Expressing regret that despite being the largest producer of vaccines in the world things have fallen apart in India, Ashok Seth, a Padma Bhushan awardee and chairman of Fortis Escorts Heart Institute, has said that the focus needs to be on  percentage and not the number of population vaccinated.       

“With a 1.2 billion population we cannot say we can vaccinate X number of people. Herd immunity comes in when a large percentage of population is vaccinated…till 70% population is vaccinated,” said Dr Seth.

“As a country considered the biggest manufacturers of vaccines in the world we started off with the right philosophy… What should have been the powerhouse of vaccination somehow seems to have fallen apart. It was said that when we started we had 60 million [6 crore] doses available a month and capacity to manufacture 100 million [10 crore] doses a month and it was assumed that we had the ability to manufacture 2.4 billion doses a year. We fell apart in understanding what needs to be ramped up.”

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Dr Seth was in a conversation with Kailashnath Adhikari, MD, Governance Now, on Wednesday as part of a webcast of the Visionary Talk series organised by the public policy and governance analysis platform.

Drawing an analogy with the voting process, he said as a country with a huge population, when India has the ability to make its 1.2 billion people come out and vote and 70% of them turn out in an election process within just a few days for the national election, when time taken to get vaccinated is longer than to go and vote… “This is considered impossible worldwide.”

He said the government has worked efficiently over the last one year and expressed confidence that once the shortage is overcome in a month or two and the required 150 -200 million doses are available every month, India will achieve its targets within six months with surplus doses available. “It has the ability to achieve this. All this was achievable in our country without having policies. There has been a 15-days lag as 18-44 years needed to be vaccinated and people needed their second dose.”

He recommended increasing the gap between two doses, and said just like Britain delayed the second dose of vaccine by three months, the WHO recommends the same. “The trials also show better immunity if the second dose is expended up to three months or 12 weeks. India could also follow the same and delay the second doze by three months instead of two. This will extend the availability of vaccine to a larger proportion of people – at least for Covishield.”  

Dr Seth added that vaccines give 70%-80% protection against Covid two weeks after the second dose and reduce risk of death by 99%. It prevents us from getting serious Covid infection. A single dose reduces transmission of disease to others at home by 50% and creates herd immunity at the community level over a period of time.

He said in 80% of cases things are going to be alright. In 20% cases the virus is going to have the better of us. He said that it is a must to follow Covid appropriate behaviour, properly wear masks, double masking, social distancing, avoiding crowds, cross ventilation and hand hygiene are barriers to the virus and protect us from infection and bring back normality of life over a period of time.

The economic disparity in country and for those surviving on daily wages, living in small rooms and settlements for survival, social distancing and sanitation is a joke, said Dr Seth as he added that the  harsh reality is that the  educated, intelligent and those who can easily follow this are setting bad examples and unfortunately biggest offenders. “We as a country have become a most undisciplined nation in the world,” he said.

Asked if the recent emergence of mucormycosis, also known as ‘black fungus’, was the onset of something potentially dangerous, he said it is a life-threatening but rare condition and can be serious for those who are immunosuppressed as it is airborne. He said it is important for those who have serious Covid and been in the hospital and on steroids and they must watch out for symptoms of continuing fever, stuffiness of nose, aches and pains around eyes, mouth, sinuses, blurring of vison, strokes and immediately approach the doctor for a checkup as the fungus can spread inside the body.

He recommended that the old and the young can get an electrocardiogram two to four weeks after recovery from Covid to ensure that there was no effect on heart muscle. He said the vaccine can be taken four weeks after recovery. He also recommended monitoring body oxygen by a pulse oximeter after some physical activity.

On antibodies, he said, testing them for your own protection is not recommended other than as part of an epidemiolocal assessment and surveys.

“The biggest vaccine is masks, social distancing, not going out unnecessarily, keeping sanitation. Covid appropriate behaviour is the social vaccine and then there is the medical vaccine. If both are combined antibodies and mutants don’t matter,” said Dr Seth.

He invoked the mission of COVAX group, the global initiative of 172 countries on vaccination, and said, “No one is protected till everyone is protected. No one is immunised till everyone is immunised.”