Bharat Rakshak

Suraj wrote:SII is constrained by US-sourced raw material for Novavax production according to Poonawalla. Novavax is a US company trying to produce in India, and it's a case of US shooting itself in the foot by licensing SII to make something and then denying them the associated inputs.

Covishield is not tied directly to anything US; SII are constrained by capital needs to scale beyond 100m doses/month, a level they will reach in May/June. they've already sunk in the costs of expansion from 60m/month to 100m/month and it's a matter of time before it comes on stream.

Perhaps it is time to give up on Novavax for now and try and repurpose the manufacturing facilities they must have earmarked for making the Novavax vaccine to produce more doses of Covishield instead. I am not sure how feasible that is and the US has shown no intention on lifting the curbs and the left-leaning media in the US is unlikely to seriously question their current president on it.

Meanwhile the GOI needs to figure out how to get the monetary support that SII and BB need to scale up quickly.

Covaxin production to increase 10 times by September: Harsh Vardhan

Listing the measures being taken to strengthen the COVID-19 inoculaton drive across the country, he tweeted, "COVID-19 vaccine supplies to small states being replenished every seven days and every four days for big states. Steps taken to quickly enhance basket of vaccines available. Production of Covaxin to increase 10 times by September 2021."

Telangana halts vaccination owing to supply shortages

Telangana has decided to temporarily halt the Covid-19 vaccination program owing to shortage of Covid-19 vaccine supplies from the union government, announced the state health minister Etela Rajender.

vera_k wrote:The high-risk young demanding Covid jabs

India has tens of thousands of young patients who are in the high risk category and need vaccination urgently.

Thanks for sharing this. For once, I agree wholeheartedly with the BBC. GoI, apparently doesn't.

What's really making me angry is, per their own stats, the number of people with co-morbidities and <45 yrs is just 1cr, whereas those with age >45 are around 30 cr. A small 3.33% drop in the bucket - given the persistent vaccine hesitancy, why not just include these people and give them some peace of mind?

Personal anecdote: since we are not eligible for jabs but have to visit hospitals for medical management (hence my angst above), we tried convincing our house help to take it for our (and her) protection. We explained the process in detail and even offered to pay for it in a private facility. But to no avail. She made up some excuse and said cannot take it. The fear is well and truly entrenched - the main argument is that that people who get jabs end up getting Covid itself. Whoever was responsible for spreading FUD and contributing to vaccine hesitancy will have to deal with their karma down the line.

It is a fair argument that those with comorbidities over 16 (the defined adult age for which vaccines are authorized) can get vaccines. But let me explain why I think the govt has balked at this:

During phase 1 (Jan 16-feb 28) the government noticed that the registered HCW/FLW database suddenly started growing almost 30%. At that point they stopped further registration of HCWs/FLWs. The problem was fraudulent registration to get vaccines. The numbers were small enough (a few million extra) that it wasn’t a real impact. It was still multiple days worth of extra vaccines used up on people who may or may not be legit HCW/FLW.

I believe the govt fears being swamped by young folks alleging comorbidities using spurious qualifications. Due to health being a state imperative it has no direct way to ensure there isn’t rampant misuse. Age based criteria are much easier to validate in this regard, and comorbidities over 45 are also an easier case to accept. Right now the eligibility is entirely age based.

This isn’t an attempt to be heartless about the matter, and I’m certainly not arguing that the young at risk folks should be left behind. Hell, at one time in my youth I was high risk. However I suggest putting the indignation aside and consider how to craft this request in a well considered manner where validation is easy, and risk of fraud minimized. I would be more than happy to help propagate a good idea using Twitter, given I’ve recently been able to make my detailed analyses heard within govt circles.

Any news regarding patanjali coronil? If it has any use as a therapeutic, now is the time.

Molnupiravir seems to be another promising therapeutic.

Suraj wrote:It is a fair argument that those with comorbidities over 16 (the defined adult age for which vaccines are authorized) can get vaccines. But let me explain why I think the govt has balked at this:

During phase 1 (Jan 16-feb 28) the government noticed that the registered HCW/FLW database suddenly started growing almost 30%. At that point they stopped further registration of HCWs/FLWs. The problem was fraudulent registration to get vaccines. The numbers were small enough (a few million extra) that it wasn’t a real impact. It was still multiple days worth of extra vaccines used up on people who may or may not be legit HCW/FLW.

I believe the govt fears being swamped by young folks alleging comorbidities using spurious qualifications. Due to health being a state imperative it has no direct way to ensure there isn’t rampant misuse. Age based criteria are much easier to validate in this regard, and comorbidities over 45 are also an easier case to accept. Right now the eligibility is entirely age based.

This isn’t an attempt to be heartless about the matter, and I’m certainly not arguing that the young at risk folks should be left behind. Hell, at one time in my youth I was high risk. However I suggest putting the indignation aside and consider how to craft this request in a well considered manner where validation is easy, and risk of fraud minimized. I would be more than happy to help propagate a good idea using Twitter, given I’ve recently been able to make my detailed analyses heard within govt circles.

Suraj-san, the indignation is due to trying to get heard for more than a month. It's actually close to two months now, come to think of it. When govt handles reply to some very frivolous requests here and there, detailed messages (tweets, grievances on PGPortal, etc.) don't seem to get through. My original submissions were detailed and backed with data where possible - thanks to you, I even got the document that estimated the population size at 1cr (I replied to you on twitter about this). Shared that as well. Total silence, what else can I do? I know the terror of having my family member spending 4-5 hours in a hospital 2-3 times a week and sky falling if either of us catch the damn thing. So, at some point, patience does wear thin.

Your point about preventing fraud is valid and perhaps the way forward, but I don't have a solution as of yet. Let me think about it some more. Evaluating co-morbidities is a subjective thing, and not everyone with co-morbidities should actually take the vaccine. So I guess the only option would be that a doctor's certificate can be insisted upon, but again, how to validate that becomes the q.

Please do. Trust me I know the situation of being high risk immunocompromised . First hand. That I even survived that phase was a miracle of sorts.

Sorry I missed your Twitter post to me. I have been unable to keep up with the volume of notifications in response to my recent threads, and I don’t know most BRFites handles.

What you hit on is the weakness of formulating policy that could be easily misused. As I emphasized, I’m not in any way alleging that’s the case with your family. However I’ve learned that creative and insightful information is heard within government and I would gladly propagate .

Suggestion: think less of what’s required and more about how it could be misused and ways to mitigate that risk. Govt is swamped by demands of all kinds, and such thinking let’s it stand out .

Just to add,that I've been using the coconut oil in the nose for over a yr.Dr.Hegde ,well-known on the net, advised it.I do steaming too and have installed an ozone disinfectant tunnel in one of my associated outfits.Bisleri have donated a few to Bombay hospitals for their medical staff to keep them safe. 30 seconds when you enter the building and again when you leave. However,the OT treatment is to me the only system that can cure you after infection,and fast. It's a v.simple procedure,no hospitialisation and v.cheap. I've tried for months along with some of the practitioners to get states and central approval using v.high powered contacts upto the highest level of govt., just for trials to prove the procedure, purely on a humanitarian basis with no costs attached, but it appears that after much enthu in babudom the ICMR appears to have shot it down.The least said about that org. the better. One year on with all their advice,where are we? The sh* t has truly hit the fan and the country suffers. For anyone further interested in ozone therapy, pl. contact Dr.Milli Shah in Bombay,head of the OFI,it can save lives.

In an online forum some Chinese commentators posted that unlike the rest of the world Chinese actually vaccinated the young first. This allowed their working population to get back to work faster; limiting damage to economy and also prevented the most physically active age group from getting infected and spreading it. Older people are less mobile anyway and easier to keep inside and hence protected if kept indoors and isolated. This does seem logical to me and something other nations should think about.

vimal wrote:In an online forum some Chinese commentators posted that unlike the rest of the world Chinese actually vaccinated the young first. This allowed their working population to get back to work faster; limiting damage to economy and also prevented the most physically active age group from getting infected and spreading it. Older people are less mobile anyway and easier to keep inside and hence protected if kept indoors and isolated. This does seem logical to me and something other nations should think about.

What happens when those young folks go out and live life as normal and bring back infection which may not harm them but can pass over to vulnerable elders ?

Sumeet wrote:

vimal wrote:In an online forum some Chinese commentators posted that unlike the rest of the world Chinese actually vaccinated the young first. This allowed their working population to get back to work faster; limiting damage to economy and also prevented the most physically active age group from getting infected and spreading it. Older people are less mobile anyway and easier to keep inside and hence protected if kept indoors and isolated. This does seem logical to me and something other nations should think about.

What happens when those young folks go out and live life as normal and bring back infection which may not harm them but can pass over to vulnerable elders ?

Vaccination does not mean that there is no mask, social distancing or other measures that go hand-in-hand. It makes it easier to keep ICU capacity for older people if younger folks do not fall sick and need hospitalization.

vimal wrote:In an online forum some Chinese commentators posted that unlike the rest of the world Chinese actually vaccinated the young first. This allowed their working population to get back to work faster; limiting damage to economy and also prevented the most physically active age group from getting infected and spreading it. Older people are less mobile anyway and easier to keep inside and hence protected if kept indoors and isolated. This does seem logical to me and something other nations should think about.

BIG difference there is that the young work in the factories and cities on the east coast while the older folks are left to live where they are. Due to the 1 child policy, they have far less of the joint family structure seen in India, where it Is very common to have 3 generations under one roof, whereas they don't have 2-3 families as very prevalent household structures if you don't count urban nuclear families.

vimal wrote:In an online forum some Chinese commentators posted that unlike the rest of the world Chinese actually vaccinated the young first. This allowed their working population to get back to work faster; limiting damage to economy and also prevented the most physically active age group from getting infected and spreading it. Older people are less mobile anyway and easier to keep inside and hence protected if kept indoors and isolated. This does seem logical to me and something other nations should think about.

China, like India, has not vaccinated enough people to have a substantial impact on preventing a wave. Neither you nor the Chinese poster are experts on the matter, as far as we know.

Raja wrote:

vimal wrote:In an online forum some Chinese commentators posted that unlike the rest of the world Chinese actually vaccinated the young first. This allowed their working population to get back to work faster; limiting damage to economy and also prevented the most physically active age group from getting infected and spreading it. Older people are less mobile anyway and easier to keep inside and hence protected if kept indoors and isolated. This does seem logical to me and something other nations should think about.

China, like India, has not vaccinated enough people to have a substantial impact on preventing a wave. Neither you nor the Chinese poster are experts on the matter, as far as we know.

But by targeting large population centers around the industrial hubs along with other measures like masks they can prevent large outbreaks. Isn't the largest source of infections in India also commercial hubs like Mumbai/Delhi consistently?

China is more than 50% urban right now. That means 700 million+ urban residents. They have barely done 25% as many vaccinations (not even persons, just vaccinations), and their main vaccines require 3 doses per person.

India is 35% urban or 450 million in cities.

The Chinese were not declaring any significant covid cases for most of last year after the initial explosion there. This was way before vaccines were available and covid was surging everywhere else. So what is different now that we have to attribute the low numbers over there to their vaccination strategy?

This is in response to Vimal:

I am not even going to go in the logic of your hypothesis. I am questioning it's very foundation.

You seem to imply that China's success in controlling the new cases is due to it's policy of vaccination. However, China has been very successful controlling covid since the very first outbreak. Moreover, they have not vaccinated enough people to have any type of substantial herd immunity. So their continued success with preventing a new wave cannot be attributed to their vaccination policy. As such, there is not even circumstantial evidence that this would work.

I hope that is clear.

The high risk young need their doctor’s referal and if they can show adequate history, can still get the jab. As also when excess vaccines per site happens to be there. That argument is a political one by the Youth Icon (someone need to tell him “po thaire” for his grandstanding on top of the covid spike)

hnair wrote:The high risk young need their doctor’s referal and if they can show adequate history, can still get the jab.

This is not true, plain and simple. People under 45 are flatly being denied the vaccine despite very valid justification existing, citing GOI rules. If they are being vaccinated somewhere, that would be a rare exception and only by somebody who follows basic common sense and is brave enough to break the idiotic rules.

Point of discussion is not, whether Chinese tamed the virus with vaccine or not.

The point to be addressed is, going forward which would be the right strategy ?
1) vaccinating only high morbidity risk people 45+ aged and government employees
2) vaccinating people who have higher chance of spreading the virus such as street vendors, delivery boys, tax drivers, bus conductors, Hotel and restaurant service providers, etc...including field working government employees who interface with many people or crowd.

I and some of us believe it is the second strategy which is better,because that strategy covers people who form the backbone of the country's economy. But, so far government believed in the first strategy of mitigating death and protecting all of the government employees.

Government rightly vaccinated the healthcare people, first. Also in Covishield trials, 65+ aged people have exhibited minor vaccine response. If that vaccine is reserved for younger population (65-), it would have benefitted more.
I learned some private hospitals are reserving many vaccines for second dose. It would be better to have as many people with atleast one dose of vaccine than few people with vaccinated with full two doses.

Still wonder, why half dose regime is not being explored. we could have vaccinated double the number of people by now. Especially even after the initial trial showed better results with first dose being half dose with covishield.

That's all fine and dandy. The reasonings for why vaccines should be prioritized by mortality risk has been well documented and presented across the world. If you believe that your approach is smarter than you should provide scientific evidence to back up your claims instead of making gross assumptions.

https://twitter.com/MeghUpdates/status/ ... 03744?s=19

Finance ministry, GOI approves credit of 3000cr and 1500cr to SII and BB respectively in order to enable them to scale up covid vaccine manufacturing capacity.

durairaaj wrote:Point of discussion is not, whether Chinese tamed the virus with vaccine or not.

Thats the Q's which has always remained unanswered; how did China contained the virus, why no second wave, why so less virus spread geographically or such low mortality rate. As per current info China's current Covid case is just 91K; Pune gets so much cases in a week+

Even if they are hiding / manipulating data - its not possible to have so much secrecy as we have seen there peak's pictures when it all started or is it the case that virus is manufactured in a way that it has less or no impact on Chines genes - for example Taiwan just have 1K case till date

Vaccine shortage is real, Tried on friday, saturday and today for my dad(second dose).
Online registration with location is done and appointment given on Friday, But no one even to tell the news that vaccines are not yet arrived to administer. After waiting for 1 hour, father dared to enter the GH and ask the nurse, only to get the answer from the nurse that vaccination not possible today as there is no supply. Some people waited from morning 8 in the hope of finishing fast and go.

This happened on a District Government Hospital-


Issue 1) - Which ever place vaccine not available, registration can be pushed to a later date.
Issue 2) - There is no one in charge to let the waiting public know that there is no use waiting.

No one should be surprised at vaccine non availability, we are such a huge population. Kodi kodi namaskarams to the medical staffs including doctors, nurses and the cleaners. They are doing the impossible thing of servicing this big population.

But communication is missing from top minister level to last mile nurse level.

^Could also be last mile connectivity issues seeing from the maps or even worse politics at play to ensure what's being said is real. Hope center is also getting inputs from hospitals directly about shortages/created shortages. If not such a system need created.

Raja wrote:... you should provide scientific evidence to back up your claims instead of making gross assumptions.

As you asked for scientific evidence, follow the two publications. I hope you judge the article by its content rather the name of the publication.
1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7124076/
If you need more information search for 2D percolation model that is described in this article. By reducing the transmission rate we can effectively bring in herd immunity. the beginning part of the article describes it with proper figures and diagrams. Most people assume well mixed population model for a geographically spread country.

2) https://www.who.int/bulletin/volumes/91/4/12-113480/en/
This paper deals with ethics. From concluding remarks, "The allocation of a limited supply of vaccine calls for a fine balance between utility and equality and fairness." Utility was considered in vaccinating healthcare workers and policemen before others. Transmission rate decrease could poentially save many more people than waiting for the complete vaccination.

As of today, there is definitely a shortage in Telengana. No shortages in other big states, but there may be shortages in rural areas due to logistic issues. Some states such as TN, Haryana are reporting a lot of wastage. Part of it is probably being illegally diverted and being reported as wastage.

https://www.hindustantimes.com/india-ne ... 39601.html

uddu wrote:^Could also be last mile connectivity issues seeing from the maps or even worse politics at play to ensure what's being said is real.

Physical connectivity cannot be an issue. I am not planning to name the city so as to not give a chance to blame game by opportunistic political parties getting the wind and making it a more politicized issue.

- International airport within 45 kms.
- Close enough to National Highways to take a two wheeler.
- GH is just 2 kms from the City center.
- The city is also called Dollar city with a thriving textile industry.


Vaccine availability is a real issue and needs to be solved ASAP , before it turns in to another ugly political fight.

nits wrote:

durairaaj wrote:Point of discussion is not, whether Chinese tamed the virus with vaccine or not.

Thats the Q's which has always remained unanswered; how did China contained the virus, why no second wave, why so less virus spread geographically or such low mortality rate. As per current info China's current Covid case is just 91K; Pune gets so much cases in a week+

Even if they are hiding / manipulating data - its not possible to have so much secrecy as we have seen there peak's pictures when it all started or is it the case that virus is manufactured in a way that it has less or no impact on Chines genes - for example Taiwan just have 1K case till date

China never gave up on contact tracing and committed to it 200%. They also did MASSIVE levels of testing. When contact tracing was no longer possible, they blanket tested entire communities. That combined with the fact that they can do things which would just not be possible in a democratic country (big brother times 10). In democracies, every one is an expert and has an opinion on how things should be done. So, Chinese way seems to be quite good at dealing with such emergencies (so far). They definitely lied about the seriousness of the first wave and are still lying.

https://twitter.com/ANI/status/1384140696982941696

Govt of India announces liberalised & accelerated Phase 3 strategy of COVID-19 vaccination from May 1; everyone above the age of 18 to be eligible to get vaccine

durairaaj wrote: As you asked for scientific evidence, follow the two publications. I hope you judge the article by its content rather the name of the publication.

Really? Anyone can find random articles to support their theories. Point is to inform yourself fully before you make your theories. How much body of work are you ignoring from the other school of thought? And the articles you cited do not even address the crux of your assumption.

Lots of policy updates today:

Everyone above the age of 18 to be eligible to get vaccine from May 1, says govt

Vaccine manufacturers empowered to release up to 50% of their supply to state governments and in the open market at a pre-declared price.

Raja wrote:

durairaaj wrote: As you asked for scientific evidence, follow the two publications. I hope you judge the article by its content rather the name of the publication.

Really? Anyone can find random articles to support their theories. Point is to inform yourself fully before you make your theories. How much body of work are you ignoring from the other school of thought? And the articles you cited do not even address the crux of your assumption.

I am glad peple in the policy making bodies are not like you.

Uttam wrote:Lots of policy updates today:

Everyone above the age of 18 to be eligible to get vaccine from May 1, says govt

Vaccine manufacturers empowered to release up to 50% of their supply to state governments and in the open market at a pre-declared price.

Massive move by GoI to open up vaccination to all adults...further great to allow vaccine makers to market directly...this will allow them to make a little bit more profit and probably further incentives for more private enterprises participation in the vaccination efforts.

Zynda wrote:Massive move by GoI to open up vaccination to all adults...further great to allow vaccine makers to market directly...this will allow them to make a little bit more profit and probably further incentives for more private enterprises participation in the vaccination efforts.

The announcement said that states can buy at pre-approved prices.

There is a plus point with the latest GOI news but also a major caveat/negative:

Plus point: They are no longer artificially and arbitrarily preventing people under the age of 45 who really need the vaccines from getting them by their directives.

Big catch/negative: They have abdicated responsibility for vaccinating vulnerable people under 45 (they are going to continue with the same criteria as before instead of showing much-needed flexibility there) and basically told them (and states) that they are free to get vaccinated/vaccinate anybody they chose but they are on their own with regard to sourcing vaccines, which we all know are extremely scarce and oversubscribed.

Seems like more of a passive-aggressive political move to put the ball back in the court of the whining non-BJP states, but doesn't help the people who need the vaccines the most and aren't eligible under the current arbitrary rules. It would have been better if they empathized with the plight of vulnerable people under 45 and took some ownership to help them out instead of throwing them to the wolves with "by all means go get vaccinated if you can find a dose somehow" message.

Hope we can sort out supply issues. If so, lets put lockdown and get everyone vaccine

Bart S wrote:

hnair wrote:The high risk young need their doctor’s referal and if they can show adequate history, can still get the jab.

This is not true, plain and simple. People under 45 are flatly being denied the vaccine despite very valid justification existing, citing GOI rules. If they are being vaccinated somewhere, that would be a rare exception and only by somebody who follows basic common sense and is brave enough to break the idiotic rules.

In Trivandrum, as part of some past work I did, I have some insight into a central institution that does good work on differently abled and autistic children. They have a priority list which they send to State health dept for pre-approval and they usually approve it pronto due to the danda of central govt. Heard same process for severe juvenile diabetics and onco/cardio patients from another central govt institute. All of them got their shots along with the first wave of older folks. Btw, this has got nothing to do with state govt, although the state will announce it later. Most of the central institutes for specialized treatment seem to have this protocol.