Covid - Handle The Second Wave As An Emergency

 The fact is that at the pace that we are vaccinating - 1.5 million daily - it will take us, according to Bloomberg, three and a half years to vaccinate 75 per cent of the population and reach herd immunity. The US is targeting September 2021. If we target only those over 18 years, it will be close to two years.

The fact is we cannot wait that long. The second wave in Maharasthra, other states and a third wave in Delhi, Haryana and the like would have consequences that are too severe to imagine. The Indian medical system would be stretched to the limit and shutdowns and curfews would devastate an economy that is just about emerging from its worst year in decades. Any more closures, restrictions and slowdown in consumer spending would break the back of most MSMEs and lead to mass unemployment.

Unless we realise that we are in an emergency situation, we will not be able to reach herd immunity this year. If we assume that the population under 18/19 doesn't need to be vaccinated for the moment, to reach 75 per cent of the balance population we need to vaccinate about 550 million people, with two doses for the most part. That means we need 1.1 billion shots (less if we get the single shot Johnsons and Johnson vaccine). How do we do that?

Isn't it time that the rules for vaccination are changed? Why should private hospitals only vaccinate 200 people a day? Large hospitals could easily manage four times that number quite safely.

How else the government can speed up the vaccination process:

1. Add more hospitals and more patients per hospital.

2. Open up the age group to everyone above 45 now and then above 30 when production hits 200 million vaccines.

3. Allow private sector to purchase the vaccine at market rates and vaccinate its staff.

4. Extend the period for the second shot from 4-6 weeks to 8-12 weeks which WHO considers to be that a safe timeline. This would boost the number of people with at least one shot.

5. With many states having allowed stock to expire, we should have open days for all when vaccines that are expiring in the following week are available to anyone. A number of states and private organizations in the US are doing this to avoid waste.

6. The armed forces have a huge medical corp. Like the US use them and other trained army personnel to help with the vaccination drive, every cantonment can act as a nodal point. Also, given the credibility of the forces, more people may take the vaccine.

7. Should we be open to geographic and occupation-targeting for vaccination?

The last point raises many ethical and political questions. Ethical issues from job-related criteria are always there; is someone like a lawyer (since this issue is on in court) more likely to catch Covid and so should be vaccinated first? Why not scooter or taxi drivers, or air hostesses and airport staff? In the US many states have included supermarket workers in their key list for vaccination. In India, with more than 60 million retail outlets, this would open a Pandora's box.

And on geography, do you choose areas of high cases, or urban areas which are more prone? Does this work against states that have managed to control the virus better? The easy answer may be to target high case areas, but then it would need a big concentrated vaccination of say Pune, over short period. But will that stop the virus from escaping into the neighbouring towns?

The fact is that people have dropped their guard. People a weary of lockdown, of social distancing, wearing masks, and have started to mix much more frequently without any protection. Testing, tracing and general government follow-up has also fallen. It's time to play hard ball again. Unfortunately, unless we resort to fines and 'no fly lists', people will continue to ignore many of the rules; railways should also implement this.

More positively, Bollywood and our cricket fraternity should turn out and encourage people to take the vaccine. Politicians should be told to go to their constituencies and rally people to take the vaccine.

Finally, unless we treat this current resurgence as a national emergency and pull out every stop to get the virus under control, we will lose the battle. New mutations are happening and already, the government is reporting an increase in the UK, South African and Brazilian mutations. If these spread faster than we can vaccinate, then even the vaccinated will be at risk. We are a few days away from the anniversary of the start of the lockdown. Let's hope we don't have a repeat this summer.