New Delhi: On a day when India reported over 3.86 lakh cases of Covid-19 and close to 3,500 deaths, a government briefing on the pandemic — the second one this week — dwelt on the inevitability of the second wave, blamed drug shortages on misuse and clamour for hospital beds on panic, and downplayed the uncertainty that shrouds the “vaccination for all” plan.
Replying to a question on the uncertainty surrounding the rollout of the third phase of India’s vaccination programme, which begins on 1 May for all adults, Lav Agarwal, joint secretary in the health ministry, said: “Till now the Government of India has given over 15 crore vaccination doses free to state governments. In the phase I and II we went by science to vaccinate healthcare, frontline workers and people above 45 years. These people will continue to be covered by the Government of India. With that, as an additionality, vaccines will be available for others.”
He added that the central government is also working on increasing the availability of vaccines, noting that states and the private sector has been allowed to vaccinate people in the third phase. “The Government of India is providing support to all states on this and they are also talking to manufacturers. We have held an orientation. Based on our conversations with states, we think the vaccination phase III will start tomorrow as designed. Then gradually the programme will stabilise.”
His statement comes at a time when several states including Delhi, Madhya Pradesh, Chhattisgarh and Rajasthan have announced that the third phase cannot begin on 1 May due to the unavailability of vaccines.
Through the rest of the briefing, Agarwal did not attempt to address vaccine supply concerns and focused on the fact that more than 15 crore vaccine doses had been administered so far.
He also used graphs from the US and Brazil to point out that second waves of the pandemic have occurred everywhere and are inevitable. However, Agarwal did not respond to a question on why the Kumbh Mela and election rallies were allowed to take place when the government had knowledge about this inevitability.
The joint secretary also cited data to show that the record number of cases and deaths being registered in high-burden states are several times their previous peaks.
In Uttar Pradesh, the numbers are five times its last peak, 4.5 times in Chhattisgarh, 3.3 times in Delhi and 4.1 times in West Bengal, he said.
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Pandemic spreading to tier I, II cities
Both Agarwal and AIIMS director Dr Randeep Guleria also talked at length about the home isolation protocols (which have already been released by the health ministry and are in the public domain), the precautions that need to be taken and the importance of giving the right drug at the right time. But they also did not acknowledge that there is a shortage of medicines in the country.
Agarwal said: “On the issue of life-saving drugs … whatever drugs are there in the clinical protocol, drugs to be used in home isolation are all available. If you think they are not available somewhere, we will work with states to make them available. Ivermectin is a very easily and regularly available medication. For everything, the solution is not remdesivir and not tocilizumab. They also have alternatives that are widely available and cheaper.
“Better understanding of the clinical management protocol at the field level will help us … remdesivir production is now 4-5 times, we are also importing. The effort is to make drugs available … every medicine has a time when it can be given. When we follow that, only then can we save patients,” he added.
Furthermore, while Dr Guleria conceded that the country’s health infrastructure was strained, he said it is a temporary phase. “The rise has been very steep during this second wave, so that has caused some strain on the hospital infrastructure for some time. But as the turnover time reduces, that should go down. The pandemic is now spreading to tier II and III cities, so it is important to train doctors in these places.”
Agarwal also talked about “misplaced bravery” of people who “believe Corona is a scam”, and the “misplaced fear” that he claimed is leading to hoarding of oxygen and drugs. However, he did not comprehensively address issues such as oxygen shortage and vaccine uncertainties, on which the Centre is now facing censure by the Supreme Court.
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‘India has enough supplies of liquid oxygen’
At the briefing, Agarwal and home ministry’s Additional Secretary Piyush Goyal, who hoped that “India would tide over the present crisis by the grace of God”, claimed that India currently has enough supplies of liquid oxygen. The Government of India, Goyal said, has also additionally started the import process.
“Orders for 1,27,000 oxygen cylinders has been placed on 21 April. Deliveries will start end of April. Additional 500 PSA plants of indigenous technology are sanctioned. These are being installed by DRDO (Defence Research and Development Organisation). Additionally, 551 PSA plants have been sanctioned to be implemented by Union Health Ministry. These plants will be installed in the different public health facilities … Oxygen is also being imported,” Agarwal said.
He added that “efforts are [being] made to increase availability of oxygen tankers to more than 2,000 (from existing 1,224 oxygen tankers with 16,732 MT capacity) through conversion of 50 per cent of existing nitrogen and argon tankers (~600 tankers) and through import of 138 cryogenic tankers for oxygen”.
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