#India #WrongCOVIDVaccinationStrategy

We as Indian public, media as well as the Govt lose the plot when we start talking about absolute numbers and vaccinating entire population, at least for now

1/n
For immediate reduction in hospitalisation and deaths (within 4-6 wks), we should ensure a rapid and wide coverage of COVID-19 vaccines in >45y population.

So
Ask data for coverage among these vulnerable pop.
Ask, is the current CoWin dependent strategy appropriate?

2/n
>45 are roughly one-fifth of the population. We should cover these using our public health vacc system thru decentralised approach (no need for CoWin). If vacc supply is the issue use sectoral approach. By spreading out thin we are not denting admissions and deaths.

3/n
We have covered such absolute numbers in past through public health vaccination campaigns without softwares and internet

<5 y- 12% of pop (pulse polio within 3 days)
9 mon-10y - 17% of pop (measles SIA campaign, used sectoral approach)

(PS:- approx %)
4/n
🤔
45-60 y- 13% pop
>60 y- 7%
>45 y- 20% (one fifth)

(PS: approx %)

If we had planned well, used public health vacc system (decentralised upto Anganwadi) without CoWin, we could have easily covered >60y with first dose by Mar itself.

Not too late to course correct

(n/n)

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More from @HShewade

4 Apr
Thread 🧵
India should urgently change its COVID-19 vaccination strategy - why and how?
@MoHFW_INDIA @NITIAayog

(1/25)
Change in strategy is not as simple as making vaccination open to all (vacc criteria).
Still after 35 days of phase II, the numbers suggest that the coverage among elderly is abysmal and this needs immediate correction

(2/25)
Opening the vaccination to all will spread thin the already available doses. And it will also be an implementation nightmare.
This sounds fine at individual level but impractical and not correct at population level.
Again context specific exceptions could be made

(3/25)
Read 26 tweets
12 Mar
@BWDDPH @BWDDPG @janisfrayer @pash
I watched the video with interest. I have been following the COVID-19 numbers and here is my take esp on the deaths.

To infer the extent of COVID-19 mortality in India using ‘reported’ COVID-19 deaths is not correct. Let me explain.
(1/n)
@BWDDPH @janisfrayer @pash In a scenario of very high seroprevalence (20%), very low covid case detection rate (3.6%), very poor coverage and quality of routine death surveillance (18% coverage), and low % of deaths in hospitals (34%), for me the reported covid deaths are waay lower
(2/n)
@BWDDPH @janisfrayer @pash Also, There is limited excess deaths data in public domain, there are no post mortem COVID-19 studies (testing all deaths post-mortem in a study area / period for COVID-19), we are not reconciling data from routine death surveillance (however good or bad it is)
(3/n)
Read 13 tweets
6 Nov 20
I will share death registration and medical certification of cause of death coverage in India-state by state. One tweet per day.
In the absence of reliable cause of death data, how can we effectively plan to reduce cause specific deaths? (1/n) #CRS #MCCD #RoutineDeathSurveillance
In India,
86% of estimated deaths are registered (CRS report 2018)
21.1% of registered deaths undergo cause of death certification (MCCD report 2018)

Therefore
18.1% (86%*21.1%) of all estimated deaths undergo registration along with cause of death certification
(2/n)
In Andhra Pradesh,
100% of estimated deaths are registered (CRS report 2018)
14.9% registered deaths undergo cause of death certification (MCCD report 2018)

Therefore
14.9% (100%*14.9%) of estimated deaths undergo registration along with cause of death certification
(3/n)
Read 36 tweets

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