New Indian Covid19 Measures : How Effective Will It Be?

PM Narendra Modi addressed the nation on the auspicious Christmas Day. All pundits having expertise in PMO functioning were predicting their own versions of the tone and tenor. It was on the lines very few had thought of. He provided an additional protective shield against the raging Covid19 through a booster dose to the two most vulnerable groups…the frontline health workers and the elderly having co-morbidities. He also marginally extended the vaccination coverage to the younger group of 12-18 yrs. Surely, the announcement would have been made following recommendations by the National Technical Advisory Group on Immunisation in India (NTAGI) and his medical advisors after elaborate deliberations.

After many countries incl UK and USA have indicated the limited immunities against the new Omicron variant among the recipient of the two dosages of the scheduled vaccination, writings have been on walls that India too will adopt some proactive measures. The nations struggling with Omicron clearly revealed that the incident and morbidity patterns of the infections were lesser among those recently vaccinated people. It was noteworthy that both UK and USA had achieved the level of vaccination required for ‘Herd Immunity’ among their populace. India though has inoculated near 90% of its eligible population with the first dose, only about 60% has received the second dose. Hence, the first priority is to achieve the minimum percentage of vaccination for Herd Immunity (which is >68%). This is extremely disappointing esp after knowing that the administration was able to vaccinate nearly 2.5 Cr dosage in a single day on 17 Sep 21, PM Modi’s birthday.

Vaccination is the best protection against any newer wave of Covid19. Vaccinating the entire population against whom vaccines are available after EUA. India has also obtained EUA for children groups of Zydus Cadila’s DNA vaccine ZyCoV-Dfor 12-18 yrs and Covaxin approval for 2-18 yrs groups. Govt of India (GOI) has not been very proactive to vaccinate the above groups. GOI has also been emphasising the need for observing Covid Appropriate behaviour that has taken back-seat in the recent few weeks esp after PM himself addressing the election rallies in UP and Uttarakhand. This is a worrying development. We all have witnessed how Bengal election rallies had fuelled the fire of 2nd Covid19 wave. In view of the possible next Covid wave and threats of Omicron, voices are already rising to postpone elections by few months. GOI must take a call in this regard in consultations with the Chief Election Commission and the Chief Justice of India. India is presently at a crossroads in preventing 3rd wave of the pandemic.

Amidst the above concerns, the decision to protect the frontline health workers and the elderly with comorbidities is a welcome development. Since both Omicron and Delta have shown its affinity to infect younger people, the NTAGI may well include the younger people with co-morbidity in the entitled list for the booster. This is especially for the individuals who have taken their second dose >6 months back. This is the group where the levels of immunoglobins (immunity) must be dwindling fast. On the other hand, Govt machinery and the health administration must show urgency in fully vaccinating the eligible groups with the same intent and dedication that they had shown on PM’s birthday. India must aim to vaccinate 1.5 to 2 Cr of eligible age groups daily. In fact, the entire 12-18 yrs age group should be cleared for vaccination at the earliest. There is neither any shortage of vaccines nor the infrastructure to vaccinate in full swing. The target is very much achievable, only intent has to come.

Omicron in India has been relatively kind. The morbidity pattern has been milder. However, there is no surety that another variant will not emerge sooner than later, in some parts of the world and then spread like fire. Wuhan virus is very much capable of it. As long as a larger percentage of the world population is unvaccinated, the renewed waves of the pandemic is very much on cards. Hence, WHO must make arrangements to facilitate its Covax program effectively. That alone will be a guaranty against preventing the mutations and newer variants rampaging the world once again. Questions are also being raised as to how long does the immunity lasts and which of the vaccines will be effective or ineffective against the newer variants. Initial hopes of achieving lifelong immunity are nearly dashed. Vaccines having m-RNA antigens like Pfizer or Moderna have not been very promising against Omicron. The same is the experience with Astra-Zeneca as seen by the present wave in UK. The Chinese vaccines are as such unreliable. Here Indian vaccine esp the whole virion Covaxin may have an edge over the others.

All said, the new announcement by the Indian PM is a welcome step towards protecting vulnerable groups. Sooner than later, the younger people with comorbidities too should be included for the booster esp those having taken their 2nd dose >6 months back. However, the pace of vaccination is far from satisfactory. Modi govt will be unable to fulfil its promise to the Supreme Court, of vaccinating its entire eligible population. Modi govt may also be failing in its obligation to proactively curb the super-spreader events taking place on electioneering by both ruling and opposition parties. The ball is in PM’s court to take some tough decisions.