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100,000 new COVID-19 cases and bad governance push India to the brink of disaster

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Chennai: India’s daily COVID-19 cases rose to 103,558 on Monday, the largest such daily increase, according to official data. This jump takes the total load of India cases since the start of the COVID-19 epidemic to 12.59 million, a width greater than Brazil, by 13 million.

This dubious moment also makes India the only country besides the US to add a six-digit number of new COVID-19 cases in a 24-hour period. (At its peak, Brazil added just under 80,000 cases, at the end of last month.) If this trend of new cases continues, India is likely to overtake Brazil this week. The actual case load doubling time is already it is said to be higher than it was in September 2020, when India quickly approached its first peak.

Growth in India parallels a slowing pace of vaccinations as well. By 9:50 a.m. on April 5, according to the health ministry website, the government had administered 79 million doses of Covaxin and Covishield together. However, experts have also said that this pace may not be good enough given India and the wider world also faces a ‘second wave’ of explosions threatening to dwarf the first last year, which peaked in September with about 99,000 new infections daily.

For example, economist Shruti Rajagopalan wrote for Bloomberg that India may soon reach a point where national and global demand for vaccines could overwhelm domestic production capacity, putting people everywhere at risk of a longer-term pandemic.

So, Rajagopalan continued, “The first thing the government needs to do is speed up the approval of some of the vaccines in use in other countries, including those from Pfizer Inc., Moderna Inc. and especially the lighter logistics vaccines Johnson & “If those companies can’t expand production fast enough, the government should pursue licensing agreements to make their vaccines in India.”

In addition, she recommended that the Government of India allow AstraZeneca / Serum Institute and Bharat Biotech, producers of Covishield and Covaxin, respectively, to “sell doses in the private market” to relieve the state of the need to purchase and distribute them freely. .

Prime Minister Narendra Modi held a summit to review the state of the country’s epidemic on April 4th. “The meeting included senior officials from the Office of the Prime Minister, the Ministry of Health, the Department of Biotechnology and Niti Aayog” Times Hindustan reported and discussed “what was leading to the increase in cases; how prepared our health infrastructure is currently to handle the rush; and what more needs to be done to ensure the system does not overload. “

The government said in a statement issued over the weekend:

“The prime minister ordered that central teams consisting of public health specialists and clinicians be sent to Maharashtra for major cases and deaths, as well as to Punjab and Chhattisgarh due to the disproportionate number of deaths reported there.”

At the same time, the state of Maharashtra which, according to the union health ministry, has contributed 57% of the total cases and 47% of the deaths in the last two weeks has decided to impose a blockade from 5 April. Kerala is the other worst affected state, but with 1.1 million cases so far, it is far behind Maharashtra.

However, other smaller parts of the country are reporting disturbing trends. For example, according to Reuters, “deaths were thrown at 478, still one of the lowest fatality rates in the world.” But last week alone, Durg in Chhattisgarh reported 6,000 cases and 38 deaths in seven days. The local hospital has only 500 beds and the morgue, only eight freezers, according to NDTV. Local doctors are already considering withdrawing non-COVID-19 services to cope.

Indeed, health officials in many states, but especially in Delhi, Chhattisgarh, Karnataka, Kerala, Maharashtra, Punjab and Uttar Pradesh, are also wary of running out of hospital beds for those who may need specialized care. According to Times Hindustan, the national test-positive rate on April 3 was 8%, up from 3.9% on March 20.

These concerns are compounded by fears of mutant strains of the novel coronavirus spreading through the population, prolonged concerns about the purpose of AstraZeneca, and most recent concerns over Bharat Biotech Covax.

People sit in a waiting area to receive a dose of Covishield, a coronavirus vaccine (COVID-19) produced by the Serum Institute of India, at a vaccination center in Ahmedabad, India, April 2, 2021. Photo: Reuters / Amit Dave

When vaccination of India began on January 16, the government set a target of vaccinating 300 million people by July. This seems impossible at the moment; In addition to logistical issues and other growing commitments, the government also acknowledged, albeit somewhat late, that there was considerable vaccine reluctance among recipients over the nature of Covaxin approval and, most recently, over the state treatment of adverse events after immunization (AEFI).

Hilda Bastian, founding member of Cochrane Cooperation, wrote ABOUT Atlantic on March 30 that it is not easy for officials anywhere in the world to communicate some of the rarest risks associated with specific COVID-19 vaccines with equal efficacy and safety. Her point that vaccine reluctance can arise even if officials are very secretive about the nuanced details of the possible and rare side effects of a stroke is obvious. This is why transparency is essential:

“It may happen that in a short time a non-vaccination cause will be established, or the treatments will make the condition manageable. Until that happens, however, regulators must do their utmost to maintain calm, perspective, and transparency. Imagine if they reacted more conservatively from the beginning, and waited to say or do anything until the number of people who presented themselves with this condition reached hundreds. If vaccine regulators are out of step with their community values, transparency will allow them to be calibrated. “

However, Indian health ministry officials have not shared daily AEFI reports since February 26, despite a growing number of disturbing reports. Then on March 17, the immunization sector of the ministry of health issued a note (Z.16025 / 02/2018-IMM) that had considered eight AEFIs. One subcommittee determined that four were “random”, one was “unclassifiable” and three were designated B1: “review factors result in conflicting trends of persistence and incompatibility with the causal link of immunization”.

No other details are available, including discussions, committee members, why these eight cases and not others, what details were considered, etc. The statement concluded by saying that none of the eight AEFI cases were found to be related to vaccines received from recipients, all Covishield. (The ages of the victims ranged from 36 to 61; they were from Aurangabad, Ballari, Belagavi, Harda, Mancherial, Pilibhit, Saran and Thane.) Indian quartz also reported on March 18 that India has no plans to stop its spread in Covishield.

On the other hand, a group of researchers affiliated with the British Society of Hematology published a document providing detailed definitions and recommended administration of unusual side effects associated with the clot that AstraZeneca hit recipients in Europe reported, which first raised concerns about the vaccine. AEFI estimates of Europe and Canada have been similarly detailed AND in the open.

Covaxin is also in hot water. Last week, the drug regulator in Brazil rejected Bharat Biotech’s application to import Covaxin for distribution in the South American country after the body determined that the company was not following good manufacturing practices at some of its Indian facilities.

One of the main complaints was that Bharat Biotech was not doing enough to verify that the procedure it used to deactivate the virus before loading it into the vaccine fluid was working as intended. This is important because inactivated virus vaccines like Covaxin have some significant advantages over other options, and which specifically arise from this inactivation process. As researchers write in a paper published in 2014 (hat type for Priyanka Stamps):

“Inactivated viral vaccines successfully formulated on the market today have an increased safety aspect compared to live attenuated viral vaccines. The fact that the pathogen is completely inactivated directly negates the return to a virulent phenotype within the vaccine recipient. Moreover, these inactivated vaccine viruses are not transmissible as their live counterparts are attenuated. The improved safety profile of inactivated vaccines means that they are also suitable for the rapidly growing group of individuals with compromised immunity.

To achieve such a high degree of safety, virus inactivation assays are essential for the production of an inactivated vaccine. The kinetics of inactivation should be fully understood and to ascertain the completeness of inactivation, the test for effective inactivation should be evaluated and well characterized in terms of sensitivity and persistence. “

Independent scientists and other experts reacted to the weakening of Brazil by demanding that the Indian government itself review Bharat Biotech vaccine production facilities. The government has already said it expects the company to deliver 120 million doses by August 2021 for use within India. (The drug regulator in India had approved the summary of both Covaxin and Covishield for national vaccination after Modi had visited the facilities of these companies a month or two ago.)

The latest thorn in the side are new variants of the coronavirus circulating in the population. Last week, virologist Shahid Jameel told Wires that part of the increase in cases in Maharashtra could be the handiwork of a “double mutant” species: one mutation made it more infectious and another enabled it to circumvent the protections offered by AstraZeneca, Johnson & Johnson and Novavax vaccines .

But even as a series of Indian efforts viral genomes from samples taken from different parts of the country are progressing more slowly than expected, political leaders have been quick to point the finger at variants when faced with sub-part preparation questions.



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