By Dr Navin C Shah
India must speed up Covid-19 vaccination: The United States had its first Covid-19 case in January 2020 when a patient came from Wuhan in China tested positive. In March-April 2020, the US was badly affected by the coronavirus with a large number of people dying and many suffering the effects. The Donald Trump administration worked hard to make ventilators, medicine, beds, and Covid-19 vaccination available to the suffering millions. And additional hospitals were created in the stadiums. By December 2020, vaccination was available and in January, the US gave 1 million doses per day. The effort was stepped up to administer 2 million doses per day by March. In April-May, 3 million doses per day was administered.
The US saw 600,000 Covid-19 deaths of which 85% occurred among people with comorbidities and those are older than 65 years. Now we have fully vaccinated 80% of the population above 65 years, and 90% are partially vaccinated. In America, 36 million cases of Covid-19 were detected, while the country recorded 617,000 deaths. About 30% of the US adults are hesitant to take Covid-19 vaccination. Right now, we are getting the delta variant in 52% of our cases. We have fully vaccinated 50% of the population. And the death rate is extremely low.
We do not know much about the long-term effects of Covid-19. We have seen patients still struggling with fatigue, memory problems, cognitive problems, and dyspnea. And we do not know much about the vaccination, with blood clotting happening in a small number of cases. India with 1.4 billion population had 32 million infections and 405,000 deaths due to coronavirus disease. As of today, only 8.3% of Indians are fully vaccinated and 28.9% got at least one dose. In India, the most important thing is vaccination. Those who vaccinated have a better chance to survive the delta and other variants.
India needs more infectious disease specialists
The second point I wanted to talk is that in America, we have 8,500 infectious disease specialists. India has totally ignored this important specialisation while training doctors. These are the main people in Covid-19 treatment and prevention. We need the help of virologists and public health specialists, but the most important thing is the infectious disease specialist. That is how, the US has standardised Covid care. In America, we also have standard of hospital accreditation. Standardisation is possible because hospitals are accredited every three years, which is not the case in India. So, one has to be very careful in treatment.
In India, Covid is treated by various doctors, In America there is a standard of care which, of course, can change on a daily basis. But it is also monitored by infectious disease specialists. I would tell you our efforts to get infectious disease specialty in India since 2004. I told the government of India officials that it will be better to get infectious disease specialty at that time because HIV and transplantations demanded it. The death rate of septicemia is 50%. In 2006, I met the prime minister, health minister, health secretary, and medical council president. I led a delegation on infectious diseases in 2008.
The medical council passed a resolution that India should have specialists, but did nothing further. I followed up in 2015 and found that only three colleges in India — Vellore, Chandigarh and Pondicherry — trained specialists. My point in telling all these is that all the doctors may not be able to treat Covid-19 effectively. And you’re witnessing mucormycosis in India which is extremely rare in America. In India, 3000 people died among 9,000 mucormycosis patients. India also is witnessing over use of steroids and high prevalence of blood sugar. That also makes a difference.
Speed up Covid-19 vaccination
And lastly, I would like to tell you about 75,000 doctors in America are of Indian origin like me, while another 20,000 is first generation Americans. And we, the doctors of Indian origin, are ready to help India. Even 10% help means 10,000 doctors. That is one group India can tap onto for better treatment, better medical education, and joint research.
India requires 10 million Covid-19 vaccinations a day to cover its 1.4 billion people in four months. It is rather late, but it is never too late to start. Unvaccinated people are the carriers of new variants. In America, all deaths in June were of unvaccinated people. In England, a study showed that fatality of Covid-19 among children is very low. We must learn from these different experiences.
India has 1.4 billion people and needs to vaccinate very fast. The bottom line is that India needs to vaccinate 10 million people per day for four months. Otherwise, we will get more variants, as unvaccinated people will lead to more of them that are more contagious, more virulent, and more transmissible. In an interview with an Indian TV channel, I said if you have Rs 100 to fight Covid-19, Rs 60 should be spent on vaccination and Rs 40 on treatment. It will be helpful if India could follow the guidelines of the CDC of America that has gone through the worst of pandemic situation.
(Dr Navin C Shah is Medical Education Director of the Metropolitan Urologic Institute and a Past President of the American College of International Physicians. This article is a reproduction of his speech at a webinar organised by Policy Circle.)