Thread by @sritara

THREAD on the spectacular single-day spike on June 21 - a whopping 8.87 million doses administered in India.
1. The questions to ask are: How may this have happened? Is this sustainable over a longer time frame?

2. First, the context. Vaccine doses delivered yesterday was 42 % higher than the previous highest single-day number registered on March 16 (6.25 m doses). Indeed, apart from the March instance, dose delivery crossed 5 m/day only once - on April 7. So, this is indeed a big deal.

3. In the first 20 days of June an average of 3.16 m doses were delivered. Monday’s spike was 181 % higher than this avg. Let us look at the numbers a little more closely. In the last month or so Covshield had been accounting for about 88% of all deliveries. Y’day it was 92.35 %!

4. Covaxin remains a laggard. 0.67 m doses of Covaxin were delivered y’day, but was only 0.17 m higher than the avg daily doses delivered in the first 20 days of June. In contrast 8.19m Covishield doses were delivered - surge of >3 times the avg in first 20 days of June.

5. Spectacular as y’day’s surge is, the data reveals some some worrying patterns. 1st, there seems to be an extreme skew in terms of regional distribution of vaccines, with possibly a political emphasis.Two BJP-ruled states - MP and Karnataka account for almost 1/3 of the spike.

6. Add two other states ruled by BJP and/or its so-called allies — Gujarat, Bihar and Haryana — and half of all the vaccines delivered y’day India went to these “special category” states! Add UP and the share of just these 6 states soars to >58 %.

7. Is the spike sustainable? How might it have happened? Whether it is sustainable is primarily a function of how many vaccines are produced by the two producers - SII and BBIL. The GoI has told the SC stated that SII’s capacity could reach 70-100 m doses/month in July.

8. Even assuming the upper bound of production capacities at SII, it can produce a maximum of 3.33 m doses/day. This means that SII has to produce at the rate of 8.163 m doses per day EVERY DAY to maintain the overall strike rate at 8.873 m doses per day over a longer time frame.

9. Clearly that asking rate is too much for even the biggest vaccine maker in the world. This is because SII has to produce consistently at a rate that is about two an a half times the upper bound of its stated capacity that has always been shrouded in mystery.

10. The Covaxin story is too well known to need retelling.Its production numbers are suspect. Now,for my take on the question of how the spike may have happened.Since a dramatic scaling up of capacity is very unlikely, a buildup of stocks, particularly Covishield, may explain it.

11. In the 1st 20 days of June avg Covishield shots delivered were only 2.66 m doses/day. The spike resulted in a one-day increase of about 5.5 m doses of Covishield y’day.Over a 20-day period an average of about 0.27 m doses/day could have been accumulated as inventory.

12. This is perfectly feasible for two reasons: 1) the utter non-transparency of output and distribution data and 2) There is simply no other way this kind of an increase could have resulted from a spike in output, for reasons cited earlier.

13. One +ve result of y’day’s spike is the demonstration of Indian state-led capability and capacity too significantly expand vaccination. This arises from the achievements in vaccination a large population over many years. It also reaffirms the need for NaMo to do a U-turn.

14. Now for a thought experiment: How long will it take India to vaccinate everybody in the 18+ age group, even if the strike rate is maintained at the rate achieved y’day? We have delivered about 284 m doses for a target population that requires 1878 m doses.

15. Even at this rate it’d take exactly 180 days.Assuming an average daily capacity of about 3.5 m doses per day, vaccinating all those above 18 would take 511 days.Running at the June avg (2.92 m doses/day) would take us 643 days (more than 20 months) to reach the target.

16. Two conclusions: 1) The arbitrary and norm-less regional concentration of the spike in vaccine deliveries is an affront to epidemiology and what science demands as a response to the pandemic, in the midst of fear about an impending Third Wave.

17. 2) The poor visibility of vaccine supplies, driven by an unwillingness by the NaMo govt to clearly articulate constraints, coupled with the truant ways of the two leading vaccine suppliers, continues to dominate the Indian response to the pandemic. (END)

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