A vaccine by Aug 15 would feel good, but more important to see that it works; ditto for the ramp-up in testing
Political leaders need to respond quickly, and firmly, to a crisis like the Covid pandemic, but it is equally important to be careful. So while it is important to get a vaccine as quickly as possible, ICMR’s directive to lead researchers and institutions chosen as test sites, and the plan to get a swadeshi vaccine out by August 15 was not just an overreach, it looked like political considerations played a big role; indeed, when Bharat Biotech, which is developing the vaccine, first submitted papers on the trial, it talked of them lasting 15 months. Scientists across the globe, whether at GSK, Sanofi or Moderna, are all intensifying their research efforts, but no deadlines have been announced; even the Oxford University scientists, tipped by WHO as the leading candidate to come up with the remedy, are only hoping the vaccine will be ready by early 2021. How did ICMR believe these institutions would be able to complete the trials in its timeline without skipping necessary checks and without breaching the protocol? And, it is difficult to buy ICMR’s defence that its directive was in line with global standards of fast-tracking and that the objective was only to cut ‘red tape’ and speed up the recruitment of participants.
It is true that several drugs being tried as a cure are also seeing their trials fast-tracked, but the health ministry is believed to have already been intimated by hospitals of instances of liver damage in Covid-19 patients being treated with remdesivir. The difference between a vaccine and a remdesivir, however, is that the latter is being administered as ‘investigational therapy’, or to be used only in last-resort situations; vaccines, on the other hand, are to be administered to healthy people. The last thing you want is for healthy people to develop some other complication after being given a dose.
Though seemingly unrelated, the policy on testing shouldn’t be driven by short-term considerations either. India’s 10 million tests so far, for a population upwards of 1.3 billion is woefully inadequate; India has done 7,398 tests per million people while Brazil has done 20,304 and the US 115,452. To that end, the near quadrupling of daily tests in Delhi, for instance, after the central government started playing a role is welcome.
But, there is a problem. Close to 60% of tests in Delhi today—and it could rise much more—are Rapid Antigen Tests (RAT). These are much cheaper than the conventional RT-PCR ones, but they are less reliable as well. Indeed, that is why the ICMR protocol is that if a person tests negative using RAT, this has to be confirmed with an RT-PCR test; this is clearly not happening in Delhi and it appears other states are also keen to start using more RAT. Apart from the speed at which results are made available, states are worried as RT-PCR tests are turning out to be very expensive; by one estimate, the cost of reagents needed to conduct 10,000 tests is about one crore rupees. But, the solution to that is for the Centre—perhaps through PM Cares—to allocate more money for testing. There is little point in just ramping up testing if the tests don’t yield accurate results; indeed, it just lulls everyone into a false sense of security. Even in the case of ventilators, the government managed to get large numbers produced due to it mobilising resources quickly, but now hospitals are finding that their quality isn’t good enough to serve the purpose. In a pandemic, where it is critical to garner as many resources as possible in as quick a time as possible, many things can, and will, go wrong. But when these are pointed out, it is just as important to course-correct.