Rise in Covid cases will affect vax drive: AIIMS

The bigger factor is the public disregarding all the Covid norms. But without doing genomic surveillance I cannot emphatically say that it is because of the mutant strains of Covid. We have an increasing number of cases. This virus infection is occurring much more readily now, it is far more infectious and it is affecting children and the young people

Dr Rajesh Malhotra, Head of Orthopedics Department, All India Institute of Medical Sciences (AIIMS) New Delhi, spoke to Bizz Buzz on the first day of the third phase of the Covid vaccination drive. Dr. Malhotra, currently heading the Covid vaccination drive at the hospital, spoke on the challenges on vaccination, the new strain of the Covid infection and the probability of a possible second wave hitting the country. The third phase of the Covid vaccination kicked off on Thursday which would aim at immunising people 45 years and above. Excerpts from the interview:

How has been the response in the first two phases of vaccination drive? Have there been any challenges so far?

There were quite a few challenges initially; the vaccine hesitancy was there, and issues with the app. But I think it has constantly picked up and I think roping in the private hospitals and now extending the facility of spot registration and increasing the timing of vaccination, from 9 am to 9 pm is a great move.

We are reaching a point where people can walk up to a vaccination centre and just show their Aadhar card and get vaccinated.

Is there scope to initiate door to door Covid vaccinations by the end of this year?

That has been said. I think we have already made one step in that direction. The issue with door-to-door vaccination is the logistic thing. All the vaccines do need the temperature to be maintained. I think the government can consider that but if majority of the population is vaccinated already, easier option should be regional registration of those not able to go to the vaccination centre. We need door-to-door services for somebody who is too old, too morbid, or too scared to venture out, and that number won't be big.

The Covid vaccination drive, although safe and successful, is still being carried out in limited numbers, whereas the Covid-19 cases are rising exponentially across India. Will this in any way affect the vaccination drive?

It is going to affect the vaccination drive. Vaccination drive gets affected when people get Covid, if they are queued up just days before getting vaccinated, you have to postpone it because anyway you don't give vaccination when your body immune system is already fighting ongoing Covid infection. Rapid increases in the cases will create difficulties for the vaccination drive but that itself is the reason to accelerate the vaccination drive because the only way to snub the virus is by vaccinating all the vulnerable population.

Which is the bigger hindrance here - The lack of awareness amongst public or the mutant strain of Covid?

I would say both. But the bigger factor is the public disregarding all the Covid norms. But without doing genomic surveillance I cannot emphatically say that it is because of the mutant strains of Covid. We have an increasing number of cases. This virus infection is occurring much more readily now, it is far more infectious and it is affecting the children and the young people. If you look at the pattern, the greater transmissibility, greater infection rate involvement of children and young adults, the pattern is similar to British variant. If you look at States like Maharashtra, Punjab and Kerala, they also have the maximum number of people who travel abroad. Also, people who were getting away with little bit of carelessness are not getting away now. We are getting cluster cases now. If you look at the rate of cases spiking, increase in number of Covid cases is far more than before.

Are we looking at a possible emergence of 2nd Covid wave?

I won't rule it out. I'm just hoping that people will behave. We will know the impact of Holi in a week or 10 days' time because if people have really thrown caution to wind, they have spread infection during Holi, the cases will start increasing in a week's time. You can see increasing cases is clearly indicates high rate of transmission. This happens when the viral load is high. It becomes even more important to wear masks and maintain distance and personal hygiene.

Some patients with co-morbidities are being turned down at the Covid vaccination centres. Is there a sense of apprehension about the doctors on the vaccination?

So, what you are saying is absolutely right. What happens is that sometimes when you are not so confident about the facts and you don't want to take any risk, the best thing they (doctors, nurses) do is turn down people with specific comorbidities. Lot of people are turned down for the unfounded fear of giving them vaccine and landing with complication. We have to counsel many such people and vaccinate them. This is an issue. If something happens, people will blame it on the vaccines, the anti-vaccine lobbyists will jump into it.

Fact is if we get close to 7 crore doses, this is not the time to look at the side-effects. I agree, people are being wrongly denied for the fear of getting some complication which is unfounded.

What can be the best strategy to cover areas with low vaccination numbers?

People have to be motivated. I know the Prime Minister took the vaccination on day 1 of the 2nd Phase of the vaccination drive (60 years and above), it motivated a lot of people. We need celebrities to come forward and tell the public that if you want to go out, you need to be vaccinated. We have to drive people to somehow accept it, work on their psyche.

As of now two brands of Covid vaccinations are being given in Delhi, i.e. Covaxin and CoviShield. And Novavax vaccine is undergoing testing. What do you anticipate once new vaccine brands get released in the coming months?

It will change the vaccination drive. For example, Johnson and Johnson needs only one dose. So, that is going to be a big factor. Major change can occur once these vaccines are available. There will be increased availability, accessibility, greater acceptance amongst people and this will change the Covid vaccination drive. Patients will have more options to choose from.