How Indian government lack of interpretation, management, and decision directed the second wave f Covid-19.
In March, a few weeks before the second of Covid-19 hit the India, the health minister of India : Harsh Vardhan stated that;
We are in the "end game" of the Covid-19 pandemic in India and succeed at this stage! justifying to the media for his government decision to export the medical resources to other countries where the India's oxygen exports doubled in January 2021 with 9,000 metric tons of oxygen. On top of that, India also exported around 193 million doses of vaccines.
But the tables turned, when the picture changed dramatically when India saw drastic increase in new cases from April which crossed 378, 000 cases a day and with more than 200,000 reported deaths which are just an estimated numbers according to experts. Newspaper is mounted with the shortage of hospital beds, drugs like Remdesivir, health equipment like oximeter and black marketing of drugs & vaccines. The deteriorating phase of second wave of Covid-19 came due the poor government decisions which took the whole nation in series of 4000 days everyday.
The Lancet - a popular science journal, published the article on 8th May stated;
"At the federal level, India's vaccination plan soon fell apart. "
Before the second wave of cases of COVID-19 began to emerge in early March, government were living in the illusion of beating Covid-19 after several low cases from January, and overconfidence of health minister declaring it as a "endgame" despite repeated warning from the Srinath Reddy, president of the Public Health Foundation of Indian and he ferociously stated that;
"We completely let down our guard and assumed in January that the pandemic was over—and COVID surveillance and control took a back seat, , ignored warnings of a second wave, despite the fact that new variants were identified as far back as in January"
Poor Vaccination Drive:
India is facing a major internal shortage of vaccines today which is paradox to everyone! Because India entered the initial pandemic with the vaccine advantage of being the one of the largest suppliers of vaccines in world with the capacity of producing 1.5 billion to 2 billion doses a year. Even after the 4 months launch of vaccination drive, it has managed to just inoculate 3% of the population while 10% of the people have received one shot each. While in US, almost 47% population had received the first dose and 36% has received both doses of vaccine. In UK, 54% have took their first shot of vaccine and 28% are fully vaccinated with second dose.
There are three consecutive factors which encompass in shortage of vaccines and poor vaccination plan.
1.) Lack of capacity:
The vaccine holders of India- Bharat Biotech & Serum Institute are facing the shortage of manufacturing capacities. In December 2020, Indian government had announced to vaccinate 30 crore Indians by July 2021. To get fully vaccinate, it requires two doses, so total it needs 60 crore doses of vaccine in 6 months. And if we consider the vaccine waste, the average wastage is 6.5% according to Indian Institute. Estimate it needed 64 Crore doses in 6 months from January to July. So each month, India needs to produce 10 crore vaccine per month!
But both the vaccines companies has the manufacturing capacity of only just 75 million doses ~ 7.5 crore. And it will extended to 11 Crore till July. And the 7.5 crore doses are not fully produced for India, 40% of the doses are exported to the COVAX agreement from WHO & Unicef. Therefore, many experts claim that the target of the government to vaccinate 30 Crore Indians has blown away very badly!
And because of high demand of vaccines in India due to second wave of Covid-19, Serum Institute is lagging behind in fulfilling the COVAX agreement and because of that, AstraZeneca sent the legal notice for vaccine supply delay to Serum Institute.
The Russian vaccine Sputnik which is recently approved by the Indian Government which would be available from May 2021 , it cannot change this deadly situation early soon because it has only capacity to produce 50 Lakh per month only .
Lack of Order:
From hindsight many would think, that the vaccines companies are responsible for the lack of capacity for vaccines manufacturing. How government is responsible for this? Government can help this companies manufacturing capacities by booking the advance orders. By advance orders, companies get the advance cash from the government from which it can extend its capacity to increase the manufacturing of vaccines. US and other European countries executed the same for the vaccination drive.
The US government launched Operation Warp Speed, committed almost $10 billion develop vaccines before their supply to the renowned companies like Pfizer, Merck, Johnson & Johnson and Moderna, which gave guarantee to the US to get the vaccines after their production. By September 2020, it had promised to buy 800 million doses with options for another 1.6 billion. The government bought doses from all companies whose candidates were in phase 3 trials at the time.
Confusion between Government & Vaccine Producers:
But, as India is developing country it can be understood that it has no enough funds to invest in vaccine companies. Although there are many theories like Serum Institute is receiving a lot of money already from elsewhere to equip itself. But CEO of Serum Institute Adar Poonawala stated that haven't extended their manufacturing capacity because "there were no order from Indian Government". Due to lack of funds, it caused an adverse effect on India's Vaccination Drive. The second reason can be that India thought of Corona to be ended and therefore initiated the "Vaccine Maitri" to export the vaccines vigorously to other countries.
Due to this illusion of Covid-19 ended , from January to April, India has exported vaccines more than vaccinating its own country and waited till January to pre-book the advance order for vaccines. First order was placed in January for just 1.65 Crores doses and February orders also were around 1.50 Crore doses. In March, when the second wave badly hit India, it has placed its first major order of 12 crore doses.
Terrible decision on Vaccine export:
On January 20, Vaccine Maitri Programme was launched by the Modi Government which initiated the export of two Indian Vaccines - Covishield and Covaxin. On that same day, India recorded 14,112 fresh cases of Covid-19. India exported around 6.6 crore doses of Covid-19 vaccine to 95 countries in which 1 Crore were from government grants, 2 crore doses were sent as part of the global Covax facility and the remaining 3.6 crore were sent as commercial exports.
India’s "Vasudev Katumbakam" policy, resulted to the stage where the gap between two doses of Covishield was 4 weeks, then 6–8 weeks and now 12 weeks in its own country! What is the advantage of “Vaccine Maitri” when its own people in India could not get the vaccine?
States responsible for Vaccines Imports:
India vaccination drive became more complicated when central government decided from May 1 to decentralize the vaccine procurement which is big bottleneck in supply chain. This will affect the private healthcare providers and state governments to manage practically on their own in managing the procurement of vaccines. State health ministers also claimed that the central government had not discussed before asking states to procure the vaccines. Lack of transparency and conflicts in the strategy which is creating the havoc between states!
Poor vaccination strategy, conflicts and sheer overconfidence of government has made the public suffer badly. Till July also, third wave will hit the India due to the slow vaccination drive which will mutate the virus in future. Now, India is importing the foreign vaccines from US, Russia and UK which should have done earlier!