The nation should be alarmed at the slow manner in which the administration has responded to the snowballing pandemic due to the Omicron variant of the Sars-Cov-2 virus. In fact, it is more like a non-response, almost a carte-blanche given to the virus, if that is possible, to do its bidding. This is surprising, given our experience of the devastation that the first and second waves of the pandemic caused.
It was more than a month ago, on November 26, to be precise, that the WHO declared Omicron to be a variant of concern. The WHO took just two days, after the announcement from South Africa about this variant, to issue its warning. Scientists in South Africa provided early signals of two sinister properties – transmission efficiency higher than that of the then record-holder, the Delta variant, and Omicron’s ability to dodge immunity, whether induced by infection with other variants or by vaccines. That the WHO made the right decision at the earliest is a lesson in the process and spirit of an “evidence-based decision”. An early decision was critical and the available evidence was judged to be sufficient.
When confronting a probable problem, the decision may range from none for the time being, to deferring for more evidence, to making a conditional decision or making a definite decision. Evidence was not the only factor in the equation, but also the potential adverse impact of any delay. We could disagree on whether the evidence was sufficient or not, but no one will doubt the wisdom of an early call, for such early and decisive announcement, gave all countries of the world information for early action.
Japan, the country that had enjoyed two months of the endemic prevalence of Covid-19 since end-September, decided to block the importation of Omicron by disallowing travellers from any country. But the virus had already entered Japan, through a twice-vaccinated Namibian diplomat. Japan abandoned the no-entry policy but is bracing for a new wave with all other well-known defences, including booster doses. India must watch the situation there.
India had been enjoying an endemic state for over four months, from the second week of July till late November. Our stakes were high; we did not desire the third wave. Life was limping back to normal; educational institutions were open. Elections were approaching in Uttar Pradesh. Immediate intervention to block a probable third wave was the expected response, but that was not the decision the policymakers made. They chose not to make any decisions for the time being.
That decision, to apply no intervention to block a wave of disease or at least to flatten the probable epidemic curve, is very strange, almost as if the policymakers were deliberately unconcerned about the risk of a third wave. Experience in other countries clearly showed that India must expect a huge rise in infections. Omicron was, and is, causing disease less severe than Delta in other countries, but the sheer magnitude of infections is sure to cause an increase in disease cases, mostly affecting senior citizens, those with risk-prone medical conditions, pregnant women, etc. There was no reason for expecting zero risk of a wave of disease. Why would a government then defer action and seemingly welcome a fresh wave?
The response strategies adopted against the first and second waves do not provide any clue. No vaccine was available during the first wave. Vaccines were approved for ‘emergency use’ on January 3, 2021, almost three months prior to the second wave, but no effort was visible to use vaccination as a method of mitigating disease, hospitalisations and death. That was also surprising and disappointing. The pace of vaccinations was about 1% of population covered per month, slowly increasing to 2% but no more until the second wave abated naturally. We could attribute that to traditional inefficiency, slow rollouts, mismanagement at logistics, distribution and a host of factors that come into play when such a large operation gets into the works.
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But now, none of these should be factors. We have enough vaccines to create a wall of population immunity to dampen the onslaught of an impending Omicron wave of disease. Yet, one full month, November 26 to December 26, passed without any sign of using vaccinations to mitigate the size or severity of the potential third wave. Then came a decision for deferred action, minimal, more tokenism than substance. The age range of vaccination was enlarged to cover adolescents of 15-17 years, starting on January 3. Even if we achieve high coverage, this response is unlikely to affect the shape or mass of a third wave. In effect, our delayed response will make no impact on the third wave, which will come and go, if it wishes, the way it wishes, when it wishes. We have surrendered to whatever the virus does.
Another deferred action is to offer a booster dose for those above 60 or those with medical conditions, as well as for front-line workers – healthcare and others. But stipulating a minimum nine-month gap between the second dose and the third dose, instead of the suggested and science-based six-month gap, tells us that the government is in no hurry to reduce the impact of a third wave on the lives and health of vulnerable people.
These decisions were announced without explanation or supportive logic. They create the impression of action. But underneath that façade is also a message that the government is in no hurry to fight Omicron and reduce the misery it can bring, particularly on vulnerable sections of society. We may even ask – are we doing this because Omicron apparently causes less disease among the young, the fit and those with means. Are we not bothered about the elderly, those who are ailing or those whose immunity has been compromised?
If that were not the case, actions would have been quicker and more goal-oriented – not merely trickling, minimalistic and ritual-like. Even if we let pass the response at the time Covid-19 first struck or during the two deadly waves, the lack of prompt action in increasing vaccine coverage this time cannot be condoned.
(The writer is a former Professor of Clinical Virology, Christian Medical College, Vellore, and former president of the Indian Academy of Paediatrics) (Syndicate: The Billion Press)
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