The country’s path ahead after the peak of a second covid wave
PremiumPublic discipline and vaccine procurement done mostly by the Centre could forestall a third wave
Let us start with the good news. India’s second wave of daily new covid infections, as per official data, peaked on 8 May. The SUTRA model had predicted a peak on 4 May. That is as good as it gets in forecasting. The model predicts that the daily rate of infections would drop to around 14,500 by end-June. There were around 12,000 covid infections per day before the second wave engulfed us. Although the model predicts that daily infection rates would continue to decline asymptotically towards zero, it cannot be taken for granted.
The SUTRA model anticipates that a third rise in cases may come in about six to eight months from now. But, whether the third phase will be a wave or ends up being just a mild bump depends as much on our behaviour as it does on matters of chance. Simply put, we need to do what we must do.
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Premium Premium Phase 3 of our vaccination drive pushed for too much too soon
4 min read . 17 May 2021Let us start with vaccination. Much criticism has been laid at the doors of the government for not pre-ordering vaccines. Writing for Swarajya, Suraj S. has done well to point out the fallacy of such arguments repeated without reference to facts (bit.ly/3fomXcO). Vaccines ordered and options held by the US, UK and EU did not convert to vaccines on hand. Ordering simply did not mean availability. The article ends on an optimistic note about vaccine availability in India between May and December. At the same time, those interested in understanding the inherent unpredictability of the exact number of doses that would be produced should read the tweet thread (bit.ly/3tPVcPQ) of Adam Ritchie at Jenner Institute of the University of Oxford, posted on 29 January.
A paper in Clinical and Infectious Diseases (‘Neutralization of variant under investigation B.1.617 with sera of BBV152 vaccines’, 7 May 2021, bit.ly/3eO1j2L) conducted by scientists at the Indian Council of Medical Research and National Institute of Virology shows that both the Indian vaccines, Covaxin and Covishield, “were correlatable with milder disease during post-vaccination breakthrough infections." This was widely anticipated, because inactivated virus vaccines can counter mutations of the virus more effectively than others.
Bharat Biotech (BB) was importing an agonist molecule from Virovax in Kansas. BB then got Indian Institute of Chemical Technology in Hyderabad, a lab of the Council of Scientific and Industrial Research, to synthesize that chemical, and has scaled up production to industrial levels. An inactivated virus is very safe for even small children and the only question is the extent of its use’s efficacy. (Note that the authors have no commercial interest in the company.)
As mentioned earlier, whether it is a ‘third wave’ or a ‘bump’ would depend on several factors; most importantly, on the roll-out of our vaccination programme. There is a misconception that the only way to stop a third wave is to achieve 100% vaccination in a few months’ time. That may not be necessary for managing a possible third wave at the community level. One possible approach, depending on vaccine availability, is that the Union government procures vaccines to provide two doses to all those who are above 60, at least one dose to those above 45, and use the balance for those aged 18-45. If there is excess vaccine availability, backfill. Data on those who died prior to 1 May and were eligible for vaccination but were not vaccinated would be useful for the government in putting out messages aimed at overcoming vaccine resistance. Any approach to vaccinating those who are willing and can safely be inoculated must take the best available wisdom into consideration, and this should be executed with the willing participation of state governments.
One unintended consequence of the decentralized approach to lockdowns this time is that we are able to compare and contrast different approaches to lockdown in terms of their effectiveness in reducing the contact parameter (beta) that determines how fast the infection spreads. The conclusion: the best approach is one that lets normal life more or less go on but does not allow the congregation of crowds, while the worst is an approach that shuts down everything, except for a few hours a day, which forces everyone to squeeze all activity into those few hours and could thus increase the contact parameter. Note that we are comparing only the efficacy in terms of reducing the contact rate, and ignoring other factors such as economic hardship, etc.
However, we believe that a centralized approach to vaccine procurement, distribution and vaccination scheduling for different age groups would work best. If procurement remains a matter of competition among states, it will be inefficient and vaccination will fall short of what is needed to avoid a calamitous third wave. Then, states will resort to lockdowns as their only antidote to the virus behind the pandemic.
The public, on its part, should not declare victory too early and ‘snatch defeat from the jaws of victory’ by ignoring covid protocols. Erring on the side of caution is essential. It will take a while to blow the all-clear bugle.
In short, winning the battle against the novel coronavirus and its variants would require discipline of the public, and logic, consistency and large hearts on the part of the Indian government.
These are the authors’ personal views.
V. Anantha Nageswaran and M. Vidyasagar are, respectively, a member of the Economic Advisory Council to the Prime Minister and chairman, DST Supermodel Committee
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