On Omicron: Before the third wave

News: It is clear that Omicron variant is present within the community and is spreading rapidly. Although, the symptoms from the Omicron variant are mild and rarely result in death, the fact that many infections are said to be asymptomatic is a concern.

This situation, therefore, demands renewed efforts to contain, and the vaccine policy urgently needs revision.

What measures have been taken by the States to contain Omicron?

Some states such as Delhi and Odisha have been proactive in limiting social functions and banning public festivities over the holidays.

Chennai has made the Marina Beach and other beaches out of bounds for New Year celebrations.

Haryana has decreed that only fully vaccinated people will be allowed into public places, and that includes fuel pumps and mandis, with effect from January 1.

Delhi and Maharashtra have also strengthened beds and oxygen supply.

All these steps are praiseworthy, but unlikely to stop the spread of the virus unless they are taken on a national level.

What is the WHO’s recommendation on boosters?

WHO’s Strategic Advisory Group of Experts on Immunisation (SAGE) has recognised a “modest to minimal” reduction of vaccine protection against severe disease six months after second dose. It has, therefore, called for “targeted” administration of boosters.

What is the way forward?

Centre can also play a significant part in containing the Omicron variant:

Decrease the gap b/w first and second dose: A little under half the population is awaiting the second dose, which is known to offer viable protection against Omicron. Vaccine supplies are no longer an issue, hence, the government should shorten the gap between the first and second doses so that more Indians are fully vaccinated.

Booster dose for the vulnerable: The Centre urgently needs to consider booster doses for the elderly, the vulnerable, and front line workers. It would be a good idea if the states were given the freedom to take this decision.

Mix and match trials: With the West’s growing reliance on mRNA vaccines, which are unavailable in India, GoI must invest in local research on booster and mix-and-match trials.

Fast track approvals for foreign vaccines: A booster typically requires a different vaccine from the original two doses. Since the bulk of India has had the Covishield jab, the booster would have to be the indigenous Bharat Biotech-ICMR Covaxin. This is simply not being produced in large enough numbers to be available for boosters. Hence, fast-tracking approvals for foreign vaccines should be considered.

Further, as their safety is well established since they have been administered to large numbers of people across the world (including among the vast Indian diaspora), the foreign vaccine makers’ demand to waive indemnity must be considered.

Source: This post is based on the following articles:

– “Before the third wave” published in Business Standard on 23^rd Dec 2021.

– “WHO recommends boosters. India’s stand still not clear. And there’s little domestic research” published in TOI on 23^rd Dec 2021.