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Thursday, July 07, 2022

Not the age of reason

No party can escape blame. Some tried hard despite obstacles, some faltered, and some buried the facts and relied on bluff and bluster. The victims are the people.

Written by P Chidambaram |
Updated: May 16, 2021 8:24:43 am
Family members of a deceased Covid-19 patient grieve outside Jumbo Hospital Shivajinagar in Pune on Saturday. (Express Photo: Pavan Khengre)

The people of India — or at least the vast majority — have reached a point where they have come to the conclusion that they have to rely only on themselves, and their families and friends, to protect their lives. In the battle against Covid-19, the State, especially the Central government, has withered away. A few state governments still enjoy a modicum of trust, like Kerala and Odisha. Since there is a change of government in Tamil Nadu and Puducherry, one has to reserve judgement about them.

No party can escape blame. Some tried hard despite obstacles, some faltered, and some buried the facts and relied on bluff and bluster. The victims are the people.

Arguments will not settle the issue about who is mainly responsible for this terrible state of affairs because this is not the Age of Reason. Instead, it is more politic to re-state certain indisputable facts and leave it to each individual to answer that question. Here goes my list:

Demand vs Supply

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1. The basic table:

The approximate size of each target group is available and was known to the government. Hence, the number that will be added on the demand side on each milestone date was calculable, but this was not done. The number of vaccine doses that would be required was Demand number x 2. Allowing for initial vaccine hesitancy, it was possible to calculate the probable demand for vaccine doses. This too was never done.

2. The rated capacity of the two Indian manufacturers — Serum Institute and Bharat Biotech — was known to the government. The actual manufacturing capacity and rate of scaling up could have been ascertained by factory inspection and periodic audit. This too was never done.

Vaccination without vaccines!

3. A firm order for vaccines was placed with Serum Institute and Bharat Biotech only on 11-01-2021. Initial supplies were made by the two companies from their stocks produced at their own risk. Thus, valuable time was lost in encouraging the two companies to ramp up production.

4. At least one company (Serum Institute), and perhaps both, required funding to increase capacity. The financial assistance for capacity addition has not been granted until this date. Supply advances were announced on 19-04-2021, but this is akin to advance payment for supply, not a capital grant or loan to increase capacity.

5. Export of India-made vaccines was allowed until March 2021. It was prohibited only on 29-03-2021. Meanwhile, 5.8 crore doses of vaccines had been exported.

6. Emergency-use approval for the Pfizer vaccine was stonewalled as a result of which Pfizer withdrew its application. The third vaccine, Sputnik V, was granted EUA (emergency use authorisation) only on 12-04-2021 and the first consignment landed in India only on 01-05-2021. No other vaccine has been approved for use or imported into India until this date.

7. Much of the additional health infrastructure created in 2020 was dismantled after October 2020 and had to be re-erected after the second wave started in March 2021, putting intolerable pressure on the surviving infrastructure like hospital beds, ventilators and oxygen tankers/concentrators.

8. As the first wave plateaued, testing slowed down considerably. When the number of samples tested declines, the number of new infections detected will fall too. Testing was not accelerated. The roof was not fixed while the sun was shining, the roof is leaking when the rain is pouring.

9. The number of vaccination doses administered every day, instead of rising, has declined. On April 2, an impressive 42,65,157 doses were administered. The daily average for April, however, was only about 30 lakh. In May, the average per day has further fallen to about 18.5 lakh. The vaccination programme is suffocating due to a shortage of vaccines.

Deny, deny more

10. There was no plan to map and tap potential resources in case of an emergency. For example, there was no plan to augment oxygen sources, convert nitrogen/argon tankers into oxygen tankers, import and erect PSA (pressure swing absorption) plants, and import and stock oxygen concentrators and ventilators. There was no plan to augment the number of nurses and paramedics.

11. When the second wave started, it was assumed that it would be like the first wave, rising slowly, then plateauing, and then declining. No attempt was made to imagine multiple scenarios including the worst-case scenario. Hence, there was no plan to counter the swift rise and spread of the second wave. It is fair to assume that there is no plan to counter a third wave or fourth wave.

12. There is no IEC — information, education and communication — approach to public health. The government’s approach during the first wave was oriented towards publicity, posturing and triumphalism. In the second wave, the approach is denial (“there is no shortage of oxygen”, “there are enough stocks of vaccines with the states”), burying the truth and passing the buck to the states. The result is utter chaos and confusion and no accountability. In any other country, heads would have rolled.

Over to the reader, to pronounce the verdict.

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