Govt Must Create A Baseline For People Who May Not Be Able To Pay For Vaccination: Saurabh Kochhar

Your views on the shortage of vaccine being faced by the country. We knew how large our population is, why did we not cater to it right from the start? What was the idea behind the staggered vaccine schedule (over 65, over 45 and now it seems the young also are equally vulnerable - therefore, staggered schedule doesn't seem to make sense in hindsight?)

The initial strategy of immunizing the frontline workers, people with comorbidities and elderly people, cannot be blamed as the decision was based on information we had at that time when the mortality rate was far lower for the younger population. The second wave is like a sudden blow to us and is affecting the younger population also equally. We cannot blame the government for the implementation strategy or the pecking order. However, I believe certain things could have been done differently. The window for each of these pecking orders or the demographics that was sorted was quite stretched, due to which there was a frenzy whenever any of these windows opened. By mid of any given window period, that were slots that were going empty and there were multiple reasons for it. But I think the implementation could have been much faster and better.

I would also say that the control that the vaccination could only happen through the government-mandated channels was not really the best way to go for it. I think by involving the private sector in the processes like administration, sourcing, imports of vaccines, number of vaccines available, we could have done better.

Can we have your views on the vaccine distribution and pricing, should we have not kept it simple and had a central body distributing and monitoring?

Govt must create a baseline for people who may not be able to afford the cost of vaccination. So there need to be government channels where it is provided for free, this was necessary and was done right by the government. But it does not mean that we also constrict people who can pay, from imported vaccines, or vaccines through other channels. The better way could have been that we had a government channel, where the pecking order is being clearly followed. But for the private sector, whether in terms of price or distribution, we should have forever kept it open and handled the distribution better.

During any medical crisis, research and data are the two factors that help win over the crisis. We don't seem to be keeping data the way we should have (the number of deaths, the cause of death-postmortems, why is black fungus only seen in India - so many unanswered questions even a year later.) Your views?  

When it comes to a crisis, I as well as Meddo, believe that the biggest problem in our country is the first line of defence, which is the out-patient care. It is where even for COVID, about 90 per cent of the people go.  A maximum of 10 per cent of the COVID-19 patients need critical care. Therefore, about 90 per cent of the cases are being treated, either under the radar or with blindfolds. That is what we need to change by ensuring that there is a structured way to approach the out-patient care, there needs to be a process that enables us to track and record ‘who is being provided what treatment and by who’. This comes, as a extremely essential part of the process, we have never had an evidence-based practice. Everything is a by-product of how the out-patient care works and thereby data around infections, hospitalisations, etc., is hearsay. The reason for this is that there is no track of how the care is being provided, at the ground level. Once we start solving the problem from there, other things will start falling into the line automatically. We need to focus on this so that, we are better prepared to deal with such crises.