The only way out of the tunnel of the raging Covid pandemic causing immense morbidity, mortality and suffering is to go through it and as the rate of the double dose vaccination steadily rises, we will soon see the light at the end of the tunnel.
On 24th April 2021, the vaccine campaign crossed its biggest milestone – one billion doses given worldwide. However, as of now, less than 3% of the world population is fully vaccinated. There are world leaders in Seychelles and Israel which have fully vaccinated 63.9% and 55.5 % of its population respectively resulting in the rapid decline of covid cases and deaths in these countries. In the U.S, 231 million doses have been given thus far with 27% of its population being fully vaccinated and 40% partially vaccinated. The UK has strategized increasing the gap between the two doses of Oxford AstraZeneca vaccine to 6-8 weeks to vaccinate 50% of its pollution with one dose. Though India has administered more than 145 million doses with more than 2.5 million doses per day only 1.7% of the population is fully vaccinated. At this pace, India will take another 11 months to cover 60% of its population with at least one dose and there is an emergent need to ramp up the administration to three times of present at each of its 73600 vaccination centres.
Emerging data globally and in India suggests that fully vaccinated individuals (Individuals who are at least 2 weeks out from having received their second dose of the vaccines) are less likely to develop severe disease, be hospitalized or die even if they were to become infected. In addition, the fully vaccinated but infected people are less likely to transmit Covid to the unvaccinated people as the viral load (which is the single most important driver of transmission) in the respiratory tract is considerably lower. Piecing all this information together, vaccination has the potential to substantially reduce the Covid-19 disease burden worldwide. Number of studies of large populations done abroad to support the high real-world effectiveness of Covid-19 vaccines as three times more healthcare workers got infected in the unvaccinated group as compared to the group vaccinated with two doses in a follow-up period of two months. Real-time data emerging from hospitals in India indicate a 5-8% incidence of breakthrough infections after double dose vaccination, however, most cases are mild to moderate and do not require hospitalization. Ongoing robust studies are needed to demonstrate the effectiveness of the vaccines.
There are 13 vaccines globally that have received emergency authorization with efficacy ranging from 60% to 95% and there are many more promising candidates including needless and oral options in the pipeline. In India, Covaxin and Covishield have been used. It is expected that Sputnik V, developed by Russian Direct Investment Fund (RDIF) and in the process of manufacture by multiple Indian firms will be rolled out from next month to support the country’s phase 3 drive .Allowing other authorized vaccines entry into India as also fasttracking vaccine trials which have been approved abroad could be explored in the country.
The liberalized third phase of the inoculation drive aims at a liberalized vaccine pricing and scaling up of vaccine coverage to the above 18. Prioritising vaccination in young mobile super spreader adults from states with a heavy infection load, vaccinating pregnant and lactating women ( already started in the west )and addressing vaccine hesitancy with good communication strategies encouraging vaccination in Covid infected but recovered individuals would prove to be a game-changer. The coming months could see the expansion of vaccine coverage to children with Pfizer leading the pack awaiting emergency FDA authorization and many more vaccines enrolling for clinical trials in 12-15year-olds.The energy of the nation should be focused on ramping up production and administration by mobilizing multiple manufactures.
Ramping up our genomic surveillance to detect the variants circulating in the country and assessing the efficacy of approved vaccines against them by strong pieces of evidence and real-world comparable data is the need of the hour. Initial result of various ongoing studies conducted in Centre for Cellular and Molecular Biology (CCMB) in Hyderabad assessing the neutralization activity of both approved vaccines in India against the variants and the double mutants show encouraging results. The future could see tweaking of the Covid vaccine much like the influenza vaccine every year.
How quickly does the world expect to return to pre-pandemic life? The truth is, not very soon, though several countries like Israel are gearing up to reopen their economy and returning to normalcy. The country’s well-trained health care providers and a digitized community-based health system that can identify highrisk persons have been major factors in the success. The countries’ tourism minister has described Israel as the first country to exit the pandemic. The United Arab Emirates and the UK have also given indication for return to normalcy.
Since getting vaccinated does not mean we cannot catch the virus or transfer the virus to others, we should continue to adhere to the safety guidelines of the well-fitted mask, hand hygiene and social distancing and avoiding crowded areas. Special precautions should be observed at vaccination centres. At an individual level, some of the traditional and herbal remedies have proven immunomodulatory potential and can play a vital role in promoting health and well-being. These include among others, the use of curcumin, black pepper, cumin, cloves, application of oils to the nose, ingestion of herbal extracts, gargling, inhalation of steam and ingestion of micronutrients like Vitamin C, D and zinc along with a good diet, regular exercise and sound sleep.
Views expressed above are the author’s own.
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