Community Must Maintain Caution In Festive Season: Dr N K Arora, Chairperson, Covid-19 Working Group, National Technical Advisory Group On Immunization To Kailashnath Adhikari, MD, Governance Now

Dr N K Arora said that a massive social mobilization campaign is required at the community level through people with credibility & respect to exercise restrain against gatherings in festivals.      

Kailashnath Adhikari, MD, Governance Now (L) and Dr N K Arora, Chairperson, Covid-19 Working Group ,National Technical Advisory Group (R)

With festival season around the corner, covid infections moving up in states like Kerala and Maharashtra, Kerela alone reporting 70% of India’s new covid cases and the lurking danger of third wave, Dr N K Arora, Chairperson, Covid -19 Working Group, National Technical Advisory Group on Immunization has cautioned that that only covid appropriate behavior is not enough and a massive social mobilization campaign is required at community level to stay safe from covid infections.

Strongly voicing for bringing together social, cultural, and religious leaders Dr Arora said a massive social mobilization campaign is required at the community level through people with credibility and respect to exercise restrain against gatherings during festivals.      

“Simply CAB is unlikely to work. We need to proactively bring in social,cultural and religious leaders to say that another year of discipline, staying within the family and virtues of spending time together to celebrate the festivals is preferred than having social gatherings. Most new infections occur in contact with the closest friends and relatives and members of social network as you let your guard  down during contact with such people. With only about two weeks left for festival season, a massive social mobilization campaign is required at community level.”

He was speaking to Kailashnath Adhikari, during the webcast of Visionary Talk series held by public policy and governance analysis platform. 

In Kerala, he said virus circulation in the population is very intense. In July sero -survey, 60% of Kerala’s population was negative. With only 3.5 crore of India’s population there are disproportionately high cases and we need drastic measures like lockdown and containment at district and subdistrict level. He said the SOP’s  require strict CAB at individual, community and district levels.

Iterating community engagement for covid mitigation Dr Arora said with India’s huge population per sq feet  community engagement is very important. “Non adherence to CAB equals to non-compliance”.

Responding to question that many states have opened up schools despite children being not vaccinated so far children have not got severe disease and very rarely die. During 1st and 2nd waves, he said, symptomatic disease in children under 10 years is only 3%  and those under 18 years is 8%.

“For children, God is kind and there are biological reasons for children to be less affected. Therefore  they are a priority after adults have been immunized and we are following that approach. Parents  and teachers should be surviving to take care of children. We know that in many European countries, children are asymptomatic but they have spread the infection to teachers and their own families resulting in deaths.”

Dr Arora cautioned that schools need to open in a graded manner with local and context specific solutions and each district has to decide about attendance in schools. He noted that hybrid teaching model has to continue for some time.

He said that with children having gone through tremendous stress over the last one and a half years, parents having lost jobs, family members hospitalized and deaths in the family, psychologists  and councilors have to be involved in mainstreaming children back into school instead of merely opening the gates of schools. He also said that difference between urban, rural private and public schools and access to technology has to be considered while mainstreaming children back into schools 

Speaking on vaccine hesitancy, the expert panel chief  said  instead there is eagerness in community for vaccine and as a country the community has least hesitancy. “As per the govt estimates we should be able to give 100 shots per center. We have capacity of about 100,000 immunization centers across the country.With 60,000-70,000  immunizations centers at present, each center is processing 125-160 shots per day. With more vaccines available the speed should pick up” he said.

He added that private sector has been asked to  participate and they can set up 20,000 immunization centers but  unfortunately they have been able to set up only 3000-4000 centers so far. 

On Zydus Cadila’s, 1st DNA fully indigenous vaccine in the world, ‘ZyCov-D’ that can be given to 12-17 year old’s, he said initial data shows it is very safe. “For 12 crore children in this age group, the vaccine will be given on priority to children with co- morbidities. he govt will come out with this list in week or so and the vaccination will start from October. With 44 crore population under the age of  18 years, priority will be given to adults” he said.

Dr Arora said with sizeable population being immunized, the momentum should continue with more gusto. With the govt now geared for nationwide network of diagnosis through Genome Surveillance the sampling is done regular through hospitals and community.

Secondly, samples are being picked up from areas with upsurge and now the govt is also collecting samples from sewerage, he said. Fourthly, the govt has now set up a network across the country to study samples of severe disease to preempt action.

Dr Arora, further said that by end September, all major district hospitals in the country will have their own oxygen  plants.Temporary hospitals/beds created during pandemic are now being made permanent. ICU beds are being increased to double their no’s and out of that at least 100,000 beds must have ventilators. “ Every district hospital and medical college has been asked to create a special ward for children with investment by central government  and complimented by state govts so that there is no disruption in health system.”

“With 70% population of country already exposed to virus it is a blessing in disguise.  On top of that vaccination provides solid protection and even with variant the intensity and severity becomes much less.”

On being asked if India is entering endemic stage of pandemic, Dr Arora said words like endemic and herd immunity are ‘mystical’ and ‘mythical’. While all diseases ultimately become endemic,herd immunity, he said is very conceptual word. In polio people said, if  80% children are immunized it should go away. It went away only when 99% children were immunized.

Praising resilience shown by community, machinery and everyone involved  he said the epidemic is an example that multisectoral engagement is the key to all our activities. “The second message that pandemic has given is that economy and health are part of the same coin. It is not time to lower our guard and we must continue with same gusto for next one to one and half years. I think we can resume completely normal lives by end of 2022 or so…there are some lingering issues of children, if booster shots are required or not…. we are generating scientific evidence if booster shots are required. Currently there is no evidence, so decisions taken so far have been on the basis of science. We are looking at locally generated as well as international evidence” he said.

Dr Arora expressed confidence that National Vaccine Tracking Platform  expected to be announced within a week or so will show real time vaccine effectiveness  and provide answers to  the need for booster shots, dose intervals, geographical variations, relationship with genomic new variants of concerns or interest, etc