Ujjain: Even as we battle the massive wave of covid-19 infections, it is important to take steps to avert the next such wave.
The first and foremost towards averting another Covid-19 wave is much larger and faster investment in vaccine manufacturing than currently planned. Scaling up
Covaxin production to 100 million units per month by July would be too little too late. Boost production capacity to at least 500 million units per month. Production license may be given to other credible and qualified manufacturers.
If necessary, the government must use public funds to buy full ownership of the patent on Covaxin at a reasonable price from Bharat Biotech. It should then mobilize multiple manufacturers to go full speed. It should also invest in rapid expansion of other vaccines such as Covishield.
Analysis of district-level data shows that our current vaccination strategy has done a poor job of prioritization. As on April 21,2021, top 40 districts by the number of active cases accounted for 52% of the cases but received only 21% of all jabs.
Arvalli district in Gujarat with 397 active cases administered 2,70,000 vaccine shots while Latur district in Maharashtra with 16,732 active cases administered 2,10,000 shots.
Turning to the strategy for the administration of vaccines, we need to recognise that the recent decentralization of purchase and allocation of vaccines has been a mistake
Unless we achieve heard immunity there is no way to protect India from the most intelligent, elusive and ever changing Covid-19.
So, what is herd immunity? To make this clear, we need to look at the so-called reproductive number R of the virus. The reproductive number is the number of people to whom a single infected individual transmits the disease on average. If this number is larger than one, the virus can spread, and more people become infected. If it is smaller than one, the number of infected people declines. We can reduce this number, for example, through physical distancing or contact tracing
and isolation of contacts. However, this requires ongoing action. As soon as we stop, the reproductive number goes up again as happened with election ralies and Kumbh.
A permanent solution is immunisation of a large part of the population i.e. at least 70% of population needs to be vaccinated, as soon as possible [ within 3-4 months]. Otherwise SARS COVID-2 will infect almost 90% of population and will lead to an uncontrollable epidemic. That means nearly 120 crore will be infected eventually 10% will need hospitalization i.e. 12 crore and at least 1.5% of them will succumb to death Out of them 70 to 80% will be poor.
"The strong do what they can, the weak suffer what they must," is a perfect metaphor, for our healthcare system in this hour of crisis.
Author Dr VK Mahadik is Medical Director,
RDG Medical College Ujjain