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Rajasthan on Sunday became the fifth state to register 2 lakh active cases and has been registering between 17,000-18,000 cases each day and over 150 deaths daily for a week.
State Health and Family Welfare Minister Raghu Sharma speaks with Shivnarayan Rajpurohit about the government’s plan to float global tenders to meet vaccine shortage and hire medical interns. He blames the Kumbh Mela and social gatherings for the second wave in the state, and explains the reasons behind the lockdown, which came into effect on Monday. Excerpts:
Between March last year, when Rajasthan reported its first Covid case, and today, how has the state’s health infrastructure been ramped up in terms of hospital beds and oxygen supply?
At that time, our testing facility was zero. Now, we have started it at 68 places in both government and private centres. Since the beginning, we have been doing only RT-PCR tests. Now, our testing capacity is over 1.40 lakh daily and around 90,000 samples are being tested. Secondly, we have set up oxygen generation plants.
Besides that, we have around 2,100 ventilators. These ventilators were enough. But now the situation is different. The first wave peaked at 3,200 Covid cases and nearly 30 deaths in a day. Rural areas and youth were spared. This time, the circumstances have changed; with around 18,300 cases and over 150 deaths being reported every day.
This has been fluctuating between 16,000 -18,000 cases and 100-150 deaths. In March this year, a total of 31 people died of Covid-19, compared to more than 1,000 in April. Youths are hit, so are rural areas. There are many factors (behind the second wave). One is Kumbh. Another is that people are not complying with Covid-appropriate behaviour, especially during social gatherings. We have 11,000 oxygen beds as of now and a centralised oxygen system has been set up. A lot of work has been done.
Amid the yet-to-peak second wave, experts predict a third wave. What is the short and long-term plan of the state?
We discuss in our daily Covid meetings about the immediate and long-term action… The most important thing is vaccination. We had made all preparations for vaccination. We set up 300 storage centres in the (state) capital and more storage centres at seven division centres. And 2,444 cold storage points were developed across the state.
We have so far received 1.41 crore doses… In the first two phases of the vaccination, the target group of frontline line workers and people above the age of 45 was 2.9 crore. Around 1 crore from this group have been given the first dose while the rest have received both shots. Even for this group, we need 1 crore more vaccines which are yet to be supplied by the Central government… And in the third phase (of the vaccination programme), the state has to bear the (financial) burden of (vaccinating) around 3.25 crore people between the age of 18-44. The expenditure (for procuring vaccines for the third group) is estimated at Rs 3,000 crore.
Since we are in a quandary, the Chief Minister (Ashok Gehlot) has decided to pay for vaccines (for the third phase). We now require 8 crore more doses, keeping 10 per cent wastage in mind. We have ordered 3.75 crore doses from the Serum Institute of India (SII) for the 18-44 age group. They first gave us 4 lakh doses on April 30, then another 4.55 lakh.
If we keep getting vaccines in this manner, I wonder how many years it will take to immunise this group. We augmented our vaccination capacity. The highest number of doses given in a day to people in the 45-plus age group was 5.81 lakh. We were prepared to increase it to 7 lakh daily. We have now only 1 lakh doses.
Whenever we raise the issue of vaccine shortage, media accuses us of politics. Who is doing politics? The point is we have not received vaccines. Even SII is not in a position to tell us by when it can honour our order. The vaccination has to be completed in a time-bound manner. According to experts, the Indian vaccines are effective against the double-mutant strain. What if there was a third mutant? Though experts are well-placed to comment on this, some believe the current vaccines may not protect us (against a triple-mutant), which may be 15 times more virulent.
Besides vaccination, could you specify the short and long-term strategy?
First, the oxygen demand in the state till today is 615 metric tonnes (MT), which is expected to increase by 900 MT. But the Central government is allocating only 270 MT. To bridge this gap, we have formed a team to immediately procure oxygen concentrators; either from the Central government or other countries. We are also planning to float global tenders for vaccines. If we increase the number of beds, where would we find oxygen? As far as remdesivir is concerned, its allocation is also controlled by the Centre. We contacted remdesivir manufacturers, but they are refusing to sell the drug at old rates.
We told these companies to supply at the revised rates. However, the Central government has limited the allocation. In the long-term, we want to set up as many oxygen plants as possible and funds have been approved for this. Within 1-2 months, the state will have enough oxygen plants… Moreover, we want to increase the bed capacity of around 200 community health centres with 50 beds or more to 100 beds so that patients in rural areas are benefitted… We are also focussing on manufacturing medicines such as remdesivir in the state after getting approval from the Drug Controller General of India.
Was the lockdown the last resort for the state government to break the Covid transmission chain?
A. For awareness, we had first announced a ‘Jan Anushasan Pakhwada’ (from April 19 to May 3) with some restrictions. Following this, we declared a ‘Red Alert’ with more curbs to ensure people followed Covid-appropriate behaviour. But these measures failed to contain cases. If the state sees a sudden spike in cases, we have neither adequate oxygen supply, nor is the Centre fulfilling our requirement (of oxygen and medicines). Considering all these things, we will see if lockdown can break the transmission chain. However, we keep reviewing our strategy daily. We are also increasing manpower by hiring final year students of MBBS, BSc (nursing) and ANM (Auxiliary Nursing Midwifery). We have today recruited 7,800 community health officers.
Reports from rural areas indicate inadequate testing and screening compared to the first wave…
No, we are doing it whole-heartedly. We have formed village-level committees for this.
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