Coronavirus SARS-Cov2 (COVID-19)

[suresh]

Can hospitals not have open air vaccination camps in parking lots, sports fields etc? Would refrigeration be an issue? It is summer, so I get that operating out of tents may be a challenge, but ventilation is key when there is so much human traffic .

Good point. The UHC that I took my mother to had outdoor seating with a shamiana. But for vaccination, we had to go inside and that did not feel great. Things happened fast but social distancing was at a premium. My wife has me isolating even though it is three weeks since my second dose of covishield.

[jayakris]

Oh gosh... This is all such a mess. Going to get a vaccine shot and getting Covid from the hospital is just horrible.

[arjun2761]

Can hospitals not have open air vaccination camps in parking lots, sports fields etc? Would refrigeration be an issue? It is summer, so I get that operating out of tents may be a challenge, but ventilation is key when there is so much human traffic .

Good point. The UHC that I took my mother to had outdoor seating with a shamiana. But for vaccination, we had to go inside and that did not feel great. Things happened fast but social distancing was at a premium. My wife has me isolating even though it is three weeks since my second dose of covishield.

Hey Suresh, with the amount of running you do, you probably have the immune system of a 30 year old!!

That said, it makes sense to be careful after the Astra Zeneca or Indian vaccine as their efficiency is around 80% (and that is for the population as a whole). For older folks (and others with weakened immune systems), the immune response may only be sufficient for 60-70% of the people, so a significant percentage may not have sufficient immunity even after the vaccinations.

[jai_in_canada]

The UHC that I took my mother to had outdoor seating with a shamiana. But for vaccination, we had to go inside and that did not feel great. Things happened fast but social distancing was at a premium. My wife has me isolating even though it is three weeks since my second dose of covishield.

Actually outdoor waiting area would be an improvement.

Your wife is wise... or may be she is just using this to isolate you. You'll know if you're still in "isolation" a month from now. What did you do now?!

On a serious note, though, I have seen some discussions on social media on the topic of enhanced viral shedding post vaccination for a couple of weeks which poses a threat to unvaccinated people. Which means vaccinated people should isolate for 2 weeks. That's a long time. Like a quarantine. Not sure if that is for both shots. Not sure how credible those points are. Social media, after all.

[jayakris]

Biological E is starting it's phase III trail for it's vaccine and it is expecting to get the nod in August for it's candidate.
https://www.reuters.com/world/india/ind ... 021-05-07/

It says it will start with 75-80M doses a month from the launch. By July both SII and Bharat Biotech will have expanded their production capacity and we will be at somewhere 6M/day capacity during the month.

This seems to be BioE's own Indian vaccine. Do they have that kind of vaccine-making capacity? I thought the US government was pumping in some billions into BioE to produce the J&J vaccine. Can they do that AND male 75K-80K of the Indian vaccine every month? I suspect that they are downplaying the J&J vaccine, because it would cost more and India would want them to produce more of their Indian vaccine for a cheaper price? I wonder if some games are afoot. Anyway, good that they will also be adding vaccines. We just need everybody to ramp up production.

We must get a whole bunch of people vaccinated before the third wave hits. Chances are that the second wave will not go down to near-zero levels like the first wave anyway. My guess is that at least about 50K to 75K cases will be regularly there in India even when the 2nd wave dies, and then the third wave will start. Within the next 2-3 months we need to get as many people vaccinated as possible and stop the wave.

[Kumar]

Another person I knew got COVID positive with in few days of second shot! The strange part is that their vaccination site also had a testing center.

They were extremely careful and just perplexed where they got I from as well.

Two older other people with other health concerns got COVID vaccination (one dose), but another much younger member(no vaccinations) in the same household passed away from COVID. The folks with vaccinations did not even have symptoms.

This virus just keeps the brightest minds on back foot from day one

[Kumar]

On a serious note, though, I have seen some discussions on social media on the topic of enhanced viral shedding post vaccination for a couple of weeks which poses a threat to unvaccinated people. Which means vaccinated people should isolate for 2 weeks. That's a long time. Like a quarantine. Not sure if that is for both shots. Not sure how credible those points are. Social media, after all.

Jai, well the school in Miami is probably reading the same social media post ! They barred teachers from getting vaccinations as it is being considered a threat to students. In fact a teacher warned kids to not come in close contact with parents who have been vaccinated.

My guess is that at least about 50K to 75K cases will be regularly there in India even when the 2nd wave dies, and then the third wave will star

The question is will be plateau at 50-75k without lockdown or full lockdown?

[suresh]

Your wife is wise... or may be she is just using this to isolate you. You'll know if you're still in "isolation" a month from now. What did you do now?!

[jai_in_canada]

Jai, well the school in Miami is probably reading the same social media post ! They barred teachers from getting vaccinations as it is being considered a threat to students. In fact a teacher warned kids to not come in close contact with parents who have been vaccinated.

Yes, and it's a Red state.

Nevertheless, these post-vaccination infections do raise a few questions.
1. What is the true efficacy of the vaccine in the real world?
2. How effective are current vaccines against new variants?
3. Is a vaccinated person more vulnerable to infection from the wild virus in the few days just after vaccination because their immune system is already overloaded “fighting” the vaccine?
4. What are the rates of infection 1-5 days, 6-10 days, 11-15 days, >15 days after the shot?
5. What are the infection rates after the first shot and second shot?
6. How much did the person adhere to pandemic safety protocols like masking, physical distancing, avoiding non-essential travel etc. or did they let their guard down soon after getting the shot?
7. Where could they have acquired the infection?
8. What further precautions can vaccination centres take to reduce the risk of being super spreaders themselves? Outdoor, better air circulation indoor, more spread out appointments…
9. Are vaccinated people a risk to unvaccinated people due to viral shedding?

Answers to all these questions are still very much TBD, and will take time TBD. Until we know the answers to these questions I think it is prudent to be cautious.

[suresh]

Are vaccinated people a risk to unvaccinated people due to viral shedding?

I believe that the answer to this is NO. No live virus is used in any vaccine.

[sameerph]

Can hospitals not have open air vaccination camps in parking lots, sports fields etc? Would refrigeration be an issue? It is summer, so I get that operating out of tents may be a challenge, but ventilation is key when there is so much human traffic .

The 2 hospitals which I went to for my 2 doses of Vaccinations of Covaxin in Mumbai had arranged it outside the hospital in an open space within the complex of the hospitals. In the first hospital, they had fairly big area within their complex and decent social distancing. Not so much in the second hospital but still ok and it was again in open space.

[jai_in_canada]

Are vaccinated people a risk to unvaccinated people due to viral shedding?

I believe that the answer to this is NO. No live virus is used in any vaccine.

It's not from the vaccine. We are all carrying the virus. Just that the viral load is not enough to cause infection in ourselves and hopefully in others. The theory is that when a person gets the shot they shed the virus that they do have. And that increased shedding makes them more infectious to others who don't have the immunity to tolerate the increased viral load. Again, it's a theory that I have seen bandied about without any credible studies to back it up. Still a question to ask, I thought.

[jai_in_canada]

Can hospitals not have open air vaccination camps in parking lots, sports fields etc? Would refrigeration be an issue? It is summer, so I get that operating out of tents may be a challenge, but ventilation is key when there is so much human traffic .

The 2 hospitals which I went to for my 2 doses of Vaccinations of Covaxin in Mumbai had arranged it outside the hospital in an open space within the complex of the hospitals. In the first hospital, they had fairly big area within their complex and decent social distancing. Not so much in the second hospital but still ok and it was again in open space.

That's great. Hope more vaccination centres know to do it and are able to do it.

[depleter]

Finally this happened! But it took 14 months into the pandemic, 2 months into the massive second wave, and it was done by the Supreme Court ... NOT by Mr. Narendra (Atma Nirbhar) Modi. Bewildering lack of visible leadership, regular direct communication to the nation, and tangible plan from the country's PM while the country is gripped by an unprecedented national emergency. So the Judicial Branch of Government had to step in. Un-freaking-believable.

Covid-19: Supreme Court Sets Up 12-Member National Task Force for Oxygen Distribution to States
https://www.msn.com/en-in/news/other/co ... r-BB1gv6lG

Supreme court should stay the hell out of executive matters. I am serious. Who the hell are justices Chandrachud and Shah to get into this matter, and make such decisions after a few hours (if even that) of education on the topic by lawyers?

Actually the thing is it's not as straight forward as that. It's actually the central government through Solicitor General who has actually recommended this task force. The reason is actually very simple, because some states, especially the Khichdiwal govt completely made it political. And some high courts with their judicial overreach are actually supporting this ridiculous demands of these states. And as the time goes on more and more govts are asking for more and more oxygen and it's unclear whether they actually need it or purely political calls. Lets take Delhi for example. Their latest demand as said by the Delhi Govt is 976 MT of oxygen. For perspective, it's basically almost 1/10th of our total production capacity and more than 12% of the oxygen allocated by the center to the states. And it's not as if though the central govt can allocate all the production capacity of oxygen to the states as it would need to allocate some part of the oxygen capacity to the pharma industries too. For comparison Karnataka with 6 times the active cases compared to Delhi has an actual allotment of some 800+MT which the Karnataka high court has ordered the central govt to increase it to 1200MT, though Karnataka govt is right now asking the central govt to increase it to 1792MT. But still even if we take 1792MT as the parameter, it's not even double the amount of oxygen Delhi govt is asking. Now take Maharashtra, it actually receives 1784MT daily and is currently requesting the center to increase the allocation by 200MT more. But if we take the active cases as a comparison, Maharashtra actually has 7 times the active cases
when compared to Delhi. Or rather lets compare Mumbai and Delhi, When Mumbai had 85K active cases, it's oxygen demand was 245MT, while today Delhi with 87K active cases is demanding 976MT of oxygen.

Or rather take the current numbers. Currently Delhi is receiving 700+MT which too is actually forced by the Delhi HC and Supreme Court and the center actually believes that Delhi does not need so much and the oxygen shortage calls from the hospitals is actually due to inefficiency of the Delhi government. And if you actually follow last 20 days of proceedings in the Delhi high Court you will actually see that the Delhi govt practically did nothing. Like nothing at all. For example when the center allocated oxygen to the states, all other states booked tankers and sent the tankers to allocated places from which they will get oxygen. Even the non industrialized states and small UT's too booked tankers except Delhi. So, after few days when the topic came up in HC, Delhi govt said they did get the oxygen they were allotted. And when the supplier is contacted, they said we are ready with the oxygen but no one came to take it. The Delhi Govt argued that they thought center will give it to them, while the center pointed out what every other state and UT is doing. Around the same time Kejriwal came on twitter and requested railways to provide oxygen express to them "on twitter". After two days when the railways is contacted about it, they said they are also waiting for the delhi govt to contact them but they didn't. Remember during these two incidents various hospitals were already giving SOS calls on twitter how they lack oxygen. Simply no micromanagement took place even when we are well into the crisis. They didn't even know how much oxygen which hospital is getting in the starting. All they did was take SOS calls and divert oxygen from one hospital to another. After one week into the crisis, Delhi HC got to know that some hospitals were receiving 10 days of supply were some hospitals are struggling with oxygen scarcity. It's because the suppliers were just told to supply to hospitals just like before where the suppliers are generally in contract with hospitals. It was then that the HC told the govt to micromanage the oxygen and govt tried to do it afterwards. But they were not successful in it even until a week back. A week back the HC told all the suppliers, hospitals and govt to sit down together and decide about it. All this can be summed up in one statement from the INOX air, a big supplier around India "Why would not I supply to Delhi, it's my business. Why wouldn't I want to do business? I have been supplying to almost every state in India and I have never received any complaint from them. And here in Delhi I don't even know who to supply." It's not just that, the amount of hoarding and black market is huge in Delhi. Just yesterday or the day before it's released that AAP MLA Imran Hussain has hoarded 630 oxygen cylinders. Atleast 10's of people might have been saved with them.

Well now back to Supreme Court committee, the thing is that the center has even argued that the extra allocation the high courts are giving to each state is actually taken from other states and will create deficit in other states. But no court listens to it. So, basically here the center suggested the SC to create the committee and here the committee will decide how much oxygen is required. So, now the states and the HC's are forced to stick to committee's recommendation. And there was another important suggestion from the center to SC yesterday which the SC accepted was audit of oxygen. So, basically we will know where every MT of oxygen given to states went. The example they gave is after audit of oxygen in Pune, they saved 30MT of oxygen. Interestingly, Delhi govt has opposed the audit of oxygen in the Supreme Court saying that it will waste time of the officials.

[depleter]

Biological E is starting it's phase III trail for it's vaccine and it is expecting to get the nod in August for it's candidate.
https://www.reuters.com/world/india/ind ... 021-05-07/

It says it will start with 75-80M doses a month from the launch. By July both SII and Bharat Biotech will have expanded their production capacity and we will be at somewhere 6M/day capacity during the month.

This seems to be BioE's own Indian vaccine. Do they have that kind of vaccine-making capacity? I thought the US government was pumping in some billions into BioE to produce the J&J vaccine. Can they do that AND male 75K-80K of the Indian vaccine every month? I suspect that they are downplaying the J&J vaccine, because it would cost more and India would want them to produce more of their Indian vaccine for a cheaper price? I wonder if some games are afoot. Anyway, good that they will also be adding vaccines. We just need everybody to ramp up production.

We must get a whole bunch of people vaccinated before the third wave hits. Chances are that the second wave will not go down to near-zero levels like the first wave anyway. My guess is that at least about 50K to 75K cases will be regularly there in India even when the 2nd wave dies, and then the third wave will start. Within the next 2-3 months we need to get as many people vaccinated as possible and stop the wave.

They actually announced in Feb itself that they will produce 600M of J&J and 1billion doses of it's own vaccine annually. And it's not as if though increasing manufacturing capacity of every vaccine is hard. I read that mRNA vaccines production capacity can be easily increased while it's hard to increase vaccines like Covaxin's production capacity because it requires BSL-3(bio safety level 3) production bases. For example in April the central govt has allowed Haffkine institute a Maharashtra PSU to manufacture covaxin, but it asked 1 year to start manufacturing. Though the Central govt asked it to do it in 6 months. Now Bharat Biotech was given some land in odissha lately from which it will manufacture covaxin. But it can start production from it only after a year.