Hastening the Vaccination Drive

18 May 2021

The second wave of Covid-19 is now firmly upon us- triggered by new variants of the virus which appear to be spreading faster than anticipated. The magnitude of the spread is far more pervasive, and the surge is much more severe than that experienced last year. Not surprisingly, the second wave has taken a significant toll on lives, it is threatening recovery in business and economy, and is once again triggering livelihood and productivity concerns.

India is now experiencing a delayed, but strong second wave. The daily Covid-19 caseload is much higher than the previous peak evidenced in September 2020. The number of daily new cases started rising since February 2021 and has shot up from an average of 12,665 during the month to an average 35,788 in March 2021, thus registering a whopping 183 per cent rise.

The daily caseload continues unabated in April 2021, with nearly 3 lakh new COVID-19 cases registered as of April 20, 2021. Maharashtra has reported the highest daily new cases at 58,924. It is followed by Uttar Pradesh with 28,211 while Delhi reported 23,686 new cases.

The recent surge in COVID-19 infections has caused various state governments to impose restrictions on non-essential activities. For instance, Maharashtra has stopped most activities except those deemed essential. Considering that Maharashtra is the largest state in the country in terms of GSDP, this is bound to have repercussions on the economy. The other affected states have also brought in localized lockdowns and created containment zones within their precincts.

Yet during the last one year there have been medical and scientific advances and, importantly, vaccines have been made available in record time to check
the spread of the pandemic.

In fact, since the onset of the vaccination drive against coronavirus on January 16, adults aged 45 and above, healthcare workers and frontline workers are being inoculated. India has administered the first dose of COVID-19 vaccine to 7.59 crore people till April 10th, 2021 and exported vaccines to other countries.

Despite this, India’s vaccination effort seems to be lagging other affected countries. So far, only 5.1 per cent of India’s population has been vaccinated with a single dose. The US has vaccinated 32 per cent of its population for the first dose; UK (47 per cent); Israel (59 per cent) and Serbia (66 per cent). Full vaccination (both doses) has been given to only 0.8 per cent of the Indian population.

What is more, the vaccine is in short supply and majority of the population is yet to be vaccinated. Unless inoculation reaches the requisite threshold, the pandemic would continue to pose risks.

The wastage of vaccine doses is also causing concern. This is being happening largely at the distribution end. Reports of wastage have emerged from Tamil Nadu (12.4 per cent), Haryana (10 per cent); Bihar (8.1 per cent), Punjab (8 per cent); Delhi (7 per cent); Andhra Pradesh (7.3 per cent); Assam (7.3 per cent) and Manipur (7.2 per cent). The national average is around 6.5 per cent.

Hence, it is important to ensure vaccine availability and reduce wastage so that the vaccination drive can be stepped up from the current rate of 90 million vaccinations/ month (i.e. 30 Lakhs/day) up to 200 million vaccinations / month (66 lakhs/day). The model of Kerala, Himachal Pradesh, Mizoram, etc. of zero wastage could be studied and emulated.

The response of the government to the crisis has been swift. It has taken steps to ramp up domestic production and fast-tracked emergency approvals of foreign Covid-19 vaccines which have successfully completed phase 3 trials elsewhere. About 60 lakh doses of Sputnik vaccine are likely to be imported in May by vaccine manufacturers. Production in India is expected to start in June, making Sputnik available for about 30 crore people between June 2021 and March 2022. Capacity of India made COVAXIN, which now has been proved to have a 79 per cent efficacy in the age group of 18-97 years and 100 per cent efficacy against severe COVID, is expected to be ramped up from 1 crore doses per month to 5-6 crore doses per month. Bharat Biotech’s nasal vaccine has also completed its first phase of human clinical trials.

Further, in a landmark initiative, the government has decided to open vaccination for everyone above 18 years from May 1, thereby minimizing the damage to lives and livelihoods. This has been followed up by sanctioning advance funds to vaccine manufacturers to further scale up production and augment capacity.

The government has agreed to partially remove price caps and allow remunerative market pricing of the vaccine for those below 45 years of age. This would provide an incentive to the private sector to produce, build scale and invest in technology. These are laudable measures to address vaccine deficiency and it is hoped that there would be speedy implementation of the measures.

CII has also stepped in to work alongside Government to counter the impact of the second wave of coronavirus. Apart from being engaged in setting up vaccination camps at many locations across the country, a task force has been working closely with NEGVAC (National Expert Group on Vaccination) to supplement and support the Government’s vaccine development and distribution.

Besides, to supplement the Government’s ongoing vaccination efforts, CII has undertaken an initiative on ‘Project Vaccine Nation’. The Project envisages mapping the vaccine requirements of CII Member companies for their employees and their families. Through a nationwide survey, CII requested Member companies to advise their requirements in terms of specific number of doses.

The Government has also permitted industry members to undertake vaccination on their premises provided there are more than 100 beneficiaries and has also placed the spending on this for non-employee beneficiaries under the CSR rules. CII has therefore requested Member companies which wish to expand their vaccination drive to external members of the community to advise their requirements which is being further added to the aggregate.

As on date, CII has received demand from 1062 small, medium and large companies from 170 plus cities across the country for approximately 36 lakhs of single vaccine doses. Of this, companies have identified demand of 36 per cent for employees, 47 per cent for family members of the employees, and 17 per cent is for community outreach efforts.

CII is in touch with the two vaccine manufacturers in the country, Serum Institute of India and Bharat Biotech International Limited, to ascertain the possibility of purchase of vaccine doses as per the requirements mapped through the survey, by healthcare providers in the 170 plus cities.

This vaccination project, largely aimed at the economic agents of the country, would help the enterprises to revert to their usual scale of operations at the earliest so that lives and livelihoods are both preserved.

Apart from vaccination, CII has been actively working with the Government to assist in the evolving situation on oxygen. More than 100 companies have been mobilised to provide augmented oxygen supply for medical use in different parts of the country. Industry has been willingly coming forward to divert the supply of oxygen from industry, for medical use, even at the cost of losing out on manufacturing.

Industry is also making the essential drugs like Remdesivir available wherever possible by connecting hospitals/ State governments to pharma producers.

CII members manufacturing Remdesivir are working towards exceeding the committed target of 78 lakh vials per month to reach a production of 1 crore vials per month. Indian manufacturers are also looking at a Remdesivir pill, which will reduce the need for hospitalisation.

CII has been consistently communicating with members ensuring strict observance of COVID protocols by the business community. Several editions of workplace protocols and guidelines for safety and protection of the workforce have been shared with Members.

In addition, it has also reached out to other stakeholders through multiple social media campaigns including in Hindi and local languages on the SMS and vaccination messages.

CII would continue to remain in constant dialogue with the Government on the action agenda to ensure a strong and adequate response based on scientific and medical advice which would help deal with the second surge of the pandemic.

While CII compliments the government for the host of measures for bringing immediate relief, CII would also recommend a seven-pronged approach on vaccine distribution plan for phase-III to ameliorate the situation.

One, the same methodology may be used in Phase-3 as in earlier phases of the program, via the Central Government distribution channels including for smaller towns and villages. This would make the program more inclusive. The same channels could be used to provide vaccines to non-state entities that are eligible for providing vaccination.

Two, the procurement price of vaccines for central and state governments may be fixed at the same amount. For non- government entities, there could be a differential price as deemed appropriate by the Government.

Three, a predictable and equitable supply for all districts may be prioritized as per a pre-determined formula which could be based on suggestions by experts.

Four, the Central Government’s involvement in distribution of the vaccines to all age groups would make the process equitable and inclusive for all adults as well. This would help States which may not have the fiscal capacity to vaccinate from their side and enable all States to progress on vaccination. The Government may also like to consider vaccination of this age group for weaker sections of society from its own side.

Five, as CoWIN app may not be available to all, walk-in registrations for all adults should be permitted.

Six, a direct approach by various entities to vaccine manufacturers may lead to concentration of supplies with a few vaccinating agencies. The mode of supplying doses through the administration would ensure that all healthcare providers are able to access the vaccines in all parts of the country. All entities, including private healthcare providers, could make their requirements known to the district authorities and collect the doses as allocated.

Seven, the Government may like to put a cap on the administrative fee that a healthcare provider can charge from the beneficiaries per shot of the vaccine. Apart from this, we need to take remedial measures, on an immediate basis, to address the problem of acute shortage of skilled health workers and their inequitable distribution. The priority should be to ramp up the supply of skilled medical personnel which, among others, would be required to treat the health emergency brought on by Covid.

In the medium term, we would need to build research capabilities and capacities to battle COVID as well as build our capacity in terms of hospitals, oxygen, ventilators, medicines, personnel, etc. so that we are not caught off guard next time.

The article first appeared in the April 2021 issue of the CII Economy Matters. Click here to read the issue.

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