Mutations continue to drive India's Covid second wave  

There was a slight dip in the daily caseload of coronavirus but daily deaths set a new record as 1,761 people died on Monday. It was the highest 24-hour spike since last year. All the talk is about mutations as India has not just reported double mutations, but a triple mutation. 

It is highly contagious. The mutations are most certainly driving India's second wave but India's prime minister is confident that the country can pull through. The PM has ruled out any lockdown. He said India is better prepared to face the second wave compared to last year.  

Many countries have decided to halt travel from India. The first advisory came from the US Centre for Disease Control and Prevention, the CDC. Americans have been asked to avoid all travel to India. Even vaccinated citizens have been asked to delay their plans after the US, Britain put India on the red list. 

From April 23, people who have visited India, will not be allowed to enter the UK. The only exemption is for British citizens. So essentially, the UK has banned travel to and from India. Hong Kong and New Zealand have done the same. It is not India's caseload that is scaring countries but the mutations. Will the vaccines work against mutants? Will the efficacy come down? These are some of the big worries. 

The vaccines will continue to work, but their efficacy rates could fall as the double mutation in India could make it harder for vaccines to create antibodies but this is not an excuse to not take one. 

Even against the mutants, vaccines will offer you some level of protection. Both Covishield and Covaxin were impressive in fighting off variants, but they are untested against the double mutation. The same for Sputnik V. The Russian vaccine maker says it is equally effective against the original virus and the variants.  

The only empirical evidence we have is for Pfizer. Israel has studied Pfizer's effect on the double mutation. The jab is at least partially effective. So, the double mutation does not make vaccines completely useless, but they won't be as efficient. 

Vaccines teach our body to recognise spike proteins and this is the outer coating on the virus. But when the virus mutates, the spike protein changes and that makes it difficult for your body to identify the virus. Difficult but not impossible, which is why vaccines are less effective, not useless. 

We can overcome this by updating our vaccines. This might sound challenging but it's actually pretty common. Flu vaccines for example are updated every season. The idea is to stay one step ahead of the virus but simply updating the vaccine is not enough. It must be transported and administered. This is where India's biggest challenge lies. From May 1, Indians aged 18 plus will be eligible for jabs. That's an additional 500 million people. Do we have enough shots for all of these people? 

The answer is no. India needs at least 10 million doses per day and India is producing less than half that number. Vaccine makers are struggling to expand capacity and now they have a new worry, lack of raw materials. India sources a large part of its vaccine raw materials from the US but the White House has curbed these exports. It wants to retain these raw materials for their own use and America's vaccine nationalism is hurting India's rollout. The second problem is this vaccine wastage. 

Until April 11, 100 million doses were rolled out and out of these, 4.4 million were wasted. Around 2 million people could have been vaccinated by these wasted doses. 

This indicates a lack of planning. Doses have to be tallied with local population. Doctors must oversee the inoculation process to avoid wastage. But what about the government? 

It must strike a delicate balance between vaccination and treatment. Both the Serum Institute and Bharat Biotech are set to receive funds from the government. Reports say Rs 4,500 crore have been sanctioned. This should help expand capacity ahead of phase 3 and if the Sputnik jabs arrive before May, India could avoid a disastrous scenario. Simultaneously, the government will have to prop up the medical infrastructure.  

The oxygen expresses have already started running. Oxygen plants have been set up at 100 hospitals and cylinder filling plants can now work 24x7. Oxygen is number one on India's wishlist and it looks like even the stock market honchos have realised this. Looking at the surging demand for oxygen, they rushed to scoop up shares of Bombay Oxygen, the company's shares soared 133% but guess what? Bombay Oxygen doesn't even produce oxygen. It works in the finance industry.  

But really, will the government response be enough?