VacciNations! The world is betting on and hoping for a V-accine shaped recovery, to resume lives and restore livelihoods. March 16 will mark two months since the roll out of the Covid-19 vaccinations in India. How is India doing? The answer, as with all data, depends on how the numbers are interrogated.
On the face of it India ranks third with 28.2 million or 282 lakh total doses administered. The United States which began its rollout a month earlier has crossed the 100 million-mark and President Joe Biden is promising a July 4 normalcy. China, second on the ranking table ahead of the EU as a bloc, has administered 52.2 million doses. In terms of doses per 100 persons or percentage of population vaccinated though India trails many countries and has a lot of ground to cover.
How has India done in terms of the target set? The government has set a target of vaccinating 300 million or 30 crore people — at two doses that would be 600 million shots — by the end of July. Its average daily run rate in the first 56 days is just over 5 lakh doses. Government data shows 2 million doses were administered on Friday. Even if one assumes a daily strike rate of 2 million doses, at the current rate achieving the target in the remaining 140 days demands ramping up of speed.
Consider the emerging picture from data points available on the dashboard of cowin.gov.in to appreciate the gap. On Friday, March 12 the planned vaccination capacity stood at 54.15 lakh whereas total doses administered was 20.53 lakh. Effectively less than half of the planned capacity is utilised. What makes the capacity to utilisation conundrum worse is that registrations for vaccinations in a seven-day period have yo-yoed from a peak of 19.7 lakh to 3.5 lakh.
The causation of the gap between the need and the jab is located in the confluence of design inadequacies in policy, uneven implementation across states and insufficient evangelism. In his pathbreaking book, ‘Nudge: Improving Decisions About Health, Wealth, and Happiness’ Nobel laureate Richard Thaler makes a pertinent point: “A choice architect has the responsibility for organizing the context in which people make decisions.”
The government is the ‘choice architect’ in the design of the vaccination rollout and it must organise and reorganise the context. While global consensus is built around first protecting the vulnerable and elderly, studies do suggest that a restrictive and slower rollout could result in room for rise of newer mutant strains. Ergo the yawning gap between planned capacity and actual vaccination calls for real-time modifications in classification of deemed priorities.
The obvious measure is to expand the ambit of age to include those above 45 or 50 years of age for vaccination to enable acceleration and protection of a larger population from the virus. The social context is critical. Think of it as ‘skin in the plan’. Those above 45/50 years of age would have children and aged parents at home. The need to hold on to jobs, attend to responsibilities makes them ideal to accelerate the rollout and present a demonstration effect. Indeed the original plan had 50 plus folks in the phase two of the rollout. Why not open up centres on specific days or at specific hours, maybe as walk-in registrations, for 50 plus folks to start with? With traction and acceleration the window could be further widened to include younger folks.
There is also the context of need. Students have missed schooling for over a year and arguably the teachers who need to be vaccinated for schools to reopen would be under 60 and this would need to be done before the term starts. Secondly, almost every business chamber in the country has pleaded for opening up vaccination so the employees could be vaccinated. This would improve utilisation of current capacity and also enable expansion of private health care participation in the process and reduce the physical and fiscal burden on the government.
Unlike other countries India does not suffer from inadequate production capacity — and is adding new ones, including the one-shot J&J vaccine, to the output list. India’s vaccine diplomacy has justifiably earned praise. Yet the stark factoid is that it has exported more doses (481 lakh) than it has administered at home calls for a review of its vaccination rollout plan.
India has a limited window to rebuild its economy on the opportunities the pandemic has unveiled. Much rests on the success of vaccine rollout – And there is no disputing the challenges of scale and complexity India faces. It is true that the formal sector of the economy is recovering but it is equally true that large parts of the economy are yet closed or are operating below potential resulting in retrenchment of jobs and opportunities for millions.
The pandemic is far from over. It is easy to be lulled into complacency — the surge in cases, in states such as Maharashtra, illustrates the consequence of systemic stasis. India can scarcely afford another wave — it will have deleterious socio-economic consequences.
Shankkar Aiyar
Author of The Gated Republic, Aadhaar: A Biometric History of India’s 12 Digit
Revolution, and Accidental India
shankkar.aiyar@gmail.com