Events
& Issues
New Delhi, 22 July 2020
Early Covid Vaccine
IMPROBABLE, NO SOLUTION
By Dr. Oishee & Dhurjati Mukherjee
India has overtaken
Russia to take the third position in the world with corona infections rising at
a galloping rate. The complacency that was manifest a month ago has now raised
concerns, not just amongst the medical fraternity but also the general public.
However, most believe that testing being way below the western nations India
witnessed lower cases being detected, though recovery rate has been
satisfactory.
According to
projections by Indian Institute of Science, India will have 35 lakh COVID-19
cases by September in a worst-case scenario and in any case in a better than
current scenario, it may hit a peak of 20 lakh cases, 4.75 lakh active and
88,000 deaths by September1. The grim scenario is manifest in the daily
nationwide testing of 27 lakh proving to be inadequate with positivity rate –
total confirmed cases per 100 tests -- reaching the double digit mark for the
first time at 10% in the first two weeks of July. Maharashtra was on top with a
positivity rate of 23% followed by Telangana 19%, Delhi 15% and Karnataka 12%,
whereas Gujarat, Tamil Nadu and Bengal crossed the 10% mark.
Adding to the
research into the pandemic, around 239 scientists from 32 nations wrote to the
WHO, saying there is evidence that the corona virus is airborne and even
smaller particles can infect people-- a significant departure from its claim so
far that it is spread primarily through cough and sneezes. A report in The New York Times stated that clusters
of infections are rising globally as people go to bars, restaurants, offices
and markets, a trend that increasingly confirms that the virus lingers in the
air indoors, infecting those nearby. In the open letter, these scientists outlined
evidence showing that smaller particles can infect people, and are calling for
the UN agency to revise its recommendations, adding they plan to publish their
letter in a scientific journal.
In such a situation,
when the pandemic and resultant lockdown in India has severely affected social
and economic situation, and studies reveal the trend will continue at least for
another 2-3 months, an avoidable controversy emerged. Last month, ICMR Director
General’s stating a 15 August vaccine launch eroded the agency’s credibility
and experts questioned the validity of the date, making him retract. As per WHO
report, 18 candidate vaccines against COVID-19 are in clinical trials while over
120 others are undergoing lab or animal studies.
The Indian Academy of
Sciences, a body of 1100-odd scientists, stated that while administrative
approvals could be expedited, clinical trials process and data analysis have a
natural time span that cannot be hastened without compromising scientific
rigour. In fact, scientists across the globe believe a vaccine is unlikely to
be made available by early 2021.
IASc President Dr.
Partha Majumder observed: “Scientifically unreasonable demands and claims lower
the hard earned international renown of our biomedical research institutions
and pharmaceutical industry”. Even Prof. Francis Collins, a top American
biomedical researcher testifying before the US Senate, stated: “We’re
optimistic that the goal we have set to have a vaccine that works and is safe
by the end of 2020 will be met by one of the vaccines...and that we would have
by early 2021, 300 million doses of a safe and effective vaccine”.
Independent
researchers have pointed out, “no one expects a vaccine to become available for
routine public use anywhere before at least the end of 2020 or early 2021”.
Obviously, they found the letter surprising because as a doctor-researcher
involved in past clinical trials, the ICMR authorities should be expected to
grasp the complexity of assessing a brand new medicine or vaccine – something
that typically takes years. Thus, it naturally follows there may have been pressure
from the political class, who have no understanding of how a vaccine emerges,
and as known are in the habit of hoodwinking people.
The neglect of health
infrastructure over the years has been the reason successive governments have
done little to ensure the barest minimum health facilities for the poor and
economically weaker sections. The situation has become worse with the invisible
enemy. While the metros and cities, where cases are more, have some health
facilities, a lot many more districts are now being affected and the situation is
indeed turning quite grave. This has emerged during the past three weeks or so
with testing being scaled up in most States.
India has 519 medical
colleges that can admit over 80,000 MBBS students a year, as mentioned by MoS Health
in the Lok Sabha on November 29, 2019. But the requirement of doctors in the
country is several times more, specially in sub-divisions and blocks. Moreover, the number of beds that is being
reported almost every day is much less, at least 40% than required. As a result
many patients are dying without getting admission in government hospitals.
As regards doctors’
strength there is a growing concern and it needs to be enhanced. These could be
specialists who have completed or are on the verge of completing training in
clinical specialities in teaching hospitals. Also those who have undergone a
fellowship programme for 2-3 years after internship could too be requisitioned,
besides those who are trained in Russia and China but couldn’t clear the Indian
exit exam too could be considered. Final year nursing students, who finished
training and are set to appear for the final exam, is another area that could
be looked into.
On another front,
there are reports that the Centre is not extending adequate financial help to States,
some of whom are fighting the pandemic with scarce resources. As the situation
is expected to deteriorate till August-end, the health infrastructure needs to
be scaled up, at least in the metros that are severely affected like Mumbai,
Delhi, Chennai, Kolkata, Ahmadabad and Pune, other than the districts. Thus,
requirement of beds, ventilators, ICU beds etc. need to be beefed up. With accommodation
in government hospitals bursting out of seams, there is need for strict
vigilance of private nursing homes to ensure they don’t charge the common man in
access for beds, ventilator or medicines.
While there is no
denying that doctors and nurses in States are doing a splendid job, inadequate health
infrastructure is putting them at greater risk and a number of them have
succumbed to the virus in line of duty. It’s critical to give them the
additional support.
With the challenge undoubtedly
quite daunting, the Central political leadership instead of seeking mileage for
an early discovery of a vaccine should immediately assist States by setting up
150-bed Covid hospitals for say six months under the Central Govt. Health
Scheme (CGHS) in affected metros. Why this hasn’t been done so far requires an
answer.
At the same time, the
nagging question persists—whether the situation shall improve, how soon and will
health infrastructure be given the requisite boost? Will the growing number of patients
get adequate treatment in a country like India, which is aiming to be a super
power? The Union Health Ministry needs to extend infrastructural support to the
States at the earliest and not leave it to them saying it has done its job and
now they need to do theirs! ---INFA
(Copyright, India
News & Feature Alliance)
|