The AstraZeneca vaccine has been clinically tested to have an average efficacy of 70 per cent. We still need containment drills

With India clearly in the midst of a third wave — some might even call it a tsunami of new Coronavirus cases — we should not be surprised. Even a cursory glance of what happened during the 1918-1919 Spanish influenza pandemic should have warned us to be prepared for winter, because even a century ago, there was a massive increase in cases in winter when the cold compromises lungs thanks to congestion and any influenza virus can be devastating. With the Delhi and Gujarat governments in a state of panic, it is almost certain that cases will begin to increase across the country whether the authorities admit to them or not. But there is some positive news with British pharmaceutical firm AstraZeneca, which has jointly developed a vaccine with University of Oxford to combat the Coronavirus, coming out with its trial results. That is because the Serum Institute of India (SII) has been a partner to this research as well and has promised that it will produce hundreds of millions of doses of this vaccine for Indians. Yet, the results have only indicated an average of 70 per cent efficacy with two full doses taken a month apart and up to 90 per cent when an initial half dose is combined with a full dose taken after one month. Promisingly, the vaccine doesn’t need super-cold storage like the ones developed by Pfizer and Moderna, requiring only refrigeration. It also appears that as many as five other promising vaccine candidates might make it to the markets by early 2021.

However, as we have maintained, the development of a vaccine is not equal to its deployment. Also, if as the trials have indicated, with at least one-and-a-half doses required for maximum efficacy, India will need a whopping two billion doses. Even if costs are kept in check, this is looking at a time frame that might take well over three-four years to inoculate a substantial number of Indians in order to gain a decent amount of protection. At the same time, because efficacy is not the same as effectiveness, even with 90 per cent efficacy, the Coronavirus will continue to pop up, tens of thousands will continue to get infected and many more will die before the Wuhan pandemic truly settles down. Till then, preparedness and preventable behaviour are the only containment devices against an unexpected surge and given India’s population density, we better reconcile ourselves to the fact that our crests will be a constant for some time. Maharashtra, which has been the worst-affected State in the country, fighting the longest battle and is now threatened with a new front, has finally released its new screening SOPs that make a RT-PCR test report mandatory for visitors who are travelling to the State from hotspots. All entry points to the State will have testing and screening centres for those not carrying such a report. This is the first time that international travel protocols are being followed domestically and perhaps would be adopted by other States, too, to keep the numbers down. It is a shame indeed that the Supreme Court has had to pull up State Governments on laxity and seek a status report on preparedness. The court also had to get into the nitty gritties of ensuring dignified treatment of the dead and vetting hospital conditions to treat the sick. A fatigue has undoubtedly set in, socially, psychologically and physically. Doctors are the worst affected, some of whom need to be relieved with younger colleagues now being drafted in to ease frontline pressure. Anticipation is the best defence now. The pandemic has forced Governments to invest in public health like never before but now investments in vaccine manufacturing and deployment will be the challenge. These are positive developments but let us not pretend that the news of a vaccine is a silver bullet that will magically cure the world.

The AstraZeneca vaccine has been clinically tested to have an average efficacy of 70 per cent. We still need containment drills

With India clearly in the midst of a third wave — some might even call it a tsunami of new Coronavirus cases — we should not be surprised. Even a cursory glance of what happened during the 1918-1919 Spanish influenza pandemic should have warned us to be prepared for winter, because even a century ago, there was a massive increase in cases in winter when the cold compromises lungs thanks to congestion and any influenza virus can be devastating. With the Delhi and Gujarat governments in a state of panic, it is almost certain that cases will begin to increase across the country whether the authorities admit to them or not. But there is some positive news with British pharmaceutical firm AstraZeneca, which has jointly developed a vaccine with University of Oxford to combat the Coronavirus, coming out with its trial results. That is because the Serum Institute of India (SII) has been a partner to this research as well and has promised that it will produce hundreds of millions of doses of this vaccine for Indians. Yet, the results have only indicated an average of 70 per cent efficacy with two full doses taken a month apart and up to 90 per cent when an initial half dose is combined with a full dose taken after one month. Promisingly, the vaccine doesn’t need super-cold storage like the ones developed by Pfizer and Moderna, requiring only refrigeration. It also appears that as many as five other promising vaccine candidates might make it to the markets by early 2021.

However, as we have maintained, the development of a vaccine is not equal to its deployment. Also, if as the trials have indicated, with at least one-and-a-half doses required for maximum efficacy, India will need a whopping two billion doses. Even if costs are kept in check, this is looking at a time frame that might take well over three-four years to inoculate a substantial number of Indians in order to gain a decent amount of protection. At the same time, because efficacy is not the same as effectiveness, even with 90 per cent efficacy, the Coronavirus will continue to pop up, tens of thousands will continue to get infected and many more will die before the Wuhan pandemic truly settles down. Till then, preparedness and preventable behaviour are the only containment devices against an unexpected surge and given India’s population density, we better reconcile ourselves to the fact that our crests will be a constant for some time. Maharashtra, which has been the worst-affected State in the country, fighting the longest battle and is now threatened with a new front, has finally released its new screening SOPs that make a RT-PCR test report mandatory for visitors who are travelling to the State from hotspots. All entry points to the State will have testing and screening centres for those not carrying such a report. This is the first time that international travel protocols are being followed domestically and perhaps would be adopted by other States, too, to keep the numbers down. It is a shame indeed that the Supreme Court has had to pull up State Governments on laxity and seek a status report on preparedness. The court also had to get into the nitty gritties of ensuring dignified treatment of the dead and vetting hospital conditions to treat the sick. A fatigue has undoubtedly set in, socially, psychologically and physically. Doctors are the worst affected, some of whom need to be relieved with younger colleagues now being drafted in to ease frontline pressure. Anticipation is the best defence now. The pandemic has forced Governments to invest in public health like never before but now investments in vaccine manufacturing and deployment will be the challenge. These are positive developments but let us not pretend that the news of a vaccine is a silver bullet that will magically cure the world.