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Combating Covid: India doing better than most

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New Delhi, Dec 3 (Agency) Of Indias 1.4 billion people, the worlds second-highest population, 1.25 billion have received their first inoculation against Coronavirus, while 38 per cent have received both the shots.

Preparations are fully on to vaccinate children, even as the world faces this unprecedented pandemic acquiring newer and possibly more dangerous strains.

Undoubtedly, much more needs to be done. Vaccinating such a large mass of people inhabiting a territory of subcontinental size has not been easy, even more so because democracy demands transparency and cooperation between the Union (Federal) government and governments in the states (Provinces) ruled by parties of differing political hues. A lot remains to be done, though.

Knocked about like others when taken by surprise, yet, India has done better than most other nations, all of whom are afflicted by Covid-19 that has acquired pandemic proportions for over 20 months now.

The key take-away is the vaccination drive, and India has been lucky and happily-placed, being the world’s largest producer of vaccines of all types.

Its expertise and infrastructure in place, India had no major hitch in rolling out huge quantities of vaccine doses once AstraZeneca was invented in Oxford, the UK. India went into overdrive in producing this under the British licence. The numbers enabled it to launch a domestic drive and also sell and gift vaccines to several countries. In doing so, it met its obligation as the larger nation in South Asia and one that honours friendly relations.

Needs of smaller and weaker nations in the neighbourhood were given special attention. India gifted large quantities to Bangladesh, for instance, and also engaged in contracted sales.

Not resting on Covishield, the Indian name for AstraZeneca, Indian laboratories and medical enterprises joined the global race for developing more and more vaccines. The result was Covaxin, produced by the government-run Bharat Biotech. It has received worldwide approval and those who have availed both the shots can travel to most counties.

To achieve large numbers, there has been extensive planning and related exercise to reach the vaccine across the country, right up to districts, towns and villages and to hospitals and clinics, where millions have lined up. As many as 7.2 million people received the jabs on a single day on November 16, for instance, during the 9 am to 7 pm routine.

This has been possible also because the private hospitals and clinics have opened significant parts of their facilities exclusively for administering Covid vaccines, keeping them well sanitised and secured from people with other ailments.

But above all, full credit is due to the healthcare workers — doctors, paramedics and support staff — who have worked tirelessly for months on end. Sadly, but inevitably, many succumbed to the disease they desperately, but diligently, sought to arrest. Their families have been compensated.

The countrywide vaccination drive was rolled out on January 16 with healthcare workers getting inoculated in the first phase. The vaccination of frontline workers started on February 2. In New Delhi, the national capital, it began on March 1.

The next phase of Covid vaccination commenced from March 1 for people over 60 years of age and those aged 45 and above with specified co-morbid conditions.

The country launched vaccination for all people aged over 45 years from April 1. The government then decided to expand its vaccination drive by allowing everyone above 18 years to be vaccinated from May 1.

The daily vaccination tally is expected to increase. The Serum Institute of India, the world’s largest vaccine manufacturer based in Pune, has just sought clearance for mass production of a vaccine specially being readied for minors, especially children. It has been named Covovax.

Serum Institute CEO Adar Poonawalla has said: “Covovax should be available in six months. (The) trials are on… no safety issues so far. We have gone down to the age of seven (with) good results…”

“Our approach will be to vaccinate children right down to the age of two with Covovax,” he said, adding that there is “a lot of stock of Covovax” and that these would be available — in India and to the world — on receipt of regulatory approvals.

“Covovax, which is called Novovax in the US and select European markets, is seeing delays worldwide in regulatory procedural approvals, so there are some delays (in the vaccine being released for India’s vaccination drive),” Poonawalla explained.

“For now, we do not want Indians to get stuck with Covovax as it has not got approvals worldwide for travel purposes. So, adults should take Covishield as it is acceptable worldwide,” he added.

N.K. Arora, Chairman of India’s Covid task force, told a news channel that vaccination for kids with comorbidities would begin sometime in December. Healthy children could expect vaccines sometime in the first quarter of 2022, he added.

In August, the Drug Controller General of India had approved Zydus Cadila’s three-dose vaccine ZyCoV-D for use on children over the age of 12. The company had then said that it plans to manufacture 100-120 million doses annually, and had started stockpiling.

ZyCoV-D (which is yet to receive emergency use approval from the World Health Organization) was found to have 66.6 per cent efficacy in a late-stage trial of over 28,000 volunteers worldwide.

And in October, Bharat Biotech’s Covaxin became the second vaccine approved for kids (between the ages of two and 18) in India. However, as with ZyCoV-D, safety and efficacy data for children are yet to be released.

Equivalent data for adults show 77.8 per cent protection, a Lancet study said. Covaxin received WHO approval in November 2021.

When cleared, Serum Institute’s Covovax (or Novavax) will be the third vaccine for kids in India. So far it has been trialed on children in two groups – between two and 11, and 12 and 17, — and, like ZyCoV-D, it has not yet got the WHO’s stamp of approval, although it has been cleared for use in some countries.

India is aiming at full vaccination, even as new variants that cause concern have been detected. November has seen a small uptick in Covid cases, even as AY4.2, a Delta variant sublineage, is slowly increasing in proportion to reported cases in the U.K. But it is so far “very infrequent” in India, as per the Indian SARS-CoV-2 Genomics Consortium (INSACOG).

In other words, the Delta variant, first reported in India last year and responsible for the staggering number of daily cases and deaths this year, is still the dominant variant.

According to WHO’s weekly epidemiological update of November 9, the Delta variant has become globally predominant and “outcompeted other variants” in most countries; 99.6 per cent genome sequences posted on the global database are Delta.

The nearly month-long door-to-door vaccination campaign across the country this month to reach out to people who have been unable to access vaccines is, therefore, a welcome step.

As proven in the universal immunisation programme for children to deliver polio vaccine, outreach programmes have a greater rate of success immunising the target population and in overcoming hesitancy and complacency.

All proven and innovative methods need to be deployed to drastically increase vaccine uptake if India is serious in vaccinating everyone above 18 years by the end of the year and before a new variant emerges. The ‘Har Ghar Dastak’ vaccination drive has been extended till December 31 amid Omicron threat.

All this calls for greater vigilance, with curbs as and when necessary on travelling, public gatherings, schools and colleges where the young are most vulnerable, the hospitals that must cater to people with other ailments and an overall maintenance of social distancing.

There have been phases of concern, even causing alarm. But overall, the situation remains under control. But there cannot be a lowering of the guard. Indians cannot afford it for their own and larger good.  (Agency)

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