India's Covid-19 response must go beyond vaccines, follow global practices

Years after causing a pandemic, the Covid-19 virus still persists. The strains responsible for the recent surge in cases in Hong Kong, Singapore, and Thailand have been traced back to the JN.1 variant, first detected in August 2023. It is a highly transmissible descendant of the Omicron variant. The recent increase in the number of cases, 257 active cases according to the latest figures, has reignited public concern in India as well. While the number may seem negligible in a country of over 1.4 billion people, it should not be taken lightly and can have implications, especially for health workers and immunocompromised groups like the elderly and children. The government, according to reports, is monitoring the situation. 

The resurgence is a reminder that Covid-19 has become endemic. The current rise in infections may be attributed to various factors, including waning vaccine-induced immunity, a reduced uptake of booster shots, and diminishing herd immunity. Vaccination efforts in India have also slowed. The newer sub-variants underscore the virus’ ability to mutate and adapt, raising questions about the efficacy of the existing vaccines. The possibility of waning immunity also needs to be studied by the authorities. While the initial rounds of vaccination significantly reduced hospitalisation and fatalities, the protection they offer has likely diminished over time. This highlights the need to adapt the vaccination strategy in response to the virus’ evolution. 

Several advanced countries are offering annual Covid-19 booster doses, especially to vulnerable groups. India should consider this, prioritising the elderly, those with chronic conditions, and health care workers for regular vaccination with updated formulations that target prevailing variants. The science of mRNA enables relatively quick modifications, and the infrastructure for the vaccine rollout exists. CoWIN’s scalable architecture made it possible to vaccinate millions during the pandemic. Preparedness, however, should not just be confined to vaccines. It should also involve public awareness and behavioural shifts. Awareness campaigns must be held, not to create fear, but to reinforce simple but effective preventive practices. Wearing masks in crowded public places, regular hand hygiene, and avoiding poorly ventilated spaces can curb transmission. These nudges, backed by clear and consistent messaging, can make a significant difference, especially in urban areas with high population densities.   

On a positive note, recent global developments signal progress in pandemic preparedness. After three years of intense negotiations, a legally binding pandemic agreement was approved by member-states of the World Health Organization at the recently held meeting of the World Health Assembly. This agreement mandates equitable access to vaccines and critical supplies, and robust national-level preparedness plans. The Pathogen Access and Benefit Sharing System (PABS), dealing with pathogen and data sharing, remains on the negotiating table, though. For India, aligning with these global standards and actively participating in the international framework are essential. At this juncture, there is also a need to strengthen genomic surveillance to identify pathogens in circulation, improve vaccine coverage with updated doses, invest in the biopharma sector, and foster a culture of personal hygiene and regular health checkups.