Since the beginning of April 2021, many states in India have experienced a rather virulent second surge and this has thrown up multiple challenges. India’s healthcare systems and personnel have been stretched, and the multiple cracks in our healthcare infrastructure was exposed. Many states in the country witnessed a shortage in hospital beds, critical care medicines and equipment, oxygen supply and so forth. Oxygen consumption, which is directly proportional to the number of cases, has shot up drastically. Prepandemic, India required medical oxygen of about 700 tons a day. The first wave saw demand rise to 3,000 tons a day, and now demand has gone up for as much as 8,000 tons a day. The second wave has also given rise to numerous make-shift hospitals across the country to cater to the growing need for hospital beds, oxygen beds and critical care equipment. Several states have responded to the crises with the installation of war rooms at the state and district level to monitor patient shifting, data collection and oxygen supply.
In response to the creation of the National Expert Group on Vaccine Administration for COVID-19 (NEGVAC) and with the objective of galvanizing Industry support, CII formed a Task Force on COVID-19 Vaccine to supplement the Government’s initiatives in the vaccination drive. The Task Force is chaired by Mr T V Narendran, President-Designate, CII and CEO & MD, Tata Steel Ltd, and co-chaired by Dr Randeep Guleria, Director, All India Institute of Medical Sciences (AIIMS) and Chairman, CII Public Health Council. The Task Force also comprises of Industry Members from across the healthcare continuum.
With the help of the Task Force and it’s pan-India network, CII has been sharing critical data and expertise with NEGVAC as well as engaging in communication and outreach on the vaccination programme. In the submissions, CII has consistently requested the Government to involve the Industry fully in the massive inoculation to ensure that the vaccines reach those who need it the most in an accessible and equitable manner. According to CII, this national mission should be approached with the joint support of private and public sectors.
The Task Force on COVID-19 Vaccine carried out multiple interactions with various departments of the Government over the last few months and several key recommendations have been submitted. Some of them are as follows:
• Private providers be included in the vaccination drive to enhance vaccinating capacity of the identified priority groups. This recommendation was accepted by the Government with the announcement of select 20,000 private providers. This was gradually opened up to include all private providers who could support the drive across India
• Given the current scarcity in the supply of vaccines as well as the time that will take for India to enhance this capacity either by way of domestic manufacturing or imports, CII suggested that the Centre take back control of procurement and distribution of vaccines. In the recommendation, CII said that the Centre Government should procure all vaccines from all channels possible, allocate equitably on the basis of the surge in infection rates for different states and then direct states to further disburse the vaccines to private providers operating in the respective states
• A direct approach by various entities to vaccine manufacturers may lead to concentration of supplies with a few vaccinating agencies. The mode of supplying doses through the administration would ensure that all healthcare providers are able to access the vaccines in all parts of the country. All entities, including private healthcare providers could make their requirements known to the district authorities and collect the doses as allocated
• The Government should once again put a cap on the maximum administrative fee that private providers can charge otherwise this will create another false shortage with access to vaccines for only those that can afford it. This will also not serve the overall purpose of inoculating the largest available adult population
• To ensure faster vaccine rollout and to boost the confidence of the workers, organizations should be permitted to vaccinate their employees and immediate family members. Enterprises could also assist in the vaccine rollout for surrounding communities on a CSR basis as well. The second phase of the vaccination allows vaccines to be administered at private hospitals in addition to the Government centres with the objective to amplify vaccination
• In-principle, the procurement price of vaccines for Central and state governments should be fixed at the same amount. For non-government entities, there may be a differential price as deemed appropriate by the Government
• While hospitals would continue to provide services to the best of their ability, hospital security is emerging a major cause of concern in many areas and needs to be addressed on priority. A mechanism may need to be put in place to facilitate orderly operations and prevent vandalism in hospital premises
• Testing (specifically RTPCR) in semi-urban and rural India is a critical issue and needs to be prioritized
• With vaccination opening up for persons above 18 year of age, supply demand gap would need to be addressed rapidly. With production estimated at 7 crore a month and demand expected at 20 crore a month, the production capacity would need to be ramped up rapidly. Similarly, an equitable distribution plan for vaccines is necessary
• Many corporates would be keen to set up hospital facilities within their office / factory premises with facilities of testing, isolation beds, oxygen supply, etc. They would also be willing to set up vaccination centres in their premises in collaboration with Government, vaccine manufacturers and hospitals
• CSR guidelines may be relooked at to permit import medical oxygen generators from abroad which can help in meeting the oxygen requirement
• Supply chain strategy needs to be taken up diligently to avoid the problem of transportation and delay in delivery of the precious commodity like oxygen.
In order to reduce the burden on healthcare infrastructure and prevent further mutations & waves from occurring, our primary concern now is to vaccinate the adult population of India. To vaccinate adult population (18 years and above), particularly in states experiencing a spike, the Government of India allowed vaccination of all persons above the age of 18 to begin from 1 May.
Vaccination is the only way through which our battle against COVID-19 can be won over the medium term, while protecting both lives and livelihoods and allowing the country to return to usual economic activity at a fast pace. The Industry has taken several steps in order to improve our vaccination coverage across the nation. CII is in touch with the two vaccine manufacturers in the country, Serum Institute of India and Bharat Biotech International Ltd, to ascertain the possibility of purchase of vaccine doses as per the requirements mapped through the CII survey.
The Government has also permitted Industry members to undertake vaccination on their premises provided there are more than 100 beneficiaries and also placed the spending on this for nonemployee beneficiaries under the CSR rules. Taking advantage of this, CII has therefore requested Members who wish to expand their vaccination drive to external members of the community to advise their requirements which is being further added to the aggregate. Through this initiative, over 1000 companies, mainly small and medium companies, from 170 cities have so far come forward to identify their requirements. As on date, CII received demand from 1062 small, medium and large companies from across the country for approximately 40 lakh single vaccine doses. Of this, companies have identified demand of 36% for employees, 47% for family members of the employees, and 17% is for community outreach efforts.
The vaccination project, largely aimed at the economic agents of the country, who are common citizens, will help enterprises to revert to their usual scale of operations at the earliest so that lives and livelihoods are both preserved.
Even though the daily active cases have plateaued slightly over the last few days, this is not the time for India to be lax about the situation. India need to prepare for the third-wave and not repeat the mistakes. The country’s healthcare infrastructure needs to be built up in order to withstand future waves that may or may not occur.
The lives and livelihoods of every single citizen is the only priority that should matter, and in order to protect them, Industry and Government together need to actively take every measure to ensure that we guard our nation. We are in this situation together, and like multiple adversities India has faced in the past, we will together overcome this pandemic.
The article first appeared in the May 2021 issue of CII Communique. Click here to read the full issue.