21 July 2021, NIICE Commentary 7114
Radha & Dr. Shantesh Kumar Singh
The COVID-19 crisis has impacted India and South Africa, like the rest of the world. Despite the fact that their populations are vastly different, both countries announced a lockdown on the 24th and 26th of March 2020, respectively, to deal with the first wave of COVID-19. India has had seven times more cases than South Africa since the lockdown. South Africa undertook extensive testing prior to and during the shutdown, allowing the government to minimize infections and casualties better than India.
The key difference between the two countries has been the testing strategy. Testing in India began on April 9th, with those who have symptoms of infection but no travel history. And it began only 70 days after the first COVID-19 case was confirmed, and 15 days after the national lockdown started. South Africa took the exact opposite approach, increasing testing and aggressively pursuing the entire population. Since the first instance of infection was verified on March 5, 2020, over 47,000 people have been tested positive. South Africa’s testing frequency is estimated to be 1,934 tests per million persons in April 2020. In contrast, throughout the past 80 days, India has carried out 291 tests per million, in the country.
While President Cyril Ramaphosa declared a national emergency on March 15, enforcing travel restrictions, the lockdown began on March 26. On the 18th of March, 13 days after the first occurrence, schools were closed. On day 33, the government dispatched 28,000 community health workers to inspect every home for signs of infection and form a rapid task force to monitor quarantine facilities and compliance. To keep track of household and personal infection data, a mobile phone application was created. Identifying infection hotspots and giving medical care as soon as possible, while also constructing field hospitals.
These early steps helped to limit the doubling of Coronavirus cases and break the chain, delaying the peak of COVID-19 cases from April to July 2020. In the meantime, hospitals had been equipped with more beds, oxygen, and other medical equipment in order to handle an influx of patients. The police strictly implemented and enforced the lockdown guidelines. However, just like in India, the police in South Africa have been criticized for using excessive force.
Until February 2021, India, on the other hand, was considered as a success story. The number of infections was decreasing, and everyone assumed that life had returned to normal. Experts expected that the Coronavirus would not thrive in the warm environment of South Asian countries, and that the comparatively young population would have better immunity. However, a devastating second wave of COVID-19 caused by new muted variants of the Coronavirus and people’s careless attitude, pushing the Indian healthcare system to the brink of collapse. On May 7, 2021, India had the highest single-day COVID-19 case count of any country throughout the pandemic, with over 414,000 new confirmed cases and over 3900 new deaths. India has now been designated as the epicenter of the COVID-19 epidemic.
This escalated the level of alert in South Africa. “What is happening in India must not happen here,” Dr. Matshidiso Moeti (World Health Organization’s Regional Director for Africa) said in a virtual press conference in May 2021. “If we prepare now, we will not pay the price later.” South Africa, which has a population comparable to India, has reported more than 4.6 million confirmed infections and more than 1,24,000 reported deaths due to COVID-19. According to data compiled by John Hopkins University and the African Center for Disease Control and Prevention, the above figures indicate less than 3 percent of global instances of infection and less than 4 percent of COVID-19-related deaths worldwide.
According to data collected by Our World, South Africa reached its peak in January 2021, reporting more instances per million people than India reported in May. However, while the Indian healthcare system has partially failed in terms of per capita infection and death rates, the South African healthcare system has remained stable.
On May 26, 2020, the Indian Ministry of Electronics and Information Technology launched the ‘Aroygya Setu’ mobile phone application, which was hailed by the World Bank as a technology-based initiative to tackle COVID-19. This application helped in contact tracing and the containment of the virus’s spread across the country. It keeps track of people and their belongings, as well as confirming cases in the vicinity of a person or a residence, so that precautions can be taken and medical care could be given to sick people.
India was severely affected during the second wave of COVID-19. During its first wave, India sent medical aids like masks, PPE kit, gloves and other emergencies medical equipment to other countries, but during its second wave, the great need of medicines, oxygen and hospital beds were felt. Therefore, India had to appeal for medical aid from international institutions and other countries. On 11 April, the Indian government announced it would ban the export of Remdesivir, citing a growing domestic demand for the drug and imported medicines and oxygens from other countries. Prime Minister Narendra Modi addressed the country time and again, urging people to get vaccinated and practice caution. Up till now DRDO, the Defence Research and Development Organisation of India, has planted more than 500 oxygen generation plants across major health institutions, funded by the PM Cares fund.
India has already started the vaccination drive in January 2021. There are five vaccines that has been approved for use in India; Covaxin (Bharat Biotech), Covishield (Serum Institute of India), Sputnik V (Gamaleya, Russia), mRNA-1273 (Moderna), AZD1222 (Oxford/ Astra Zeneca) and 13 more vaccines are in the clinical trial. The vaccination for children above 12 years will be ready by the end of September 2021. India has made a record of the highest vaccination number over 85 lakhs in a single day on 21 June. But until now less than 5 percent population with the first dose and only 2 percent of population with two doses, has been vaccinated which is far below achieving herd immunity. To achieve herd immunity in India, 70 to 80 percent population has to be vaccinated which means about 2 million doses. Mass vaccination should be the highest priority of the government so that the infection could be tackled. The precautionary measures need to be followed by people as the third wave of COVID-19 is on the chart as warned by health experts.
Meanwhile, South Africa is lagging behind in vaccinating its population since it is mostly dependent on the ‘COVAX’, the global vaccine sharing alliance, and its major supplier is the Serum Institute of India. It is the largest vaccine manufacturer in the world, which manufactures the Oxford/ AstraZeneca vaccine. In March 2021, it paused vaccine export when the peak of COVID-19’s second wave has experienced in India. Therefore, the President of South Africa appealed to the rich countries to share excess vaccine doses with the needy countries. Early in January 2021, health experts and academia raised concern over the absence of vaccine strategy in South Africa and there would be winter wave of COVID-19. First, package of Vaccine of AstraZeneca by COVX reached in February but health ministry discarded one million AstraZeneca vaccine doses in April citing the reason that these were not effective for the Beta variants infection of Coronavirus. Thought many experts advised that South Africa should accept all available vaccines. South Africa must learn from its misstep in vaccine strategy and should emphasis this issue aggressively.
New variants of the Coronavirus have been muted and continued to survive. New cases of infections of Delta plus, Kappa, Lamda and other variants are identified across the world. India shows a gradual lower rate of infection, but some states still have a 10 percent infection rate and new cases are being reported. A strong leadership, more health preparedness and investment and cooperation of people across the country is the need of time, to cope up with the pandemic. We need to understand the difference between a careless and carefree attitude – we need to be carefree while taking all precautionary measures like washing hands time and again, using sanitizers, wearing masks, maintaining social distancing, taking vaccine doses, we should not be careless anymore.
It is the time for the countries around the world to cooperate on the health issues. The greater responsibility lies on the leading powers and international institutions. It is necessary to assure that every country, community, and individual have access to the vaccine. The WHO, GAVI and CEPI have launched a noble initiative ‘COVAX’ for universal access to the vaccine, with a very relevant slogan of the time, “No one is safe until everyone is safe”.
