Vaccines To Be Available At Government, Private Hospitals: AIIMS Chief
With news coming in of a drastic increase in numbers of Covid cases across the country, the government has opened up the vaccination process to the private sector, a process that could begin on March 1. In an interview to NDTV's Vishnu Som on Left, Right and Centre, Dr Randeep Guleria, the Director of Delhi's AIIMS, who is a part of the taskforce that is handling the coronavirus crisis in India, answered several key questions on how the new vaccination process will work.
Here is the full transcript of the NDTV interview with Dr Randeep Guleria:
NDTV: Dr Guleria first up, before we actually get to all of these questions that have been sent in to us- the Maharashtra situation, the numbers have just come in. What does this indicate to you? Are we seeing this going up very sharply? What is your thought on the numbers?
Dr Randeep Guleria: So I think this is a cause of concern, because there is a spike in the number of cases. And this has been seen for the last few days. And therefore the trend is not very encouraging. And therefore I personally feel we need to be very aggressive, we need to sort of literally nip it in the bud, because the situation in our country is good. But we've seen globally that the situation can change very quickly. And therefore in terms of testing, tracking, isolating, developing containment zones, and possibly also trying to vaccinate as many people as possible in that area - like UK did - we need to develop strategies in that manner, so that we are able to contain the spread of infection and make sure that it doesn't spread to the rest of the country or to other parts of the state.
NDTV: And so doctor, is that why we have speeded up the process of vaccinating different categories of citizens now because of these numbers? Not just in Maharashtra, it has to be said, a few other states as well.
Dr Randeep Guleria: Yes, that could be one of the reasons because what the... we don't have an effective antiviral drug right now. What we have currently available is a vaccine, which is effective, and it will help to at least decrease serious illness and mortality. And that will bring down the Case Fatality Rate. And it will also help to break the chain of transmission. So I think it's very important for us to start vaccinating as many individuals as we can. Because as we are seeing in Maharashtra, we don't want the situation... a similar situation to develop in other states. And one of the ways to really prevent that is by vaccinating as many individuals as we can. This is a strategy which UK also adopted when they had a huge surge in the cases in the southern part of England.
NDTV: When will the process of administering vaccines to 60+ citizens and 45+ citizens with comorbidities begin?
Dr Randeep Guleria: So this process should start... I think the first week of March - as early as possible. It may be even on the first of March itself. To some extent, it will possibly start at a slow pace. And once we have more and more vaccination centres coming on board and having the ability to do it, it will become a bigger movement, a larger movement. And I'm sure there will be a lot of participation of the private sector which will really increase the number of people who can be vaccinated on a given day.
NDTV: Doctor, how do you define 'comorbidity?' People above 45 with comorbidities can get administered. So what is a comorbidity?
Dr Randeep Guleria: So comorbidities... there has been a group which has worked on this and tried to develop what should be comorbidities. Especially looking at those illnesses, which could lead to a higher chance of that individual having landing up in hospital or dying because of COVID-19. So you have a large number of comorbidities, some of them may not be a risk factor for having severe co-... death. But there are others, which could be obesity, which could be diabetes, which could be heart disease, which could be cancers. It could be also people who are... who are, let's say, having disabilities, which can lead to higher chance of respiratory infection, or those who are on drugs, which lead to a lower immune response. And we know that that can lead to a more serious pneumonia or serious COVID infection. So based on a criteria, it can... it is... you could be in that category. And you could go and get yourself vaccinated.
NDTV: What proof of comorbidities need to be produced, and by who?
Dr Randeep Guleria: So for comorbidities, you don't need to get any tests done. If you have your record, which show that you have got comorbidities, you can go to any GP or any doctor, either in the government sector, in private sector, and based on the commodities that you have and a one page pro forma, which will just say that you have this comorbidities and if it's signed and stamped by that doctor, then you are automatically included into the list. So it's trying to be more inclusive rather than exclusive as far as people with comorbidities is concerned.
NDTV: How do citizens register and where?
Dr Randeep Guleria: So registration, as far as I can understand would be based on two things. One is data which will be uploaded onto the CO-WIN app based on the electoral roll, which will give you the age group. And then if you still are not there on the electoral roll, you could go to one of the vaccination sites or upload your data onto the app with your photo ID card - it could be Aadhaar Card, it could be your Driving License, it could be a Passport. But if that shows that you are in the priority group, you would be accepted into the vaccination programme and you would get an SMS on your registered mobile number. And then you could select a site near your residence where you would want to get yourself vaccinated. And then it could be using an appointment system, as you would do for booking a railway ticket in routine practice.
NDTV: Doctor, what if a citizen is not tech-savvy?
Dr Randeep Guleria: So if you are not tech savvy, you could go on to the vaccination site. So that I think there are two things that are being looked at. One is that you could directly go to a vaccination site - you will have walk-in also available. And if you are carrying your photo I-card, the site itself will help you to register and you will get registered on to the app and you will get yourself vaccinated, your phone number will be recorded. And you will get a reminder message when you have to come for the second dose. There will also be healthcare workers and other volunteers who could help people, especially in rural India, to really go on to the app or could help people come to the vaccination site and get themselves vaccinated. Because many elderly will not be able to come on their own. So you have to develop a strategy that they can actually be brought to the vaccination site, and someone - a volunteer can help them get themselves registered, get themselves vaccinated, and then they could go back to their residence so that this could be facilitated.
NDTV: Doctor, how many citizens are being targeted in this next batch?
Dr Randeep Guleria: So we are looking at as many as we can cover. The target always depends on how many people come forward to get themselves vaccinated. So the target would be something like maybe around 25 crores or maybe more than that. But a lot will depend on how many people come forward to get themselves vaccinated. I personally feel that we need to really develop a lot of aggressive strategy for getting public awareness and sort of getting over the infodemic which is creating a lot of vaccine hesitancy. Because as we are seeing, there is a spurt of cases happening in different states in the country. If you are able to vaccinate more and more people, then we could really prevent any surge in the number of cases, not only in Maharashtra, but in other states and that is why we need to aggressively work on a programme of getting more and more people vaccinated. And getting people to come forward and get themselves vaccinated.
NDTV: Where can citizens go to get vaccinated?
Dr Randeep Guleria: So now it's been opened up both for the government sector and the private sector. Many private hospitals which are part of the PMJAY or are being covered, will get registered. And they can therefore get the vaccine, the cold chain logistics will be worked out. And most of such hospitals already have facilities for storing the vaccine, the vaccine is just an ordinary fridge. And if you can, therefore have the facility to do it, you could become a vaccination site. And then based on the CO-WIN app, vaccination could be given at that private or government hospital or center.
NDTV: So would these hospitals acquire the vaccines from the companies or from the government?
Dr Randeep Guleria: I think that is being worked out. Possibly it will be through the government and some mechanism of how the payment process is going to be done will also be worked out by the government. But I think the... it will be acquired by the government and the government will distribute it to all the vaccination sites, whether they are in the private or the government sector, so that there is some accountability, as far as doses is concerned. And there is no misuse of the doses in terms of the priority group not getting it and other people getting it or it being sold in the black market. If I put it that way.
NDTV: Dr Guleria, how much will vaccine shots cost?
Dr Randeep Guleria: So I think that needs to be worked out. I don't think we have a definite costing that has been done. But I'm sure it's not going to be very much because the cost of the vaccine is not very high, it's only around 300 rupees. And many of the private sectors, hospitals have come forward and said they will charge only the basic minimum charge that they need for the logistics. And that could be just the cost of a syringe and needle, and possibly some degree for human resources. This is more of a, I would say a social movement to really get out of the pandemic, which is useful for the hospitals also, if they want to really come back and start having more and more patients coming in for routine procedures. So I think they will be... it will not be something which will be very costly.
NDTV: All right. Can you get your second dose from a separate location?
Dr Randeep Guleria: You can. So I think one would like to really get people to get the second dose at the same site. But if you're traveling, or if you're at a different place, using the CO-WIN app, you could still get the second dose at a different site, if that is available at that site, and they have the doses on that site.
NDTV: Will citizens have a choice of the vaccines that they receive?
Dr Randeep Guleria: So, this is something that needs to be worked out. It will create a little bit of confusion. So each site will probably have a given vaccine - it could be either Covaxin or Covishield. And if you get yourself vaccinated there, then you'll obviously get the vaccine which is available at that site. Giving too much of a choice may create a little bit of confusion, and remember, we still have an issue of supply versus demand. The supply is still limited as compared to the demand that we are seeing. And therefore we will not really be in a position to have too much of choices. Currently as things progress and we are able to match the supply with the demand, the choice will obviously be available and more and more vaccines will actually come into the market at that given point in time.
NDTV: When will the additional stocks of vaccines roll out across India?
Dr Randeep Guleria: So, so there are two things. One is additional stock of the vaccines which are currently being made and that is something which is happening on a regular basis. Both the companies are working on providing a continuous stock of vaccinations. But as we already know, Dr. Reddy's laboratory has also filed for emergency use authorization for the Sputnik vaccine. There is now published data of the efficacy of the vaccine, which is close to over 90 per cent. And one is hopeful that within the coming few weeks, we will also have this vaccine available in the market. This will add to the number of vaccine shots available in India, which will be a big boost in terms of the absolute numbers
NDTV: Has Sputnik been cleared today, doctor?
Dr Randeep Guleria: I am not aware of that. That data will come out from the DCGI's office actually. But the meetings are being held and the data is being critically analysed by the expert group.
NDTV: All right, Dr Guleria. So you've answered 13 questions. I meant to ask you 11. But thank you so much. Again, entirely in public interest. And we will try and transcribe all your answers so that our viewers and our readers can actually understand, so many questions coming to us. Thanks, doctor.
Dr Randeep Guleria: Thank you.
Here is the full transcript of the NDTV interview with Dr Randeep Guleria:
NDTV: Dr Guleria first up, before we actually get to all of these questions that have been sent in to us- the Maharashtra situation, the numbers have just come in. What does this indicate to you? Are we seeing this going up very sharply? What is your thought on the numbers?
Dr Randeep Guleria: So I think this is a cause of concern, because there is a spike in the number of cases. And this has been seen for the last few days. And therefore the trend is not very encouraging. And therefore I personally feel we need to be very aggressive, we need to sort of literally nip it in the bud, because the situation in our country is good. But we've seen globally that the situation can change very quickly. And therefore in terms of testing, tracking, isolating, developing containment zones, and possibly also trying to vaccinate as many people as possible in that area - like UK did - we need to develop strategies in that manner, so that we are able to contain the spread of infection and make sure that it doesn't spread to the rest of the country or to other parts of the state.
NDTV: And so doctor, is that why we have speeded up the process of vaccinating different categories of citizens now because of these numbers? Not just in Maharashtra, it has to be said, a few other states as well.
Dr Randeep Guleria: Yes, that could be one of the reasons because what the... we don't have an effective antiviral drug right now. What we have currently available is a vaccine, which is effective, and it will help to at least decrease serious illness and mortality. And that will bring down the Case Fatality Rate. And it will also help to break the chain of transmission. So I think it's very important for us to start vaccinating as many individuals as we can. Because as we are seeing in Maharashtra, we don't want the situation... a similar situation to develop in other states. And one of the ways to really prevent that is by vaccinating as many individuals as we can. This is a strategy which UK also adopted when they had a huge surge in the cases in the southern part of England.
NDTV: When will the process of administering vaccines to 60+ citizens and 45+ citizens with comorbidities begin?
Dr Randeep Guleria: So this process should start... I think the first week of March - as early as possible. It may be even on the first of March itself. To some extent, it will possibly start at a slow pace. And once we have more and more vaccination centres coming on board and having the ability to do it, it will become a bigger movement, a larger movement. And I'm sure there will be a lot of participation of the private sector which will really increase the number of people who can be vaccinated on a given day.
NDTV: Doctor, how do you define 'comorbidity?' People above 45 with comorbidities can get administered. So what is a comorbidity?
Dr Randeep Guleria: So comorbidities... there has been a group which has worked on this and tried to develop what should be comorbidities. Especially looking at those illnesses, which could lead to a higher chance of that individual having landing up in hospital or dying because of COVID-19. So you have a large number of comorbidities, some of them may not be a risk factor for having severe co-... death. But there are others, which could be obesity, which could be diabetes, which could be heart disease, which could be cancers. It could be also people who are... who are, let's say, having disabilities, which can lead to higher chance of respiratory infection, or those who are on drugs, which lead to a lower immune response. And we know that that can lead to a more serious pneumonia or serious COVID infection. So based on a criteria, it can... it is... you could be in that category. And you could go and get yourself vaccinated.
NDTV: What proof of comorbidities need to be produced, and by who?
Dr Randeep Guleria: So for comorbidities, you don't need to get any tests done. If you have your record, which show that you have got comorbidities, you can go to any GP or any doctor, either in the government sector, in private sector, and based on the commodities that you have and a one page pro forma, which will just say that you have this comorbidities and if it's signed and stamped by that doctor, then you are automatically included into the list. So it's trying to be more inclusive rather than exclusive as far as people with comorbidities is concerned.
NDTV: How do citizens register and where?
Dr Randeep Guleria: So registration, as far as I can understand would be based on two things. One is data which will be uploaded onto the CO-WIN app based on the electoral roll, which will give you the age group. And then if you still are not there on the electoral roll, you could go to one of the vaccination sites or upload your data onto the app with your photo ID card - it could be Aadhaar Card, it could be your Driving License, it could be a Passport. But if that shows that you are in the priority group, you would be accepted into the vaccination programme and you would get an SMS on your registered mobile number. And then you could select a site near your residence where you would want to get yourself vaccinated. And then it could be using an appointment system, as you would do for booking a railway ticket in routine practice.
NDTV: Doctor, what if a citizen is not tech-savvy?
Dr Randeep Guleria: So if you are not tech savvy, you could go on to the vaccination site. So that I think there are two things that are being looked at. One is that you could directly go to a vaccination site - you will have walk-in also available. And if you are carrying your photo I-card, the site itself will help you to register and you will get registered on to the app and you will get yourself vaccinated, your phone number will be recorded. And you will get a reminder message when you have to come for the second dose. There will also be healthcare workers and other volunteers who could help people, especially in rural India, to really go on to the app or could help people come to the vaccination site and get themselves vaccinated. Because many elderly will not be able to come on their own. So you have to develop a strategy that they can actually be brought to the vaccination site, and someone - a volunteer can help them get themselves registered, get themselves vaccinated, and then they could go back to their residence so that this could be facilitated.
NDTV: Doctor, how many citizens are being targeted in this next batch?
Dr Randeep Guleria: So we are looking at as many as we can cover. The target always depends on how many people come forward to get themselves vaccinated. So the target would be something like maybe around 25 crores or maybe more than that. But a lot will depend on how many people come forward to get themselves vaccinated. I personally feel that we need to really develop a lot of aggressive strategy for getting public awareness and sort of getting over the infodemic which is creating a lot of vaccine hesitancy. Because as we are seeing, there is a spurt of cases happening in different states in the country. If you are able to vaccinate more and more people, then we could really prevent any surge in the number of cases, not only in Maharashtra, but in other states and that is why we need to aggressively work on a programme of getting more and more people vaccinated. And getting people to come forward and get themselves vaccinated.
NDTV: Where can citizens go to get vaccinated?
Dr Randeep Guleria: So now it's been opened up both for the government sector and the private sector. Many private hospitals which are part of the PMJAY or are being covered, will get registered. And they can therefore get the vaccine, the cold chain logistics will be worked out. And most of such hospitals already have facilities for storing the vaccine, the vaccine is just an ordinary fridge. And if you can, therefore have the facility to do it, you could become a vaccination site. And then based on the CO-WIN app, vaccination could be given at that private or government hospital or center.
NDTV: So would these hospitals acquire the vaccines from the companies or from the government?
Dr Randeep Guleria: I think that is being worked out. Possibly it will be through the government and some mechanism of how the payment process is going to be done will also be worked out by the government. But I think the... it will be acquired by the government and the government will distribute it to all the vaccination sites, whether they are in the private or the government sector, so that there is some accountability, as far as doses is concerned. And there is no misuse of the doses in terms of the priority group not getting it and other people getting it or it being sold in the black market. If I put it that way.
NDTV: Dr Guleria, how much will vaccine shots cost?
Dr Randeep Guleria: So I think that needs to be worked out. I don't think we have a definite costing that has been done. But I'm sure it's not going to be very much because the cost of the vaccine is not very high, it's only around 300 rupees. And many of the private sectors, hospitals have come forward and said they will charge only the basic minimum charge that they need for the logistics. And that could be just the cost of a syringe and needle, and possibly some degree for human resources. This is more of a, I would say a social movement to really get out of the pandemic, which is useful for the hospitals also, if they want to really come back and start having more and more patients coming in for routine procedures. So I think they will be... it will not be something which will be very costly.
NDTV: All right. Can you get your second dose from a separate location?
Dr Randeep Guleria: You can. So I think one would like to really get people to get the second dose at the same site. But if you're traveling, or if you're at a different place, using the CO-WIN app, you could still get the second dose at a different site, if that is available at that site, and they have the doses on that site.
NDTV: Will citizens have a choice of the vaccines that they receive?
Dr Randeep Guleria: So, this is something that needs to be worked out. It will create a little bit of confusion. So each site will probably have a given vaccine - it could be either Covaxin or Covishield. And if you get yourself vaccinated there, then you'll obviously get the vaccine which is available at that site. Giving too much of a choice may create a little bit of confusion, and remember, we still have an issue of supply versus demand. The supply is still limited as compared to the demand that we are seeing. And therefore we will not really be in a position to have too much of choices. Currently as things progress and we are able to match the supply with the demand, the choice will obviously be available and more and more vaccines will actually come into the market at that given point in time.
NDTV: When will the additional stocks of vaccines roll out across India?
Dr Randeep Guleria: So, so there are two things. One is additional stock of the vaccines which are currently being made and that is something which is happening on a regular basis. Both the companies are working on providing a continuous stock of vaccinations. But as we already know, Dr. Reddy's laboratory has also filed for emergency use authorization for the Sputnik vaccine. There is now published data of the efficacy of the vaccine, which is close to over 90 per cent. And one is hopeful that within the coming few weeks, we will also have this vaccine available in the market. This will add to the number of vaccine shots available in India, which will be a big boost in terms of the absolute numbers
NDTV: Has Sputnik been cleared today, doctor?
Dr Randeep Guleria: I am not aware of that. That data will come out from the DCGI's office actually. But the meetings are being held and the data is being critically analysed by the expert group.
NDTV: All right, Dr Guleria. So you've answered 13 questions. I meant to ask you 11. But thank you so much. Again, entirely in public interest. And we will try and transcribe all your answers so that our viewers and our readers can actually understand, so many questions coming to us. Thanks, doctor.
Dr Randeep Guleria: Thank you.
