The last nine months have tested our collective resilience like no other period in recent human history. A virus, the size of a fraction of human hair, has ensured that countries across the world are put under varying levels of lockdown, movement of people and social interactions have assumed a new meaning, businesses have been impacted, and lives have been lost. Everyone across the world is now pinning their hope on the arrival of a clinically proven and safe to administer vaccine.
This hope is not misplaced — vaccines indeed are the fastest and most effective means of achieving herd immunity while ensuring minimal socio-economic loss. More than 200 vaccine candidates are at different stages of progress, with six having received a limited/early approval for restricted use and 12 undergoing Phase 3 trials. However, the fact remains that there is an over-optimism as far as the timelines of vaccines being available to a large section of our population is concerned. Covering a large majority of Indians for vaccine administration within a drastically compressed timeline is nothing less than unprecedented. Once a vaccine is clinically approved, it will be months before we can guarantee access to the requisite doses for all Indians who ought to be vaccinated. Despite having a robust vaccination ecosystem and a track record of successfully driving vaccination campaigns, it will be a long process that will demand collaboration and support of several stakeholders in India.
This effectively means that our efforts to manage COVID-19 through public behavioural change coupled with an efficient testing and tracing strategy will remain crucial. As a result of PM Narendra Modi’s call to increase COVID-19 testing in India in August, we have made significant progress in conducting over a million tests a day. Gujarat quickly ramped up testing and, as a result, succeeded in bringing down the positivity rate from 8.84 per cent (in May) to the current weekly figure of 2.1 per cent. The surveillance system was scaled up by deploying over 5,000 teams and introduction of “Dhanvantari Raths” (mobile vans) for testing and basic health check-up. This was supported with rigorous airport screening of all passengers travelling from China and other affected countries, determined tracing all contacts of infected persons and virtual training of over seven lakh doctors, nurses, and other paramedical staff to treat COVID-19 patients.
However, as the virus continues to surge in both urban and rural settings, we need to continue to learn, evolve and improve our testing and tracing strategies and ensure that tests are accessible to the most vulnerable communities and rural parts of India. We can see the costs of not doing so in Europe where entire countries have had to go under a complete lockdown once again, which could impact their economic activities as well.
Scalability of testing is only possible when we adopt innovative technologies that offer accuracy as well as cost-effectiveness. We have seen some great innovations in this respect — for example, the Feluda paper test that uses CRISPR technology, developed jointly by CSIR-IGIB and Tata Group, does not require expensive equipment or reagents and has reported high levels of accuracy (96 per cent sensitivity and 98 per cent specificity). It is speculated that once launched in the market, it can be scaled up very quickly owing to its portability, low price and efficacy.
In another interesting development, a team led by scientists from IIT-Gandhinagar detected the genetic presence of the SARS-CoV-2 virus in wastewater of Ahmedabad, which corresponded with the incidence of COVID-19 in the city as well. This is an innovative method of monitoring the presence of a virus in a certain area and deserves to be scaled up in other urban areas across the country so our policymaking can become more evidence-based and data-driven.
The fact remains that India and other countries will continue to have to test millions in the weeks and months to come, if we are to keep pace with the spread of the virus. State governments with support from the Centre need to work on a revamped and robust testing and tracing strategy, which can help us save lives and manage this pandemic more effectively.
This article first appeared in the print edition on December 3, 2020 under the title ‘After the vaccine comes’. The writer, a surgeon, represents BJP in Parliament from the Ahmedabad West constituency