Time for Introspection

Who could have believed, a few months back when on 15 February the daily case count of Covid-19 cases in India had dipped to just 9,121 following a steady decline, that we will be in the middle of such an alarming resurgence? The numbers on 17th April were 2,34,692 with a last week’s average of 1,88,660. This speed which is mind boggling has shocked all the stake holders. The result is that patients are dying, with no ICU beds available in many cities of India, despite most hospitals being converted into COVID units. Scientists are busy discussing that the infection is really not a droplet infection which was being speculated as the main route leading to 3 mantras: Distancing, Hand Washing and Wearing of Masks. The latest research published very recently in the Lancet on 15 April suggests that airborne transmission of SARS-CoV-2 is the main route. These findings are very concerning because of their enormous public health implications. Although other routes do contribute, airborne route seems to be the dominant one.

 Why did this unexpected resurgence happen? It is very clear that after a battle of over one year, a fatigue has set in at all levels. Opportunities were missed. Instead of going all out with the facilities of testing, tracking and contact tracing to get rid of the virus, the systems all over the states became lax. The advisories and decisions were taken without consulting the epidemiologists and experts. The SOPs which had been prepared were put aside and decisions to go ahead with Kumbh Mela and the state assembly elections were taken without consulting the relevant authorities. The public which was forced to stay at home and venture out only with multiple precautions was also eager to start normalcy once again. Everybody wanted to get back to their occupations. Sportsmen to their grounds, artists to their studios, rich men to the late-night parties and of course the politicians to their elections and canvassing for masses. This COVID-19 fatigue is not peculiar to India only and has been seen in many other parts of the world including the USA.  The size of the rallies for electioneering is becoming enormous – ‘bigger means victory’. The masses seeing their leaders without observing any precautions while addressing, also are following the suit.

   

 The availability of the vaccine in January this year built up the sagging morale of our people. The oxford vaccine which is bulk manufactured by the serum institute of Pune became available along with COVAXIN which also got a nod for emergency use. Israel with a population of around 9.3 million has achieved herd immunity and with effect from 15 April this year do not need to wear masks. This they achieved by mass vaccination and their positivity rate which was the highest per capita Covid rate in the world came down to 0.7%. This all was achieved by mass vaccination program. India though a much bigger population has not learnt lesson from this scientific fact. Maharashtra’s Huffkin Biopharmaceutical Corporation got permission to manufacture COVAXIN only now in April having applied in early February. The Government has after 3 months of indecision now given permission to Chengalpattu unit in Tamil Nadu, IIL, facility at Hyderabad and BIBCOL unit at Bulandshahr to produce COVAXIN. In December 2020 the Pfizer m RNA vaccine was refused grant to bring their vaccine to India. Now after we have got a ferocious 2nd wave crossing the 2 lack mark last week, the central government has decided to issue a waiver of having bridging trials for vaccines produced in Europe, Japan the US etc. These rigidities in policy when it is the health of the country at a stake are not good. We need to vaccinate such a large population in the shortest period of time, we need more vaccines. While our needs are not being fulfilled the decision to export hundreds of million doses abroad for getting laudable remarks by international community is again a matter for introspection.

 This second wave which is ripping our systems apart had been predicted by many and had its precedence in Europe and USA also. We have been much better prepared for this since the last year when pandemic entered our country. We have no shortage of masks, PPE’s, ventilators and oxygen. Vaccination process is also in full swing. This has set a sense of complacency. The results of this are disastrous and now Government is saying that “April is a difficult month”. We should have been prepared better. 

 It is hoped that we all work together to face this wave and cooperate with the authorities who have finally conceded to the presence of this alarming 2nd wave. The latest scientific fact that COVID-19, is an airborne transmission is another really scary news. Who knows we may be in for a third wave soon?

Prof Upendra Kaul is founder Director Gauri Kaul Foundation. A recipient of Padma shri and Dr B C Roy Award

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