A good recovery from disastrous second wave
Complacency is spreading about Covid conquered
India is good at dealing with crises when a monumental effort is made to focus minds on a single short-term target. It has problems however with staying focussed and with continued standards of delivery and quality.
That is the story of the country’s impressive achievement of delivering 1 billion Covid vaccinations, which was reached yesterday (Oct 21) with 75% of the 1.4 billion population receiving the first jab. China reached 1 billion in June and has now delivered 2.2 billion.
A second jab has however only been accepted by 30% of India’s eligible population. That is mainly because there is a widespread lack of interest after the first dose and also, probably, a lessening of official interest in driving the delivery. The average daily jabs’ figure has gone down from 8.4m in August to around 5m.
“People say to me ‘Covid has gone so I do not need a second jab’,” says Dr Randeep Guleria, director of AIMS, Delhi’s biggest hospital and a pandemic expert. “It takes a lot of convincing….we need to establish with people that one shot is not enough”.
Some states have been distributing gifts to fully vaccinated people. In Gujarat, free medical kits and ropeway rides have been to those who have both doses.
Like prime minister Boris Johnson, who recovered politically from Britain’s disastrously unfocussed government performance on the first wave of Covid last year with an efficient vaccination drive, so Narendra Modi in India can boast about the one billion jabs after political indifference, government inefficiency and an appalling health system led to a crippling second wave early this year with hundreds of thousands of deaths.
As one report put it this morning, “after months of acute shortages, a raging second wave, an opaque system of placing vaccine orders and technical glitches, India finally seems to be on track to at least partially inoculate its adult population by December”.
For Modi it is good politics – his photo adorns every vaccination certificate and he has been involved in extensive publicity in the past 24 hours, including a broadcast that has ignored earlier problems. On September 17, a daily record of more than 20m doses was reported to mark his 71st birthday.
Such feel-good publicity diverts attention from killings in Kashmir and Hindu-Muslim unrest elsewhere in the country, and an arms build-up on the Himalayan border with China.
With a total of 34m Covid cases, more than 450,000 people have died in India from the pandemic, according to government figures that are widely believed to be considerably under-stated. Total deaths have been estimated at one million and more.
It will now be difficult to rebuild the drive and focus that enabled the billion jabs to be achieved at an average of 3.6m a day since they began last January.
Extensive co-ordination has been needed stretching from the prime minister’s and state chief ministers’ offices, and the Serum Institute of India (SII) factories where most of the vaccinations are produced, down through state organisations, hospitals, medical centres and charitable and other volunteer organisations and local village helpers.
“It’s a huge step making a cold chain from the manufacturer to the site of delivery,” says Guleria. A billion syringes and needles were needed along with trained manpower to deliver and monitor any acute adverse reactions.
Logistics solutions have included drone supplies to some remote locations. IndiGo, the country’s leading private sector airline, is reported to have carried some 1,700 tonnes in over 4,500 flights, 68% of the total vaccine doses.
Persuading people to accept the jabs has been a major problem with widespread rumours throughout this year on social media about the risks that range from simply becoming sick to blood clotting and infertility. Guleria says that people were waiting “for some six months to watch for side-effects” among those who were jabbed.
The Serum Institute is now producing 220m Oxford-AstraZeneca vaccines, known in India as Covishield, a month. The ceo, Adar Poonawalla, expects this to rise to 370m by January. The company would by then be able to build up exports that were stopped by the government earlier when supplies were scarce in India.
Ultimately, the success depends on what the telecoms industry calls last mile delivery, which is a challenge in India with 60-7% of the population living in rural areas, many of them remote locations where there is frequently mistrust of officials.
“We belong to the same tribal (Mayalali) community as the residents in these (Jawadhu) hills. It bonds us. It also makes them trust us,” 52-year-old T. Chennammal, one of three volunteer health nurses in a remote area of Tamil Nadu, told The Hindu newspaper.
Chennammal and her fellow nurses have walked miles on pathways to remote villages, administering vaccines for plantation workers, traders, village elders and farmers covering at least two villages every day.
The people in that area are lucky because the nurses regularly visit to do health checks and provide medicines. That is not the case in many other places, which is why Modi’s target to have everyone vaccinated with two jabs by the end of the year is a tough challenge.
Poonawalla’s vaccines are readily available but the demand has to be created and deliveries completed.
This article is on the Asia Sentinel news website https://www.asiasentinel.com
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