India has bucked the global trend and is showing a sustained improvement in containing the Covid-19 outbreak, senior government officials said on Tuesday but warned that trends in other countries are also a strong reminder of how the situation can quickly go out of control even if one peak is contained.
Speaking at the government’s routine briefing on the Covid-19 situation, Union health secretary Rajesh Bhushan and Niti Aayog member (health) VK Paul also enumerated the legwork being done across the country for the logistics and training that will be required to deliver vaccines to hundreds of millions of people by next summer.
“Active cases have declined from over 10 lakh in mid-September to fewer than four lakh at present… India’s cumulative fatality rate has also come down to 6.37%, and if you take into account the last week, it is 3%,” said Bhushan, before speaking about the ongoing spike in infections and deaths in other countries.
Paul described the contrast between India and the world as a warning as well as a source of satisfaction. “It is a reminder of the nature of the virus because even we might get a second wave of infections and deaths since this is how this virus behaves. Things can take a drastic turn even after it stabilises. The key lesson is, don’t take things for granted,” he said.
On the other hand, he added, “it is reassuring that we are saving lives. Our situation now is like it was in July. People are now saying that the R-naught has reduced to below 1 and the outbreak is shrinking”. Paul went on to stress on the need to be careful, saying: “Remember, we have a large population of people who are vulnerable”.
On Tuesday, 26,249 new infections were reported across the country, taking the total number of confirmed cases in the country to 9,932,841, according to HT’s Covid-19 dashboard. Meanwhile, 385 more patients lost their lives to the disease in the past 24 hours, taking the total number of fatalities in the country to 144,149.
The Niti Aayog official highlighted the case of the national capital, congratulating the Delhi government and the departments involved for having brought the outbreak under control. “But even as many regions show an improvement, some are still a concern, like Uttarakhand, Nagaland and Himachal Pradesh. We are in touch with officials there,” Paul said.
According to Bhushan, preparations are underway to prepare local officials to receive and administer vaccines, a process that is likely to cover close to 300 million people by the middle of next year. “We will use 29,000 cold chain points, 240 walk-in coolers, 70-walk-in freezers, 45,000 ice-lined freezers, 41,000 deep freezers and 300 solar refrigerators will be used. All these have already reached states and more equipment is being sent,” the health secretary added.
The supplies were among three broad focus points from detailed guidelines sent to the states. These largely dealt with assigning of responsibilities (Bhushan said 23 ministries and departments of Centre and states have been told their roles), training and equipping the people who will be involved in logistics as well as administration of shots, and on how to monitor for and respond to any adverse reactions people might have.
“Instructions (have been) issued on minor, severe and serious AEFI (adverse effect following immunisation). States will identify one AEFI management centre in each block, which could be fixed health facilities. Each AEFI management centres will be mapped with every session sites (vaccination centres) to make sure people can be taken to these instantly,” Bhushan said.
These preparations are being done while at least three vaccine candidates are being assessed for an emergency approval. Paul said there was good progress in the vaccine pipeline, and highlighted a candidate by Gennova which is based on the same mRNA platform as the doses developed by Pfizer and Moderna and was cleared for clinical trials last week. “Unlike Pfizer and Moderna, this vaccine will require normal cold chain temperatures,” Paul said.
To be sure, this vaccine candidate has just been cleared for Phase 1/ 2 trials. Following that, it will, subject to approvals, enter Phase 3 trials.
“We now have six vaccines undergoing human trials in India,” he said, while adding that the approval and assessment process is being done in an independent and objective manner. “This process is being carried out by independent experts and people should feel reassured that whichever vaccine will be approved, it will be on the basis of established scientific and global parameters,” the officials said.
The Drugs Controller General of India is assessing emergency use authorisation applications from Pfizer, Serum Institute of India and Bharat Biotech. Of these, Pfizer has been approved in several countries after having completed phase III trials and finding an efficacy of close to 95%.
Serum Institute has applied for approval of the vaccine developed by University of Oxford and AstraZeneca, which has shown an efficacy of 62%-90%, according to an interim analysis. Bharat Biotech is at present carrying out phase III trials. Both of these companies have been asked by the DCGI’s subject expert committee (SEC) to present more data relating to their trials for their applications to be assessed.