Centre, States in a quagmire over vaccination

Of late making a lot of noise and less of action has become the order of the day. We have seen how the Centre, States and people ignored early warning with regard to Covid-19 and how people had to suffer. We have seen how private and corporate hospitals had a free run and fleeced people but nothing was done.

There was no vigil on them. The government issued a GO fixing rates for various procedures which were violated with impunity by all private hospitals but still no action was taken till recently. About a week back the government issued notices to some hospitals but refused to give the names. Even when it claimed it had issued notices to 64 hospitals, the Director Health refused to announce the list.

On the other hand, health department officials are claiming that they were not defending the private hospitals and the fact is that they have to pay higher salaries to employees as the investments in such hospitals is also heavy.

Well it is a debatable issue but then why should the Government issue GO if there is no sanctity to it? How can any hospital violate the government order particularly during the pandemic situation? That is the big question. There are any number of examples where bodies were not handed over till the bills were cleared even if it meant keeping the body in hospital for over nine hours.

Similarly, the country seems to have slipped in working out a vaccine strategy. We have reached a stage where booking slots has become herculean task. And once again the blame game between Centre and States has begun.

Telangana government feels that Centre erred in working out plan for distribution of vaccine and that has resulted in unusual gap in demand and supply.

The IT Minister K T Rama Rao found fault with the system of centralised supply. The minister lamented that though Hyderabad is the global capital to manufacture vaccine, the state and private sector have been asked to share from 15 per cent of the production.

Not just that it had created different rates for Centre, State and private hospitals. People are ready to take vaccination, but it is the wrong policies that had led to confusion and there is near chaos. He certainly has a point.

The decision of the Centre to suddenly throw open the market to State governments and private hospitals has led to a situation where the private sector will have to negotiate the price with manufacturers and this has led a to a situation where the difference of price of the vaccine is four times more in private hospitals.

Even if one goes by the argument that those who can afford will go to private hospitals, the government has again indulged in flip flop by centralising allocation of slots. There is no system of walk in vaccination. Registering through CoWin website is next to impossible.

It is like 'apply apply no reply'. Even the WhatsApp facility to know the availability of slots by mentioning area code is of no use since the instant reply one gets is 'no slots available here try another code'. The hits on CoWin seems to be much more than Facebook, people say.

The government could have explored other options to see that the process of vaccination was put on fast track, but instead massive confusion has been created. The new policy putting the onus of procuring vaccine on their own by States and hospitals has left no time to negotiate the prices or stockpile vaccines.

Even if orders are placed, the manufacturers are not able to deliver them as the orders from Centre are also pending. This has resulted in a situation where stocks are just trickling in and the situation is unlikely to ease before next few months as the maths simply does not add up.

According to estimates, the Centre requires at over 600 million doses to vaccinate all those who are in the age group of 45 and above. It has now decided to vaccinate all under 18-44 age group as well. It is estimated that nearly 900 million doses are required to vaccinate majority of the population.

Experts feel that the government should have completed its target of vaccinating 45 and above groups before deciding to allow vaccination for 18-44 age group.

Till April, the indications available were that it would first complete vaccination to those in the age group of 45 and above but perhaps the Centre took the decision to expand the base in view of the sudden spike in Corona cases. The decision is good but it apparently faulted in its arithmetic.

To cover the entire population in 18 and above age group, India requires around 3.5 million doses a day and we are short by about a million doses or so, claim experts.

Chances of importing Astra Zeneca or having collaboration to manufacture the same here also is unlikely. Reports also indicate that Pfizer's German partner who announced that it would set up a factory in Singapore would take another two years to be ready.

There are other Indian companies like Zydus which are manufacturing vaccine but are still in third stage of trials and are yet to get emergency clearance from the Centre.

The supply is nowhere close to what is needed. We have two major companies manufacturing the vaccine, Serum Institute of India in Pune and the Bharat Biotech in Hyderabad. While SII can produce about 70 million doses, Bharat Biotech can produce another 20 million.

Both are trying to ramp up the capacity but it cannot happen overnight. Though the third vaccine Sputnik will become available from June, the high level of shortage would continue for some more time.

In fact, experts say that the production process itself is time taking process. It is not like churning out medicines once formula is available. Even manufacturing the vaccine doses or filling them into vials takes substantial time and they can be shipped immediately.

They need to undergo quality check as well. Another issue that needs to be resolved yet is transfer of technology to other pharma companies. As of now, the companies manufacturing vaccine do not appear to be willing to go in for technology transfer.

Manufacturing vaccine is a long-drawn process. On the other hand, there is shortage of raw materials like bio reactor bags, lipids and filters have been in short supply. Experts say that the situation may not improve before 2022. By that time more and more vaccines will hit the market, they say.

If the Centre and States had ensured that the pace of vaccination was kept high and it was given top priority during February and March, perhaps the second wave would have been far less intense. The Centre and States were busier in elections and gave an impression that Corona was gone once and for ever.

They never bothered to take effective measures to see that Covid-19 behavioural norms were followed.

The Centre did not keep Plan 'B' ready in case Plan 'A' does not give the result as it desired. As a result, now things are in a state of chaos.

It's time the Centre and State governments review as to where things had gone wrong and may be they should sit together and come up with Plan 'B' instead of each blaming the other. The Centre says they had given millions of doses to states and states challenge those figures.

This is resulting in political 'Tu Tu mein mein' while the common man continues to suffer. Reeling out statistics makes no sense to the common man. What he wants is streamlining of the system and smooth procedure to get vaccinated.

Those who want to get vaccinated free of cost in the government designated centres as well as those who are willing to pay the high rates in private hospitals are equally suffering because of the slot system.

Another major confusion that has been created is regarding the gap between first shot and the second dose.

Initially it was said that the gap between the two doses should not be more than 28 days. Then they said that in case of Covishield it can be six to eight weeks and now they say it can be more.

This raises questions like who is more confused, the government, the experts or the manufacturers. Well, whether any one of them is confused or not people are totally confused.

Of course, in politics it is always said if you cannot convince people confuse them. May be that is what we are witnessing.