As coronavirus disease (Covid-19) cases and deaths rise in India with businesses, transport and activities opening across states, the responsibility of stopping the spread of the infection lies with each one of us, besides the government.
India’s test, track and treat strategy can be effective only if people with symptoms or with possible exposure to a Covid-19 case voluntarily get tested or stay in home isolation for two weeks after exposure or symptoms. Since the infection can be spread by asymptomatic and pre-symptomatic people, wearing masks and maintaining social distancing in public places is non-negotiable, irrespective of symptoms, till a vaccine is widely available.
Protection and vaccination are the only way to get a semblance of normalcy back. The World Health Organisation (WHO) on Friday called national lockdowns “a blunt instrument” that could be avoided with the right mix of targeted and tailored measures, such as using a data-driven approach to drive a targeted response.
For example, instead of waiting for test results that have a lag of five days to a week — after a person gets infected, develops symptoms, gets tested and, finally, receives the result — containment zones with mass testing should be set up the moment people in a neighbourhod report symptoms.
Hopes for an early vaccine were bolstered on Friday with Russian researchers publishing results from two small, early-phase clinical trials that demonstrated that their Covid-19 vaccine, Sputnik V, is safe, and produced antibodies and an immune response in all 76 volunteers. It stimulates both arms of the immune system – antibodies and T cell responses – attacking the virus in the body and also cells infected by Sars-CoV-2.
Sputkin V has two formulations (frozen and freeze-dried). The frozen formulation is planned for large-scale use with the help of existing global supply chains for vaccines, while the more stable freeze-dried formulation was developed for hard-to-reach regions where it can be stored at 2-8 degrees centigrade.
“I think they have a good vaccine, the early-phase results are promising. Like for all other vaccines, it needs to undergo larger and more safety and efficacy trials before it is approved for population use,” said Dr K Srinath Reddy, president, Public Health Foundation of India.
Dr Randeep Guleria, director, All India Institute of Medical Sciences, New Delhi, agreed. “Sputnik V has elicited an immune response and caused no adverse side-effects. The results are encouraging, but it’s a very small sample size,” he said.
All vaccines aim to expose the body to an antigen that won’t cause disease but will provoke an immune response that can block or kill the virus if a person becomes infected. Each type relies on different viruses or viral parts to trigger an immune response.
Russia’s vaccine consists of two shots that use two adenoviruses (26 and 5) to carry the gene for the surface spike protein of Sars-CoV-2, the virus that causes Covid-19. Adenoviruses, some of which cause the common cold, are efficient vectors for delivering genes or vaccine proteins to the target host tissue. It is a tried-and-tested method used in vaccines and gene therapy.
Russia drew flak last month when it approved Sputnik V, which became the world’s first Covid-19 vaccine to be approved for use on August 11, before publishing early trial results for scientific scrutiny. The experimental Sputnik V is now in Phase 3 trials that include 40,000 volunteers from different age and risk groups. Vaccines developed by Oxford-Astra Zeneca, Moderna and CanSino are the other candidates in large late-stage trials.
There are 34 experimental vaccines in clinical trial phases and 142 vaccines in preclinical evaluation stages, according to the WHO landscape of Covid-19 candidate vaccines on September 3, which raises hope that one or more effective vaccines will be ready for use by early next year.
Even so, the supply will be limited and priority will be given to vaccinating essential workers and those most at risk. The Covid-19 Vaccine Global Access Facility (COVAX Facility) partnership, which is the world’s largest and fastest-ever procurement and supply of vaccines effort supported by WHO, GAVI-The Vaccine Alliance, Coalition for Epidemic Preparedness Innovations, Pan American Health Organization, World Bank, the Bill and Melinda Gates Foundation and other partners, aims to ensure no one gets left behind.
Unicef is leading efforts to supply Covid-19 vaccines on behalf of the COVAX Facility to 92 low- and lower middle-income countries whose vaccine purchases will be supported by the mechanism through the Gavi and a buffer stockpile for emergencies. Unicef will use its existing supply chains as it is the world’s largest single vaccine buyer, procuring more than two billion doses of vaccines annually for routine immunisation and outbreak response on behalf of nearly 100 countries, including India.
As the governments, both Centre and states, ramp up testing and streamline medical support and infrastructure, each one of us must do our bit to stay safe and break the chain of infection till the world gets a vaccine.