable to say whether the variants are more virulent or not and also about the resistance to vaccine because resistance to vaccines needs to be proven for different strains though it is clear that the immune response to vaccines is very good and it can protect against multiple kinds of variants.”
So, what is needed to address concerns around understanding the variants and dealing with them? “Right now, we need to do much more in terms of functional studies to try and understand the performance of variants in humans. We have imported variants and they are spreading and we have local variants too and those will spread as well. We therefore need to understand the performance of variants,” she says.
Again emphasizing on the maintaining the non -pharmaceutical interventions such as masking, maintaining physical distancing and pushing vaccines as quickly as possible to as many people as can be done, she says, “ultimately, it is people mixing with each other without adherence to the safety protocols needed to deal with COVID that really leads to virus spread and if the variant is highly transmissible then the virus will spread that much more easily.”
That there are elections in five states underway and religious get togethers too happening, there is reason to believe that unless safety precautions are maintained, more people will keep falling sick and wind up in the hospitals.
On vaccine supplies per se, Dr Kang sees a general problem with many vaccine companies, “they all over-project in the beginning but ramping up production takes time and even for the best players, there will be times when batches will fail.”