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Vaccinate more, and faster

As India reports the second wave of Covid-19 infections, experts call for increasing the speed of inoculation and extending it to a wider population

March 2020 to March this year has been one the most difficult post-Independence years India has lived through. We all remember March 24, 2020, when at 8pm. Prime Minister Narendra Modi announced that to battle coronavirus disease (Covid-19), India would lock itself up. All movement, except for essential services, was restricted. People were told to stay home. Those who were moving out for essential services were told to follow Covid-19 protocols, which meant wearing masks, using hand sanitisers and maintaining physical distance. The 21-day lockdown was to break the chain of transmission, and also to give the country the time to ramp up its health facilities to tackle the most devastating pandemic in a century. The lockdown was eventually extended, in several phases, for 68 days.

Pay cuts and pink slips broke the back of the middle class, and as incomes dipped during lockdown.

The government did well to use the lockdown to improve its testing and medical management infrastructure. Central oxygen lines, ventilators and dedicated beds for Covid-19 were put in place even in the primary healthcare facilities. But, at the same time, lockdown brought tremendous misery to migrant workers, who lost jobs and, for lack of any transport, decided to walk back home. Pictures of men and women walking with their limited belongings and kids will remain the abiding image of the lockdown for many years to come. This period also resulted in an unprecedented economic contraction. Pay cuts and pink slips broke the back of the middle class, and as incomes dipped, more people had to fall back on social welfare initiatives of the government and non-government sector to fight the distress.

All this while, the number of patients was also on the rise. Experts would want us to believe that with the lockdown, the transmission would have been more rapid and fatalities far higher. One reason for low transmission could be the fear associated with the disease. People knew that if they tested positive for the infection, an ambulance will come along with police officers and take them to government hospitals for 15 days of mandatory isolation. The family would be quarantined separately.

But as the country began to unlock in a phased manner and the government decided to allow patients to be quarantined at home, the fear decreased. People became a little casual although they were still wearing masks and using hand sanitisers regularly.

Then the markets opened. Other things followed. The restaurants, gyms, cinema halls, schools and colleges. And people threw their guards away.

That probably is the reason for the second wave of infections. Arrival or emergence of more virulent mutant variants of the coronavirus is another reason. The good news, however, is that the vaccine is also here. India is currently using two vaccines against Covid-19 – Covishield and Covaxin. In February this year, only the health and frontline workers were eligible for the vaccines. The government allowed the first of the general public in March and allowed people at higher risk due to age (60 and above), pre-existing health conditions (for 45 and older) or their profession (health workers or frontline service staff) to get the jab. Till the time of writing this report, close to 50 million doses have been administered.

Studies show that in India, 62% of all infections have been among people below the age of 45 but because the fatality was 87% among people above this age, they were allowed inoculation first. From April 1, everyone above 45 will become eligible for the vaccine.

The country needs to speed up the vaccination and also vaccinate those people who travel for work faster.

As of now, the rate of vaccination in India is far greater than the spread of coronavirus infection. But, in the second coming, the infection is spreading at an alarming rate once again. Reports show that the rate of reproduction, called R0 and pronounced as R-naught, has reached its highest level since March-April 2020. The R0 tells us about how many health persons an infected person can spread the disease to. Currently, R0 also called the R-factor is 1.32. This means that one infected person is passing on the disease, on an average, to 1.32 healthy persons. In March-April last year, the rate was 1.83. It has been declining ever since but has gone above 1 again.

As India reports the second wave, reports of lockdowns in some parts of the country, especially in Maharashtra and Madhya Pradesh, force us to think if lockdown is the answer. The economic activity has already suffered much and at a time when the Mahakumbh in Uttarakhand is allowed, when crowds are turning out for political rallies in election-bound states, will it a wise decision to tell people to get locked in their houses again?

Experts said the only way forward is vaccinating as many as possible and quickly to cut the cycle. They suggest that covering about 10 million a day will ensure that the country has covered the entire vulnerable population within a month.

At least three states — Maharashtra, Punjab and Kerala — have urged the government in recent days to allow more people to seek doses and expedite deliveries. The latest of these appeals was by Punjab chief minister Amarinder Singh, who said the urgency deepened after the variant B.1.1.7 (first identified in the UK) was detected in 81% of samples taken from the state at random for genomic sequencing.

The country needs to speed up the vaccination and also vaccinate those people who travel for work faster. The elderly are mostly in the houses. If people going out for work get infected, the chances for the elders staying with them to get the disease increase manifold. India also needs to increase vaccination because it is only after about two months that a person who has received the jab becomes fully safe against the infection.

And, until that time, it is our responsibility to follow protocols. The protocols are as important today as they were in March last year. Please remember, the battle isn’t over yet.

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