Given that it took 99 days for the country to get to the first one lakh infections and that number is exceeded in less than a day now, prime minister Narendra Modi did well to tell various state chief ministers that they needed to get back to the traditional test-track-treat. With the nation dealing with Covid for more than a year, massive fatigue has set in, not just among the citizens, but also within the official machinery; it is not just in street corners and markets that you see people wearing just chin-masks, even massive election rallies addressed by people like the prime minister and the home minister had people without masks or any form of social distancing. Daily tests that had risen to over a million per day in September and October last year were down to less than eight lakh in January and seven lakh in February. Within this, as the union health ministry pointed out, the share of the unreliable – but fast – Rapid Antigen Tests are very high; 85% in the case of Telangana, 80% for Odisha, 64% for Kerala etc versus the ceiling of 30% prescribed by the centre.
And if testing levels suffered badly, contact tracing all but collapsed in most states as the numbers kept getting bigger; with the total number of case crossing 1.2 crore, it is very difficult to do detailed tracing. Indeed, as the Mid-Day investigation showed, a simple bribe makes it easy to avoid the mandatory institutional quarantine for those coming in from abroad; the main reason for the sudden jump in cases could well be the new and fairly virulent UK (807) and South African (47) strains that would clearly have come in from overseas travellers. As a result, hospitals are over-run and, to the extent there is a delay in testing, more patients are being admitted in a critical stage where they need either ICUs or ventilator support. In Mumbai, for instance, between March 30 and April 8, the number of vacant ICU beds fell from 336 to 72 and ventilators from 213 to 28.
While the prime minister did well to remind the chief ministers of the need to refocus their efforts, understandably, he underplayed the role of vaccines in both reducing the spread as well as the intensity of the disease. India beat Covid the first time around, he was right, when there was no vaccine; but this was done by massive lockdowns to break the transmission chain. Given the enormous loss to lives and livelihood, as the PM recognized, such lockdowns are to be avoided now. And both he, and those in his party, who argued that it was important to focus on those about the age of 45 as their fatality is higher missed the point. To the extent, vaccinations slow the spread, the young also need to be vaccinated quickly. Nor is the vaccination just about reducing the fatality; less than one percent of the population has been infected so far and, of those, 1.3% die.
Given its role in both reducing the spread and the intensity, the vaccine is an integral part of India getting back to normal; after two shots, with the appropriate level of masking and personal hygiene, if Indians can go back to work, millions will get their jobs back. The PM downplayed the role of vaccines because they are in short supply, but given their criticality, he needs to do everything he can to allow producers like Serum Institute and Bharat Biotech – and others doing bridging trials – to quickly expand production. No amount of testing and tracing, difficult as that is, can possibly substitute for a vaccination-led campaign.