NEW DELHI — India’s coronavirus crisis, which cost thousands of people a day just seven months ago, has abated after the nation’s leaders revamped their policies and dramatically ramped up their vaccination push.
As India celebrates the delivery of its billionth dose, a feat that until recently seemed unlikely, public health experts are sounding another warning: The turnaround is losing momentum.
Vaccinations are slower. As temperatures drop during India’s main festival season, people populate the markets and host unmasked friends and family indoors. And the government tells vaccination campaign volunteers like Namanjaya Khobragade that they are no longer needed.
“Now is not the time to slacken our vigilance,” said Ms Khobragade, a coordinator for a nonprofit organization in the eastern state of Jharkhand. “A lot of people have just taken the first vaccine. We can’t leave them like this. We need to increase the intensity.”
India’s progress is an important step towards a global end to the crisis and is a major political victory for Prime Minister Narendra Modi, whose government has been heavily criticized for failing to prepare for a devastating second wave that hit earlier this year. . After the virus killed tens of thousands of people, the Indian government poured money into boosting vaccine production, halted vaccine exports and ditched cumbersome regulations that had made it difficult for state governments to get doses and for people to adhere. report for injections.
According to official figures, daily infections have fallen to about 12,000 a day, from about 42,000 four months ago. The number of deaths has also halved, to about 400 a day.
Experts consider India’s statistics on infections and deaths to be a gross undercount. Yet in many parts of the country, normal life has returned. Malls are overcrowded, roads are full of traffic and children who have not attended school since March 2020 have finally returned to classrooms this month.
But with only a quarter of the massive population fully vaccinated, India remains highly vulnerable. The possibility of a dangerous variant developing remains a concern.
The central government seems to recognize that India has lost a step. Shortly after his return from the climate conference in Scotland, Mr Modi led a meeting targeting parts of the country where less than half of the inhabitants have been fully vaccinated.
“Now we are preparing to bring the vaccination campaign to every household,” he said in a statement, adding that officials would take a “knock on every door” approach toward “every household that has the safety net of misses a double dose of vaccine”.
Complacency contributed to the devastation of the second wave. In January, when India reported cases comparable to this fall, Mr. Modes the victory over the coronavirus. The government, encouraged by a flawed mathematical model showing that the pandemic was nearly over in India, prioritized vaccines for health professionals and the elderly with conditions that made them more likely to die from Covid-19.
For everyone else, the government slowed down. The Serum Institute of India, the world’s largest vaccine maker, has reserved 100 million doses of the AstraZeneca-Oxford University vaccine for its home country in January. That month, Mr Modi’s government bought just 11 million doses. It exported more than five times as much to the Caribbean.
“There was an unfortunate sense of hubris that the pandemic with India had ended,” said Dr. K. Srinath Reddy, President of the Public Health Foundation of India.
Then the second wave hit. At its peak in May, India reported more than 400,000 new cases every day. Demand for vaccines skyrocketed. To cope, the government of Mr. Modi introduced a vaccine pricing system designed to give doses to those in greatest need. Instead, cities fought over limited supplies and companies stockpiled supplies, exacerbating shortages.
By June, five months after the national vaccination campaign, just over 3 percent of the population had been vaccinated.
As criticism from opposition parties mounted, Mr. Modes the procurement and distribution of vaccines. India’s immunization program got off to a good start, leveraging the systems and know-how that had made vaccine campaigns against polio and other diseases such a success.
He has paid billions of dollars – the government has not disclosed the exact amount – from India’s budget for a prepayment agreement that would allow the Serum Institute to ramp up production to 220 million doses per month. It struck a similar deal with another Indian vaccine maker, Bharat Biotech.
With supplies up to scratch, Mr Modi’s government enlisted an army of volunteers, including paramilitary forces, teachers and religious leaders, to assist in the gunfire.
Nonprofit aid organizations and charities with a long history of supporting public health campaigns were brought in to help organize the push. Priests and clergy were sent to reassure hesitant villagers.
In a village in the Himalayan state of Himachal Pradesh, residents agreed not to get vaccinated until officials spent hours climbing a mountain to consult local gods. Elsewhere, in India’s remote northeast, villagers received vaccine doses by drone.
The Serum Institute now says the government has cumulatively purchased a billion doses. More than three in four adults have received at least one injection. Modi’s government is now so confident that it will fully vaccinate all adults, some 900 million people, by the end of the year that it has lifted the eight-month ban on vaccine exports.
At a meeting of the world’s largest economies in Rome last month, Mr. Modi that India could provide five billion doses next year for the global vaccination efforts.
That may be good news for the world, but at home health experts are warning governments must remain vigilant. Health professionals struggle to persuade millions to come back for a second dose.
Vaccination rates have fallen sharply since the peak on Mr Modi’s birthday in September, when 25 million doses were administered, and now stands at about three million a day. India still has to deliver more than 700 million rounds to reach its year-end target, which at the current pace is becoming increasingly unlikely unless India can repeat Mr Modi’s birthday a few more times.
“There’s hesitation in going for the second dose because the community is thinking, ‘Do we really need it right now?'” says Dr. Jacob John, a public health physician in the South Indian state of Tamil Nadu. The makeshift groups the government has tapped into to boost the vaccine push, he added, weren’t built for a sustained campaign.
Delay could provide opportunities for a new variant to strike or to reduce immunity. Recent serological prevalence studies, which measure antibodies that form in response to infection or a vaccine, show that some of India’s largest cities, including the capital New Delhi, report more than 90 percent containing antibodies.
“But it’s not a uniform distribution across the country,” said Dr. reddy. “You have vulnerabilities.”
The Indian government seems to know that it still has a long way to go. India recently applied for a $2 billion loan from the Asian Development Bank and the Asian Infrastructure and Investment Bank to buy doses for an additional 300 million people.
Delivering a billion doses “is an important milestone,” NK Arora, the head of India’s National Expert Group on Vaccine Administration, wrote in an op-ed, “but the fact is, there is still a long way to go to effectively control Covid. ”
In Jharkhand, Ms Khobragade, the health worker, said myths are still rife among some villagers that the vaccine is more deadly than the coronavirus, renders men impotent or – among Muslim and Christian worryers – converts people to Hinduism.
Ms Khobragade plunged into the vaccine campaign in April, as Covid hit entire villages and the constant smoke from pyres darkened New Delhi’s skies.
Now that an important milestone has been reached, the state government says Ms Khobragade can resume her work in maternal and child health. It has withdrawn funding and the additional vaccine vans and nursing staff Ms Khobragade relied on to reach reluctant villagers.
“There is still a huge hesitation about vaccines,” she said. “Now is not the time to rest.”