Death toll rises at record pace as vaccine crisis hits India

Since India opened vaccinations to all adults this month, hoping to tame a disastrous coronavirus surge sweeping the country, the pace of administering the shots has dropped, with states saying they only have limited stock.

Cases meanwhile are still rising at record pace in the world's second-most populous nation. Alongside a slowdown in vaccination, states have gone to court over oxygen shortages as hospitals struggle to treat lines of Covid-19 patients.

India today reported 403,738 confirmed cases, including 4092 deaths. Overall, India has more than 22 million confirmed infections and has had 240,000 deaths. Experts say both figures are undercounts.

India's Supreme Court said yesterday it would set up a national task force consisting of top experts and doctors to conduct an "oxygen audit" to determine whether supplies from the federal government are reaching states.

Relatives stand near the funeral pyre of their loved one who died of Covid-19. Photo / AP

Complaints of oxygen shortages have dominated the top court recently, which stepped in earlier this week to make sure the federal government provided more medical oxygen to hospitals in the capital New Delhi.

The country's massive vaccination drive kicked off sluggishly in January when cases were low and exports of vaccines were high, with 64 million doses going overseas. But as infections started to rise in March and April, India's exports drastically slowed down, so doses went to its own population, reaching daily record highs. So far, around 10 per cent of India's population have received one shot, and just under 2.5 per cent have had both.

At its peak early last month, India was administering a record high of 3.5 million shots a day on average. But this number has consistently shrunk since, reaching an average of 1.3 million shots a day over the past week. Between April 6 and May 6, daily doses have dropped by 38 per cent, even as cases have tripled and deaths have jumped sixfold, according to Bhramar Mukherjee, a biostatistician at the University of Michigan who has been tracking India's epidemic.

One reason for the drop in shots is that there are just not enough available, experts say.

Currently, India's two vaccine makers produce an estimated 70 million doses each month of the two approved shots — AstraZeneca, made by the Serum Institute of India, and another by Bharat Biotech.

Vaccine supply has remained nearly the same throughout, but the target population eligible has increased threefold, said Chandrakant Lahariya, a health policy expert.

"In the beginning, India had far more assured supply available than the demand, but now the situation has reversed," he added.

Relatives perform the last rites at a cremation ground on the banks of the Ganges River for the cremation of a man who died of Covid-19. Photo / AP

In Kerala state, the drive to inoculate all adults is crawling along because "our single biggest problem is the very slow arrival of supplies", said the state's Covid-19 officer, Amar Fetle.

In New Delhi, many are waiting for hours outside vaccination centres - but only after they've been able to book a slot. For Gurmukh Singh, a marketing professional in the city, this has been impossible.

"It gets really frustrating, having so many hospitals and vaccine centres around but not being able to get access because they are all pre-booked," he said.

Experts also point to a new policy change by the government, which has upended how doses are being distributed. Previously, all of the stock was bought by the federal government and then administered to the population through both public and private health facilities. But from May 1, all available stock has been divided into two, with 50 per cent purchased by the government going to public health centres to inoculate those above 45.

The remaining half is being purchased by states and the private sector directly from manufacturers at set prices to give to adults below 45. This has led to lags as states and private hospitals, still adjusting to new rules, struggle to procure supplies on their own.

"You have now taken it out of a fairly efficient system where every dose was still centrally controlled," said Jacob John, a professor of community medicine at Christian Medical College, Vellore.

"But with market forces at play and unprepared states burdened with such a daunting task, the efficiency of the system has fallen."

The country's massive vaccination drive kicked off sluggishly in January when cases were low and exports of vaccines were high, with 64 million doses going overseas. Photo / AP

Things could change in the coming months as the government last month gave an advance to Serum Institute of India and Bharat Biotech, which could help boost manufacturing. And last week, India received its first batch of Sputnik V vaccines.

Russia has signed a deal with an Indian pharmaceutical company to distribute 125 million doses. But with vaccines in short supply, there are worries that those most in need are missing out.

The goal should be to prioritise preventing deaths, which means fully vaccinating the elderly and vulnerable first, said Dr Gagandeep Kang, a microbiologist at Christian Medical College in Vellore."You need to give it [earlier] to people who are more likely to die first," Kang said.