The rise in COVID-19 cases as part of India’s ‘second wave’ has the government and public health authorities truly worried. In many ways, the concern is larger than during last year when there were several more cases. V.K. Paul, Member, NITI Aayog, who has been in the forefront of public communication on all matters COVID-19, described the ongoing situation as going from “bad to worse”. The Health Secretary, Rajesh Bhushan, has also reiterated in the last two weeks that urgent action must be taken. On March 1, concerns of a spike were still on the horizon. In a month, however, the situation appears catastrophic. The number of new active cases added on March 1, around 3,000, has now become nearly nine-fold. Daily deaths too have, in that interval, skyrocketed three-fold — from around 112 to 354. As of this month, India has administered nearly 6.3 crore doses of Covaxin and Covishield and since March 20, has been inoculating a little over 2 million every day. What is apparent is that the States registering a high number of cases — Maharashtra, Gujarat, Karnataka, Kerala and Madhya Pradesh — are also those where many are signing up for their first dose. A notable exception is Punjab. The government is also bearing down on local vaccine companies to prioritise delivery to India over their international commitments as several other vaccine candidates line up emergency approvals from regulators. So, vaccine hesitancy is not India’s most pressing problem.
India’s communication of the tides and ebbs of the pandemic has always been below par. The broader strategy by the Central and State governments is to take credit when there is a declining trend in cases and blame people’s laxity for an upward trend. More research needs to be conducted and communicated on whether mortality in the second wave is biased towards the group yet ineligible for vaccination, and whether reinfections are an emerging problem. It was always known, from the vaccine trial data, that the inoculations were extremely effective at addressing severe disease but less so in containing infections. This aspect needs to be amplified and communicated more clearly to encourage vaccination. It is hypocritical on the government’s part to allow large religious gatherings and political melas in election-bound States and also blame normal movement for the second wave. What is needed is messaging that emphasises the realistic protective abilities from vaccination and physical distancing measures. It is also unclear why new vaccines are not being accelerated for emergency use when Covishield and Covaxin were rushed through without any local efficacy data. More vaccines and a sharpening of India’s communication strategy are essential.