Covid Vaccine Politics | Kapil Khandelwal KK

Ask What You Can Do for Me, My MP and MLA

Vaccine Politics and Funding

Background

India is the world’s leading vaccine producer. However, a lot of discussions in the media by the politicians blaming the Center for the shortage of vaccines has been doing the rounds. One politician even went to the length of sharing the ‘formula’ of the vaccine to other so that they can manufacture the vaccines. A lot of the noise on the increased supply has been creating smoke screens and mirrors to deflect the current mismanagement and blame game between the center and the states for the second wave of Covid. India had set up its vaccine strategy which was

Phase 1: Healthcare and other front-line workers, while gradually opening it up to the 45 plus age group.
Phase 2: Vaccination for all persons above the age of 18 years from 1st May 2021 under phase 3 of its vaccination
From 1st May, under a liberalised & accelerated phase, vaccine manufacturers would supply 50% of their monthly released doses to the govt and would be free to supply the remaining 50% doses to the state govts. And in the open market at a pre-declared price. States are empowered to procure additional vaccine doses directly from the manufacturers. So far, many states have placed their orders directly with the manufacturers and most states have decided to provide free doses to adults. That said, vaccination will continue as before in govt vaccination centers, providing free of cost to health care workers, front line workers and all people above 45 years.

In between, Investeq, a leading financial analyst states in its report Vaccine Supply Modelling for India: Supplies set to improve, Foreign Vaccines to make a big difference Vaccinations: Total spend of $8 billion on Covid vaccines for India in 2021: Investec, Health News, ET HealthWorld (indiatimes.com).

Why is this noise and panic been created? First the politicians, then some equity investment analysts and then even some scientific journals like the Lancet have started voicing this issue of shortages of vaccine all-together. Is this a foreign vaccine lobby playing to put pressure on India to buy their vaccine as India is one of the biggest markets that they cannot ignore as demand saturates in the US? The second issue is why should states or their politicians not fund the vaccine costs for their constituencies?

Indian Vaccination Drive versus The World/China

The chart below shows that India has started out early and is better in its vaccination drive than 90 percentile of the countries of the world.

Let’s understand that India is one of the most inhabited countries of the world. Their nearest neighbour China does not even provide information on their immunization status and yet report near zero Covid cases these days. China has procured for only 13% of its population while India 18% of the population so far.

Country	Vaccine	Amount (USD Mn)	Dosage	Population Covered (Mn)
India	AstraZeneca (Covishield)	417	2	209
	Covaxin	80	2	40
	Sputnik V (Russia)	3.15	2	2
Total			500 Mn	250

China	Sinopharm	177	2	89
	Sinovac Biotech	118	2	59
	CanSinoBIO	30	1	30
	Anhui Zhifei Longcom Biopharmaceut	18	3	6
Total			343 Mn	183

Asking our MPs and MLAs to Pay for the Vaccination

India has already administered 185 million doses. The current split is 166 million of Covishield and 19 million of Covaxin. There are around 315 million doses that has already been paid for. This would cover around 25% of our population. We will need another INR 75,000 crores to fund the immunization program to reach the Covid herd immunity. Now comes the political issue that some of the States want to deliver the vaccine free of costs to all in their states and do not want to pay or have the adequate budgets. Therefore the issue of political blame game between the Center and the States. If you see the current vaccination drive across the districts, some have a higher rate than others. When we dissect the same information as per Parliamentary there is a surprising revelation. Some of the Parliamentary Constituencies has performed better and are not correlated to the district coverage of the immunized population.

So why not decentralize this process of vaccination to the grassroots to the elected MPs and MLAs for their electorate so that all the politics of vaccine supply is nipped in the bid. We have 543 MPs and 4215 MLAs in India. An MP gets INR 5 crores while the MLA get INR 2 crores per annum to be spent on their in their constituency for the local development. This comes to INR 2715 crores per year from Lok Sabha MPs and INR 8430 crores per annum by the State MLAs. Over 5 years this amounts to INR 55725 crores. History shows that hardly 25% of this money is spent. As Covid is a black swarm event for the country, the next 5 years of the MP and MLAs Local Area Development Spend is advanced right now so that they can procure the vaccines for their constituency electorate and get them vaccinated as per the vaccination strategy announced. This will also ensure that the blame game between the parties and the Center and State is put to rest and the elected representative are put to work to deliver the results of the vaccination to their electorates.

Should We Impose Complete Lockdown Now?

Background

Our Supreme Court has directed the Central and state governments to consider imposing a ban on mass gatherings and super spreader events. “We would seriously urge the Central and State governments to consider imposing a ban on mass gatherings and super spreader events. They may also consider imposing a lockdown to curb the virus in the second wave in the interest of public welfare,” the SC said.

Let us understand that the national lockdown in the first Chinese Wuhan Virus Wave was to create the requisite infrastructure and capacity to ensure that the country does not go into a crisis and the 7-day moving average (7DMA) of infection does not increase the stipulated doubling rate of 1 day. Moreover, the cost of lockdown to the economy for a single day of lockdown is around USD 6.0 billion (INR 45,000 crores approx).

In the second wave, the issues are different. We have our 7DMA of infections is much lower and the doubling rate is much higher. Moreover, as the immunization drive picks up, we will see the two parameters of 7DMA and doubling rate become even more manageable.

So the issue in front of us is, should we impose a complete lockdown and for how long taking cognizance of the Supreme Court directives.

How Far Are We From the Peak in this Second Wave?

In order to arrive at a predictable view of how long should India and its states go into a lockdown and even out the daily economic losses to the country, there are several parameters which we need to consider:

Second Covid Wave in 12 countries before India
Second Covid Wave Peaks in Different States and Cities in India
Covid Immunisation strategy

Second Covid Wave in 12 Countries before India

we can learn from the other countries which have gone through the second wave before India. Based on the learnings from these countries, our Central and State Governments can work out a formula to impose lockdowns and unlockdowns without hurting the economic activity in the country. The table below gives out the duration of the second wave (in days) and % of population that was infected during the Second Wave:

While it is pretty apparent that each country reacted to the second wave differently. The chart below shows how effectively did each of the 12 countries manage the second wave.

Spread of the Second Wave of Chinese Wuhan Virus

Mexico, Turkey, Israel has the second wave duration of less than 100-days, while Germany and Canada had a duration of over 200 days. The peak of the Second Wave was around 120 days (ie 4 months) as an average). The average population that was infected in these 12 countries was around 2.5%.

This is valuable information and analysis for us to predict where India is in the second wave.

Second Covid Wave Peaks in Different States and Cities in India

Maharashtra including Mumbai was the first state to begin with the Second Wave in India. It has already seen the peak and is around the global average of around mid-point of the 120 days wave (ie. 60 days). We will see India as a country peaking by mid-June 2021, unless we solve all the infrastructure and logistical nightmares which some cities like Delhi is undergoing.

WhatsApp Image 2021 05 04 at 08.40.09 — Analysis by IIT Kanpur Prof Manindra Agrawal

The other silverlining is that many other Indian cities are already in their peaks. An interesting analysis by IIT Kanpur Prof Manindra Agrawal shows.

Covid Immunisation Strategy

As I have already written, our Covid immunisation strategy needs to be reworked. It’s not the political compulsions and broad headlines. We need to immunize over 15% of our population by Mid-May 2021 which we have not yet achieved and most likely going to miss the target for the total duration of the second wave and the imposition of nation wide lockdown durations to recede.

Therefore, the opportunity costs for the country in reducing the duration of the lockdown in the second wave is huge provided we implement our covid vaccine immunization strategy and coverage astutely. Invest, invest, invest in immunizations and make it free for all as an incentive. The rest the statistics at the end to the lockdown will reveal.

No Courts in the World Bear the Economic Outcomes of the Country based on their Judgement!

Science of Politics of Covid Vaccine in India

Covid Vaccine Politics

Background

India has finally developed a vaccine for Covid which was approved by the regulatory authority the DCGI and it now the front runner for production of vaccines in the world. This is a great moment for India’s scientific might and I want to congratulate all the scientists who have worked tirelessly to deliver this solution to fight Covid to the world. Let me tell you that having worked in the drug development industry and also on the boards of several pharma companies, and biotech industry policy making, all efforts of the scientists are guided towards drug safety and efficacy before the final vaccine candidate is commercially produced for the masses. In the last 24 hours, leaders of several political parties have placed their roles in shamming and shaming the Indian scientists on the Covid vaccines being approved by the regulators in India. Let me inform you that Indian scientists do not work for political parties, they work for the advancement of science and technology. In this blog, I want to debunk some of the politics going on around our Covid vaccine and the timing of their political statements

The Political History of Bharat Biotech

Bharat Biotech whose vaccine Covaxin started in 1996 in the Genome Valley in Hyderabad. At that time the Deve Gowda Government with the support of Congress was at the center and the Telgu Dessam Party (TDP) was ruling in Andhra Pradesh. Let me remind the leaders of Congress who have come out with some statements, why did your Minister heading the Department of Science and Technology under which Department of Biotechnology (DBT) comes in provide grants to such a company if you believed that today that company is a fraudulently and premature in producing a vaccine for Covid. Over the years under the Congress rule, Bharat Biotech received some many grants and awards from the DBT to further their development of various vaccines. Infact BIRAC an arm of DBT also owned equity in Bharat Biotech at some point in time for the funding that was provided to Bharat Biotech by the Congress Government. I had been associated with the DBT and the Principal Secretary, DBT during the Congress Government who I worked closely to deliver the Biotech Ignition Grant Policy to the nation. He was very appreciative of the work Bharat Biotech had done and achieved several milestones in its journey with several vaccines and patents.

The Science into Politics – Way Forward

Rather than making baseless statements around the vaccines being approved, its time political parties appoint a Chief Scientific Advisor like they had Chief Economic Advisors in their party. The job of this Chief Scientific Advisor and his team would be to sieve through the clinical data presented to the regulators DBT, DCGI and other departments and raise scientific issues and challenge the science on the floor of both the houses of the Indian Parliament through their elected party representatives rather than make frivolous public and press statements outside the house. This would imbibe science into politics and allow for the ruling political party of the day to address any issues relating to the science of drug development through the right governance mechanisms of our Parliamentary Democracy. All I must say here is: Dear Politicians, please do not debunk our Scientific progress for your political gains and headline statements for your parties and your social media impressions and eyeball. In the eyes of science, you all have been marginalized completely.

Jai Hind!

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