Blog: India's Risky Plan Betting On A Mild Omicron

The party is over. Covid is back with a bang and we could be getting into a worse outbreak than summer this year. Yet, with everyone sounding the alarm, why are we all so complacent? Markets are full of unmasked people, airfares have surged with demand, and partying is at its peak as we head to the end of the year. Yes, we the people seem to be blase about another wave despite the world warning us of a potential disaster. But we were like that before this summer, until the funeral pyres brought home the reality.

With the relatively small numbers (126 Omicron cases so far), we probably feel there is no real wave. Unfortunately, the reality could be quite different. First, Omicron positivity only comes after four or five rounds of genome testing, so the 126 could be two to four multiples of that. Second, given that many of the symptoms seem mild, many people may not be testing. Third, as WHO chief Tedros Adhanom Ghebreyesus put it, "The reality is that Omicron is probably in most countries.... we have a more transmissible virus, we could be setting ourselves up for a very dangerous situation."

Frankly, we cannot afford a repeat of what happened earlier this year. Even if Omicron is just a milder version, we know it is more virulent, spreading more than 5.5 times faster than Delta and doubling every 1.5-3 days. The government's own estimates using UK data suggest Omicron is affecting 1.4 million people daily. Given that it takes 10 days to be rid of the virus, that means at any given time we could have 25 million people afflicted by the variant. To put that in perspective, that's the population of Australia.

After two years of lockdowns and restrictions, the economy is just about getting back on its feet. Another big Covid blow will knock out whatever little resilience there is left, especially in construction, retail, hospitality and MSME sectors, which provide the bulk of employment in urban India.

Despite both WHO and the G-7 calling this 'wave' disastrous, there seems to be complacency both within the populace and the government, very similar to what we saw in March, when celebrating Holi, weddings and holding election rallies seemed to be the big concern. Today, Holi is replaced by Christmas and the New Year, and weddings and election rallies continue.

Strangely, the Health Ministry, in its press conference on Friday, played both sides of the coin; it sounded the alarm that we could be overrun by another wave - a brilliant bureaucratic cover in case things go awry - and yet offered solicitous advice on how to tackle the situation; avoid unnecessary travel, reduce partying, follow Covid norms, get vaccinated etc etc. It also rejected the possibility of booster shots for health and frontline workers, as well as for senior citizens (like the writer) until everyone is vaccinated.

The desire to get everyone vaccinated is understandable, even a noble goal. But we have only fully vaccinated 39% of the total population or 57% of the adult population (see below). At our current rate of vaccinations, we are unlikely to reach the target of all adults before March. The whole population? Never.

Partly, we have lost the oomph of vaccination.

Almost 120 million people haven't turned up for their second shot. The vaccination rate has fallen from an average of 8 million shots a day in October to 6-7 million now. And we are not keeping pace with most countries in our overall drive to vaccinate.

Even in the West, the vaccination levels aren't going to reach 100%. Yet most of these countries have started the booster shot. In Britain, which is facing a huge outbreak, they have already managed to give 50% of the population boosters, without waiting for the 15% who haven't got vaccinated. So, for the government to hide behind the curtain of completing vaccinations before giving the booster shot is like waiting to eliminate poverty.

There is an issue that a Covishield booster to those vaccinated with Covishield is not seen as the most effective booster, although studies do show that it does help (1). Since 90% of the vaccinations are Covishield, the government needs an alternative. The first alternative is stop further Covaxin vaccinations (except the second shot) and use it for the 28 million health and frontline workers who are already vaccinated. Bharat Biotech says it will produce 80 million doses this month, so there should be adequate supply to kick off this part.

Giving these two groups boosters immediately is absolutely necessary. For many of them it's nine months or more since they were vaccinated. All studies show considerable waning in immunity after 6 months, which means this group needs a booster shot, Omicron or no Omicron. Delta is still around, so why should these workers risk their well-being because the government has some nebulous aim of total vaccination? The risk of them falling to Omicron could potentially bring our medical system to its knees, especially if we have an outbreak of the proportions that the government is saying is possible. The doctors' body has been demanding this for a few weeks, and they know what's good; they have to face the public, not bureaucrats isolated in their bunkers.

Covaxin, along with the WHO-cleared Covavax (which SII is producing and is said to have adequate stocks of - about 250 million shots) is also seen as a very effective booster (1), and should be enough to give the third shot for the elderly and immune-compromised without affecting the availability of vaccines for those not vaccinated or fully vaccinated.

There must be some other reason the government isn't pushing for the booster. Could it be money? The Business Standard (2) estimates that having spent Rs 50,000 crore on vaccines so far, they would need another Rs 10,000 crore to pay for the boosters. Given how stingy the Finance Ministry has been on Covid-related spends (yes, we did get long plaintive lectures that professed crores and crores for everyone, but most of it was just reworked numbers, little extra came out of the kitty) would they, six weeks before the Budget, be willing to disturb the delicate deficit balance?

Why are they unwilling to act more decisively to prevent another wave, instead of just offering a set of homilies in press conference? Where is the Health Minister? Whoever he is, since no one has seen or heard of him (oops, sorry! he was doing press ups in Madhya Pradesh). Perhaps, having seen his predecessor dispatched to the dustbin for talking too much, Mansukh Mandaviya believes that invisibility is a virtue. Isn't it time, like other countries, to take some decisive action, rather than making pithy requests to public?

Around the world, campaigns for booster shots are on, compulsory masking has returned, get-togethers have been reduced to immediate families, vaccine certificates are demanded for entry into restaurants, and night curfews are back. The Dutch have shut down, Britain is debating a post-New Year lockdown, most of Europe has brought in restrictions. Isn't it time we acted?

If so, what could we do besides pressing the booster button?

First, we need a big campaign, including political leaders, film stars and cricketers, asking people to vaccinate. We haven't done it and we need to do it. Yes, by all means, spend crores on advertising highways that are being built, Udhaan or whatever else self-promotions state governments need, but also open the purse strings for Covid campaigns during cricket match telecasts, on TV generally, on social media and the press. Let companies use their CSR to promote.

Second, we need to clamp down. Vaccine passports are a must for travelling by public transport - either bus, train, or air ( except those still in the 12-week gap) - or be allowed into malls, restaurants, hotels, offices, and public gatherings, including weddings. They have given them enough time, so now if they don't want themselves vaccinated, they should take the downside. RT-PCR test are great, but they only tell you that you didn't get infected three or four days ago; that gap of four days is crucial. In that much time, say at a wedding, you could infect 200 people. It's not good enough in times of impending crisis.

Third, shouldn't we be acting more vigorously on international arrivals? Seeing that we don't have the infrastructure to see that people are home-quarantined (remember all those passengers who disappeared after arriving earlier this month from Omicron countries) should we re-impose hotel quarantine? Yes, that sounds awful, but the British government took a lot of flak for allowing Indians in the country in March - we were seen as the Delta carriers, which we probably were. Now that Western Europe is getting overwhelmed, shouldn't we be tougher? Of course, the NRI community carries disproportionate political heft, and with the Punjab election around the corner, it may be a big ask.

Is it, in fact, elections and campaigning that is holding the state(s) back from acting decisively? Let's not anger the voters with restrictions or more importantly, let's not remind them of the tragic summer. They may have forgotten the misery. Let sleeping dogs lie. The hope is that a 'mild' Omicron will pass by without too many serious cases, hospitalisation and deaths, and will not trigger too much negative publicity. It seems to be a risk both state and central governments are taking.

(Ishwari Bajpai is Senior Advisor at NDTV.)

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.