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The speed and scale of a COVID-19 immunisation programme will determine how India copes with the pandemic: Dr Alok Roy

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Dr Alok Roy, Chair, FICCI Health Services Committee and Chairman, Medica Group of Hospitals lists his suggestions on how the government can distribute the COVID-19 vaccine like developing an app where all the steps on vaccination can be tracked and following the election structure. Excerpts from an interaction with Viveka Roychowdhury

As a clinician and a hospital management specialist, what are your expectations from the government in terms of ensuring equitable access to the COVID-19 vaccines? 

Given the huge global demand for COVID-19 vaccine, it is but natural that every country wants it first for its citizens. There are legitimate apprehensions as to how much of the total availability will fall into India’s share, at least in the early months. Although a very large portion of COVID-19 vaccines are likely to be manufactured in India through the country’s strong and robust private sector partners. Government needs to plan accordingly before starting to roll out vaccination.

The areas that are densely populated and highly affected by the virus needs to be vaccinated first followed by the regions where the COVID spread is less or insignificant in number. The vaccine should be first given to the frontline COVID warriors like doctors, nurses, health workers who are dealing with COVID patients daily and to those who are into public services at municipal corporations, banks.

The government should create and maintain a directory of all healthcare providers comprising of both private and public sectors. Post which it can be applied to vulnerable patients with comorbidity. This directory will help to plan and monitor the vaccine distribution.

In your opinion, what should be the distribution process so that all Indians get the COVID-19 vaccine shots in the quickest possible time?

The Government should start the vaccination process keeping the most vulnerable population in mind. India needs to have a PPP model for vaccine distribution. The government must follow the election structure for vaccination procedure. During elections, millions of polling booths are set up across the country and the entire nation is covered up in phases within months. The COVID -19 vaccination should be in the similar lines.

There should be cold chain points across the country so that the vaccination process becomes smooth and convenient.   We must be able to spread the vaccine much faster than the virus can destroy lives. Bottom line is the vaccine must be accessible to every citizen of the country, but with a population of 135 billion it will be a humungous task. Both state and centre should keep aside differences and set examples by working together in giving all a chance to reclaim their lives.

What would need to be the safety and efficacy benchmarks for a COVID vaccine getting the authorisation for use in populations?  

Taking a leaf from the benchmarks set by World Health Organization and US Food and Drug Administration, the Indian drug regulator has said it plans to approve COVID-19 vaccines that can provide immunity to at least 50 per cent of the participants in phase 3 clinical trials. Central Drugs Standard Control Organisation (CDSCO) has stated it is keeping the efficacy level at least 50 per cent. It all depends on the scientists involved in developing the vaccine, they are the best judge and will conform to certain benchmarks laid by ICMR. As caregivers we can hope it soon clears all testing parameters and is made available for the greater benefit of the mass populace.

All those those receive the COVID-19 vaccines will need to be observed for any side effects for a long period of time as ‘first generation’ vaccines are likely not to be the best. What is the ground work that needs to be put in place to ensure that India has the capacity to monitor for and report such adverse events, etc?

The COVID-19 virus has already mutated more than 300 times in less than a year. There can be serious side effects and Government, scientists working 24×7 from ICMR, health officials must detect that on real time basis. The government should develop an app where all the steps on vaccination can be tracked. If anyone faces some problem, then they can directly convey it through the app and necessary action can be taken. There should also be a campaign to educate the people about the app specifically in the rural areas. The speed and scale of a COVID-19 immunisation programme will determine how India copes with the pandemic.

As Chair FICCI Health Services Committee, what are healthcare facilities, hospital managements doing to support this endeavour of the Indian Govt?   

This is the biggest and worst pandemic that mankind has faced so far having cataclysmic effect not just on the lives of human beings but also crippling the economy which will take years to recover and rewind back to the times we have left behind. After a lot of research and hard work the scientists and doctors and all frontline workers are just at the edge of victory. So, we all must join hands and fight unitedly to get rid of this deadly virus.

The private and public healthcare bodies should come together and support each other. We must help in building the cold chain, support management, distribution process of vaccine. India is one of the largest syringe makers in the world with a current production capacity of over a billion a year when it comes to 0.5 ml syringes for intramuscular vaccination. So we must advice and lend our hands to support each other.

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