COVID-19 complexities pose new challenges to govt; much depends on success and availability of vaccines

It is almost a year that the news of first case of COVID-19 in Wuhan in China became known to the world. There has been much research since than about how this virus has grown to spread as a Pandemic. There have been blames and counter blame that this has been grown in China to be used as a biological weapon. But this has not been substantiated with evidence till date. In our country first case was reported on 30th January 2020 in the state of Kerala when a student from Wuhan came back. Laxity and unpreparedness on the part of the government at that time led to several problems and increase in the number of cases.

Sudden lockdown in the end of March added to the misery of the people particularly the daily wage earners and small & medium entrepreneurs. The migrant population faced the worst. The first lock down was the time to prepare to meet the disease. But in fact it did not happen to the desired level and it took much longer time before some preparedness to meet the disease became apparent. Public healthcare system was too inadequate to meet this challenge. This has been the result of consistently ignoring the public healthcare system by the successive governments. As a result the people had to shelve out huge amounts of money for the management of the disease in the private sector.

The disease is having a surge again. Third wave has already started showing up in Delhi with alarmingly high number of more than 8000 cases per day. The surge is expected in other parts of the country too as the winter will advance. Already the number of cases which had come down for about a month have now started increasing in the state of Punjab.

Lockdown cannot be a long term phenomenon particularly in a country like ours where the people have to live without any support from the state in the event of crisis. Despite repeated demands that workers should be paid Rs.7500/- per month the government did not do pay any heed. The Micro Small and Medium Enterprises (MSME) too did not get any support from the government and they had to bear the losses due to locked down. The lockdown however only delayed the progress of the disease and deaths. Our GDP fell to -23.9%.

Despite the surge in the number of cases the people do not favour further lockdown. The people are now in the pandemic fatigue. They do not want a restricted life anymore. That is why we see rush in the marketplaces more so because it is festival time. The apprehension is that this will lead to rise in number of cases. It is therefore advisable that people must continue the basic precautions like wearing masks, maintaining physical distance, washing hands and sanitising hands regularly so as to prevent the infection.

We must understand that vaccine is still far away. The WHO has already said that for the healthy young people they may have to wait for more even up to even till 2022 for vaccine. Vaccine production involves large period of time as it is to be tested several times on volunteers before it is put to use among the population. Since the vaccine has to be given to the healthy population it must ensure that it does not cause side effects and harm. Dr Juan Gérvas, Doctor of Medicine, retired rural general practitioner, CESCA Team, Madrid, Spain has raised several questions on the Pfizer vaccine. How long does the immunity caused by the vaccine last is not known.

We do not know yet about the efficacy of the vaccine in different groups, by age, comorbidity, professions, social class, ethnicity, etc. It is also not known if it produces group immunity/ herd immunity in the population. We do not know whether the vaccinated persons can become transmitters (healthy carriers) of the virus. We also must know practical data on price, distribution, conservation, etc.

Ours is a big country with a population of 138 crores. How the vaccine will be prioritized is a big question. The vaccination has to begin from the health workers to the vulnerable section of the society and then the turn of the young people. There is a genuine fear that the vaccine may not be so easily available in the developing countries. The cost of the vaccine is a big factor.

As the population mixing has increased the danger of disease is likely to increase but it may also lead to development of immunity in the population. As per AIIMS Director Randeep Guleria in an interview to IANS, ‘we may reach a stage down the line where we may have a good amount of immunity and the people feel there is now good immunity, the utility of the vaccine is not there. And, if the virus doesn't mutate or does not cause changes that may need you to again vaccinate yourself, because you may get re-infection, then there will be less utilization of the vaccine down the line’.