Doctors from the Rajawadi Hospital
Doctors from the Rajawadi Hospital pose for a selfie as a television broadcasts a live address by India's Prime Minister Narendra Modi before the start of the COVID-19 vaccination drive Image Credit: AFP

Things were going well. Daily infections were down, hospitals were finally coming up for air themselves and experts globally were flummoxed at the deep dive — from a 100,000 cases in September to just 9100 cases recorded across India towards the end of January. For a country of 1.4 billion people, the numbers were no less than a miracle.

Theories came out fast and furious — many questioned if the country had already reached herd immunity. Other experts wondered if our living conditions made us inherently tough — had the lack of hygiene and clean water that caused diseases like malaria, typhoid and dengue made our immune systems sturdy or was our predominantly humid climate a barrier to the virus.

There has been talk of demographics as well — whether the mortality rate of 1.42% was because more than half the country is young and below the age of 25.

The mystery of the dwindling numbers remains unsolved but whichever way you did the math, there was light sneaking in from the end of the tunnel. Schools were beginning to reopen and traffic jams for once only brought back comfort of the familiar.

Taking it easy

And then complacency set in. People became unmasked, social distancing became distanced, and weddings went from a small private affair to the entire shebang with hardly a mask in the photographer’s frame. Whether it was Covid fatigue or the belief that the worst was over, travel thirsty citizens eyed an evening or more in Goa rather than chase a trail of contact tracing.

We were suddenly back in peak 2019.

An exhausted medical fraternity now warns, if we don’t mask up and ramp up the vaccination drive, bad days look imminent. A second wave almost always follows the first and with the new variants it could get tricky.

The signs are now more than a trickle. The state of Maharashtra has banned all political, religious and social gatherings after a recent spike in cases saw the daily figures jump to 6000 for the first time in three months. One district is under a weeklong lockdown and there are rumours others may follow if the trend continues.

240 new strains have been found and one of the country’s top doctors Randeep Guleria warns they could be even more contagious. Below par genome sequencing though makes it difficult to gauge whether the strains are imported or local but there is fear that the mutations may infect even those with antibodies.

Along with Maharashtra, four other states now have a worrying surge in numbers- India has hit 1.5 lakh active cases after the steepest rise in cases since November. Dr Guleria though rubbishes the comforting thought that India may have already reached herd immunity dismissing it as a myth in an interview. 80% of the population he says needs to have antibodies for the remaining country also to be protected.

Vaccinating at a snail’s pace

Which then begs the question, why is India vaccinating at a snail’s pace especially when there is still a window? It has the capacity and the capability- the world’s largest vaccine manufacturer, the Serum Institute is based in the city of Pune and it expects to ramp up production to 100m doses by the end of March.

Yet, medical experts fear India may be leaving its vaccination drive too little too late.

When the vaccines started rolling out the common man watched bewildered as Covishield — the Indian name for the Oxford developed AstraZeneca — was gifted to one country after another (at least 17 countries have been sent free doses and more are on the way) in what the Prime Minister termed vaccine maitri (friendship).

20210128 covid-19 vaccines
An airplane carrying two million doses of AstraZeneca/Oxford vaccines from India lands at Galeao Air Base in Rio de Janeiro, Brazil Image Credit: Reuters

As lakhs of doses made their way to several countries, upset and angry citizens ask how a resident in Nicaragua or Bahamas has, access to our vaccine while they are told to wait. A month after the vaccination drive started the numbers were barely more for domestic jabs targeting predominantly only health and front line workers.

India’s covid diplomacy may be winning it global points but it is at the expense of vulnerable Indians and senior citizens. On Sunday, just over 30k shots were given to a population of more than a billion. At this rate experts are sceptical of India meeting its August target of vaccinating 300 million citizens. It is anybody’s guess how many years it will take to protect the entire population.

India’s key ally Israel has been vaccinating the elderly and has seen a steep decline in cases. We became the ‘pharmacy of the world’ but ignored our own. Vaccines lying stockpiled could expire as citizens above the age of 50 and those with co-morbidities wait to line up in the next phase. Pune residents say it is ironical that they have a stock of vaccines in their backyard and yet have no access to it.

Frustrated doctors urge for vaccinations on a war-footing, many have even offered to help in increasing the pace but privately say the government prefers to not share the credit or control. In an unpredictable environment most are uneasy to speak openly.

Appeal from the corporate world

Corporate chiefs though have written to the government asking for companies to be allowed to vaccinate their employees as part of CSR (corporate social responsibility). There have been relentless calls to include the private sector in the vaccine roll-out to speed up the process by allowing those who are willing to pay, to do so. Everyone unfathomably remains on standby.

Wipro founder Azim Premji — whose foundation has contributed handsomely in tackling the virus in the country — has also urged the government to involve the private sector saying their participation will help cover 50 crore vaccinations in two months.

Mahindra group chairman Anand Mahindra, Confederation of Indian Industry (CII) and many others have similarly implored the government to urgently consider opening up the private sector. When every day matters, any decision in the future will cost.

For now, even in the times of a pandemic, between an aggressive diplomatic outreach and the country’s infamous bureaucratic red tape, citizens are left to haggle every step of the way. Whether it is to get a certificate on the government app Co-WIN or to get a vaccine itself, nothing comes easy. Logging on to the app itself is an exercise in patience for many — linking to Aadhar perhaps would have been simpler for everyone around.

What is more worrying though is the discrepancies in the data. Many phone numbers reportedly don’t exist, and one mobile number was allegedly filled against the names of 40 people who came to get their first shot — a reason perhaps why many didn’t return for their second dose. With incorrect data they were probably not informed.

But there are plenty others who haven’t come back for the second dose simply because they didn’t want to and the bulk is health care workers. There is widespread scepticism over side-effects especially with the other approved vaccine Covaxin given the green light for emergency use, despite no data for stage 3 efficacy.

No leading by example

Unlike US President Biden who got vaccinated on live television or Isreali Prime Minister Netanyahu who kick-started his country’s vaccine drive by being the first to get inoculated, in India no top leader has been publicly seen getting the vaccination. With no leading by example, hearsay is having its day in the sun.

Instead, the health minister Harsh Vardhan was more prominent as he sat alongside Ramdev — a yoga guru -- to launch Coronil — a tablet Ramdev’s company Patanjali claimed had WHO certification to fight Covid — a claim denied outright by the WHO.

Indian Medical Association calls it ‘blatant lies’ and has demanded an explanation from the Minister on the false ‘unscientific’ claims especially at a time when clarity is needed.

Meanwhile, the common man waits as time runs out. He knows it is the last mile connectivity — he needs the immunity and yet he is but a bystander, waiting for his government to put him first.