In their opinion piece, ‘Left out of CoWin’ (IE, May 15), Apar Gupta and Anushka Jain pit data against vaccine equity. Ironically, the data refute their arguments on India’s use of digital systems in the quest to vaccinate over a billion citizens against the deadly Covid-19 virus.
The contention that CoWin prioritises data collection over vaccine equity is a misplaced view of the innovative use of CoWin in public health. Manually run mass inoculation drives in the past — polio and smallpox being cases in point — reached the rural poor the last. The lack of data visibility was a clear shortcoming of such drives. Contrary to this, CoWin enables data collection that supports, close to real time, development, implementation and evaluation of India’s response to a fast-evolving pandemic. This is a stellar example of evidence-based decision making in public health. Data collection is not at odds with vaccine equity, it helps the government spot the excluded and strategise their inclusion.
The authors question mandatory registration for vaccination. However, evidence supports pre-registration for several reasons. The registration for citizens aged 18 to 44 years was opened on April 28 at 4 pm. Within eight hours, CoWin witnessed a total of 1.37 crore registrations. Since then, there have been nearly 5.3 crore registrations as of May 14 for this age bracket on CoWin, of which only 48 lakh have been vaccinated. This indicates a supply to demand ratio of 1:11, and an unsatisfying conversion level below 10 per cent. The perception that vaccination slots are scarce is correct, but that is a result of the skewed demand-supply. Assertions that it’s a “fastest finger first” syndrome or a deficiency in CoWin are incorrect.
Imagine the chaos if online appointments had not been compulsory. Vaccination centres would have been swamped by people, creating not only law-and-order issues but also risk of infections. Invoking the digital divide, as the authors do, is premature and misplaced, for the vaccination drive is evolving as it unfolds, and data is the torchlight for correcting the anomalies.
A related contention of the authors is the limited access of the rural population to the internet. The government is cognisant of the barriers to access. CoWin provides for on-site registration of people without access to the internet, smartphones or even a feature phone. Out of the 18.22 crore doses administered as on May 16, only 43 per cent have been administered through online appointments, the rest availed of on-site registration. Self-registration is just one component of CoWin. On-the-spot registration, walk-ins, registration of four citizens on one mobile number and use of common service centres for assisted registration underline the inclusive nature of CoWin.
Data show growing affinity of Indians with digital technologies — 150 million people have downloaded the Aarogya Setu, more than 3 billion UPI transactions take place every month, 60 million users have registered on DigiLocker and 4.28 billion digi-documents have been issued. The CoWin platform leverages many of these applications to reach the last mile on the understanding that a digitally aware India is in the making.
The assertion that functionalities of CoWin are available to automate functions, ranging from notification to slot reservation is fallacious. There are no cases of booking by scripts. Vacancy search can be automated (being done by Paytm and Telegram using open APIs), but bookings cannot as OTPs and captcha are required. There is irrefutable data to prove that no algorithmic appointments have been made.
The opposition to the use of facial authentication, even in the future, is but an old Aadhaar allergy. It is currently in the stage of proof of concept. It will augment authentication capability, result in more inclusion and will be a gamechanger in service delivery. Opposition to it mirrors the scepticism against pioneering technological feats, particularly Indian.
There are seven documents to choose to get vaccinated. Only 14 per cent registrants have so far used Aadhaar, so why pick on it? The Supreme Court has ruled fingerprint, iris and OTP-based authentication do not violate privacy, only the intransigence of the authors makes them opine otherwise.
Clearly, pitting technology and digital systems against equity and right to health is rhetoric. Vaccination of a large population cannot be managed without a technological backbone. Technology ensures a person takes the same vaccine the first and the second time. It helps to collect After Effects Following Immunisation (AEFI), providing a single source of truth on progression of the vaccination programme at a granular geographical level and supporting data-driven public health policies. It will be foolhardy to dispense with technology in the face of evidence suggesting it makes the vaccination programme orderly and transparent at a scale unlikely to be demanded elsewhere in the world. Most importantly, technology democratises access and eliminates information asymmetry.
CoWin and India’s forays to vaccinate its population may not be perfect, but they are well-meaning efforts in the face of an unprecedented crisis. Constructive criticism helps to improve public systems, angular trashing raises avoidable doubts and misapprehensions without pointing to solutions.
This column first appeared in the print edition on May 20, 2021 under the title ‘Let data do the talking, please’. Sharma is chairman, empowered group on Covid-19 vaccine administration; Singh is former member of the postal services board. Views are personal
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