Mr Nandan Nilekani has publicly stated that it is a matter of pride how India has led the vaccine drive with technology and how his good friend RS Sharma has made that possible. Dr Sharma as we enter phase three – it is going to be the largest phase we have seen so far – how prepared are we, what kind of population size are you looking to cover?
RS Sharma: I would certainly like to thank Mr Nandan Nilekani for saying such kind words about me, of course, India has always shown the way in the technology space for about a decade or so. We have created wonderful digital artefacts which are Aadhar, Payment gateway and other tonnes of artefacts so certainly this particular drive could not have been complete unless you have a very robust technology architecture because it is not about just inoculating a couple of million people, we are talking about billions and even if you leave out children and other people it still going to be about 1.5 billion minimum and therefore the only way it could be completed in a flawless manner is to ensure that the same vaccine is inoculated to an individual twice; not that he had been given Covaxin in the first dose and Covishield in the second dose.
So all these kinds of things and the appropriate gap between the two doses etc. Essentially it is a job that cannot be done in a manual manner and that is why we need a robust architecture and I am happy to say that India has built that architecture and this architecture is going to be not only useful in COVID vaccination, it will also be useful for all future endeavours of the country.
As of now, you cannot get an appointment for the second jab on the COVID website even if you look at the slots that are being given. By when are you hoping to refine all of that so we also get hourly slots?
RS Sharma: The first question which is basically getting an appointment for the jab, so what is happening is that the hospitals are publishing their timetables for the vaccination and the usual number of days for which they publish the timetable is about two to three weeks and sometimes the gap proposed is four weeks and now in case of Covishield it is six to eight weeks so that being the case, people will be able to sort out a slot for appointment
If you want to slot an appointment for six weeks in advance, that may be a difficult thing because that kind of visibility is difficult. However, to say that you are not able to schedule is not correct.
In fact, we will be sending the messages to all those people who have got their first dose to tell them that please fix your appointment so that is number one. Number two is that the question about refining the time is also very important, where you have 100 as the capacity of the hospitals. We are currently having morning and afternoon.
Now what was happening earlier is that many hospitals were actually running multiples sites, for example, AIIMS was running about 10 sites, site one, site two etc. We have told them that just have one site and that will probably have the capacity of 1000 and then we will be able to fix hourly things, so that is not a problem at all. We are consolidating the sites and also refining the slot allocation so that there is no crowd at one particular point in time.
Eminent doctors whether it is Dr Naresh Trehan or Dr Randeep Guleria, have been talking about the younger age group being the super spreaders. By when do you think the system will be in place and the government will be ready to vaccinate the younger population?
RS Sharma: The question is in a public health policy so one has to take the policy decisions depending on the vulnerability of the person. The government started with the most vulnerable section of the people which is 60 years plus and, of course, the people with comorbidities between 45 and 60 and now that thing has been sort of enlarged to cover everybody above 45 and you will see these changes as we go along, because ultimately it is a question of how do you spread or how do you begin vulnerability wise rather than beginning overall and then creating confusion at these vaccination centres.
So no timeline has been decided as yet. You first want to finish this large population of 45 years and above and then address the younger population which many doctors think are the super spreaders.
RS Sharma: The decision is not mine, the decision will be of the government. As far as I am concerned, I am certainly cognizant of the fact that whatever the government decides, software-wise there is not going to be any kind of restrictions. But my understanding of the government’s policy is that we began with the most vulnerable group and then we have opened it further and maybe in future, it will be opened up further and as far as the finishing of the thing is concerned, please understand that this is not a compulsory kind of vaccination. It is actually demand-driven in the sense that it is voluntary. So if somebody of 46 years of age does not want to get vaccinated, we cannot really force him. We can try to convince him or her but not force, so therefore there is no such thing called finishing of a particular population like that. But we will certainly see the trends going forward as to what is the demand, how much is the demand and then certainly the government will take a decision to include other groups as well.
You are trying to bring the vaccine wastage down to 1%. Would the corollary of this also mean that we have enough vaccine supply that there are no apprehensions over the supply of the number of vaccines as you look to cover more population?
RS Sharma: The government has made it clear many times that there is no shortage of vaccine. Number two, there is no shortage of capacity. Ultimately it all depends on the demand like how many people turn up to get themselves vaccinated and that is what is important. But I think from a supply-side perspective we are all ready both in terms of the capacity and also in terms of vaccine availability.
The question about wastage is extremely important and the honourable PM also in one of the meetings recently has expressed his concern. Yesterday also when we had a meeting with the states, the health secretary himself expressed the concern, I also kind of emphasized this issue that we should avoid vaccine wastage and take the appropriate steps to increase the capacities, have centres with larger capacities because once you have a larger capacity, then the percentage of the vaccine wastage will automatically come down because at the most one vial of 10 or 20 will be wasted and if you have done about 900 vaccinations, then the percentage is much less so that is how it is going to happen.
What is going to be different about Phase-3 as we are in the middle of a new wave? This time we are seeing that the new phase of vaccination drive coincides with the surge in Covid-19. How are you handling that? Are there any special do’s and don’ts that the people need to keep in mind when they go to get vaccinated?
RS Sharma: I agree with you that it is a race against time so I think while there are many measures required to be taken to contain the infection with obviously mask and social distancing and other types of Covid appropriate behaviour. At the same time, the speed of vaccination will also play a very important role in containing the infection spread. And by opening it up to everybody of age 45 and above, India has started this third phase of vaccination and we have an adequate supply of vaccines and we have sufficient capacity of hospitals because now we have involved private sector hospitals also. We are going to see a quantum jump in the numbers starting today onwards.
We also are requesting the states to kind of accelerate their efforts and especially the efforts of the private sector hospitals because then we will be able to have a full capacity. And I personally think that we will touch five million a day and it will all depend on how much is the demand and how many people turn up and how many people reserve their slots etc and how many people come for walk-in. But you are going to see a very significant jump and we want to maintain this pace so as to cover our population as early as possible.
No special provisions in the districts, while we are seeing COVID-19 cases rise in cities. What is the reason for this rise in cases?
RS Sharma: I think I did not answer the second part of the question as to what is the appropriate arrangement which we have made at the hospitals so as to ensure that hospitals themselves do not become the centre for spreading the infection. So what we have done in the standard operating procedures which have been prescribed for hospitals is to maintain the social distancing to create appropriate facilities for people to sit there and of course the water and other types of arrangements. There should be arrangements to take care of the adverse effects of the vaccination so that is also one of the important things.
People should be asked to wait for 30 minutes after the vaccination and thereafter they can leave. So those things are actually being arranged and ensured so that the hospitals themselves do not become the spreading centre. Number two, as I answered your first question which is about creating slots, hourly and two-hourly slots depending on the capacity that I think we are going to take care of it within a day or two. You will see on the Covid side for those centres, especially those whose capacity is more than 100 per day to actually see hourly and two-hourly appointment slots.