Taking Public Health Measures Can Dampen Cycle Of Covid Transmission In India: Harsh Vardhan

Health Minister Harsh Vardhan speaks to Outlook on the second Covid wave, vaccination, challenges, if vaccine acceptance has increased, and much more. Excerpts:

 1) Covid-19 cases are rising steeply again after a long lull. How worrisome is this and how will you stop the surge?

The cases in the country had started to decrease since September 2020. The recent rise in cases is indeed worrisome, however, our systems are sensitive enough to detect such changes timely which enables us to take timely steps. This time again, in coordination with the State Governments and every citizen, we can stop the rise in cases right away.

We know which states are showing a steep rise, how much variation is there from before and, accordingly, have given directions to States/UTs to focus on test-track-treat strategy, individual actions through Covid appropriate behaviour, quarantine & isolation protocols, defining containment zones where a cluster of cases are found, proper and timely clinical management of cases, ensuring adequate supplies and equipment in health facilities for case management and analysing the deaths/cases to reduce mortality. Also, all steps to cover the districts showing high caseload with Covid-19 vaccination as per the prioritised groups.

2) The vaccination drive is opened for all adults above 45. What is the size of the target population?

No set target has been given to the States/UTs for the vaccination drive. The Covid-19 vaccination is an ongoing and dynamic process, which is being expanded to include beneficiary groups as prioritized by the National Expert Group on Vaccine Administration for Covid-19 (NEGVAC). Given the dynamic and evolving nature of the Covid-19 pandemic, no fixed number or target or a time frame can be assigned for the vaccination drive.

3) What are the challenges? In recent weeks, India has been administering an impressive 2 million-plus doses a day but there's still a long way to go in terms of population coverage.

There were few challenges initially like apprehensions about a new vaccine and some technological challenges. However, these problems have been gradually resolved. Co-WIN 2.0 is a flexible platform and improvised based on feedback from States. The communication strategy has helped in allaying apprehensions towards the vaccination drive and address vaccine eagerness. 

The vaccination process is guided by NEGVAC where scientific rationale, disease epidemiology as well as vaccine availability is considered to guide the decisions. The current rate of Covid-19 vaccination is very satisfactory and is being further increased through an increase in the number of Covid-19 Vaccination Centres (CVCs) in both government and private health facilities.

4) Has vaccine acceptance increased? How are the concerns over Adverse Events Following Immunisation (AEFI) being addressed?

The number of beneficiaries vaccinated per day has been gradually increasing which in itself is an indication of public confidence and acceptance of the vaccine. The Adverse Event Following Immunization (AEFI) is monitored through a well-structured & robust AEFI surveillance system. For Covid-19 vaccinations, the same process is being followed and helps to capture all the AEFIs to analyze for any causal relationship with Covid-19 vaccination. Causality assessment by the designated AEFI committee helps in determining if AEFI is related to the vaccine or vaccination process or otherwise. Also, measures have been put in place like availability of anaphylaxis kits at each vaccination site, immediate referral to Adverse Event Following Immunization (AEFI) management centre and observation of vaccine recipients for 30 minutes at session site for any adverse events to take timely corrective measure. Also, the AEFI management of such cases is provided free of cost treatment in Public Health Facilities.

5) What will be the likely road-map of the vaccine rollout going ahead, and the private sector participation?

The rate of Covid-19 vaccination is being increased through an increase in the number of Covid-19 Vaccination Centres (CVCs) in both government and private health facilities. This provides more choice and convenience to the citizens and makes it a citizen-centric programme. The NEGVAC will guide the future course of action based on scientific evidence.

6) So far, Covishield accounts for 90 per cent of the 60 million doses administered and the remaining is Covaxin. Why?

This is based on the supplies and quantity offered by the manufacturers.

7) Will more vaccine candidates be offered shortly?

Going by the development landscape, there are five vaccines under clinical trial in India. Some of those are under Phase III clinical trial and are expected to be for potential use provided they show promising results. The Covid-19 vaccines which will be approved by the National Regulator, i.e. Drugs Controller General of India, will be taken up under the vaccination drive.

8) Covid-19 cases are rising steeply again after a long lull. How worrisome is this and how will you stop the surge?

This is indeed a very pertinent question. After witnessing nearly, a four-month decline in cases, we have again started to notice an upswing in many States. However, as this trend of resurgence has been witnessed in many countries, the Government was very aware of this possibility and I have also cautioned against such resurgence in cases during many past media interactions.

However, it may be noted that only a handful of districts in selected States/UTs are contributing too much of this rise in cases. A case in point is that around 70% of the new cases of Covid-19 in the country are reported by only 46 districts. If we take up requisite public health measures with a renewed vigour in these districts, we can once again dampen the cycle of Covid-19 transmission in the country.

Not only do we now have the long experience of tackling the pandemic but also have the availability of safe and effective vaccines. The containment strategy using the test-track-treat approach remains as valid as it was before. Perhaps more importantly, the Covid appropriate behaviour as a preventive tool remains the best social vaccine we have, and strict adherence remains extremely fundamental in our nation’s fight against the pandemic. We are working together with the States to ensure readiness to manage any surge in cases.