Distributing Vaccine for COVID-19

(A Narrative of a high level meeting that was never held! All my imagination)


Since the outbreak of COVID-19 pandemic, several institutions in the world took up the challenge of developing effective vaccines. Many companies  have been in the race, conducting the required trials and following the procedures laid down by international bodies like the World Health Organization. In the last few weeks, there are indications that some of the vaccines will be successful and will deliver the vaccine with efficacy ranging between 70 to 95%.

India has already started working on the logistics of distribution of the vaccine and prepared a plan. A high-level meeting was held to discuss the plan and receive any suggestions as well as ensure that there was agreement and support of all concerned.

My Professor friend was invited to be present. As usual, he asked me to join and help him take the notes.  Taking notes was important as the virtual meeting was not going to recorded.

The meeting began with the first major issue – who should be receiving the vaccines as the first priority.

Director of AIIMS said that the first batch should be the medical staff consisting doctors, nurses and ward boys and those working at the COVID-19 test centres. All agreed.

President of All India Senior Citizens’ Confederation said that all senior citizens should be given the next priority. This suggestion was readily approved as most ministers and politicians in India are senior citizens.

One senior member of the Committee suggested priority States as Madhya Pradesh, Uttar Pradesh and Bihar. His suggestion created a big uproar as these States belonged to the ruling party.

A research professor from one of the IITs suggested an analytical approach, He worked out a State allocation formula that was based on COVID-19 cases reported by each State. Accordingly, States that had maximum reporting of COVID-19 positive cases will receive more vaccine doses from the total stock of 10 million that was expected to be immediately available.

This suggestion looked rational, but most States disagreed. The reason was that earlier the States had underreported the COVID-19 statistics to show how they had taken stern measures for testing and tracking the COVID-19 patients and had provided the necessary medical infrastructure for treatment.  The underreporting would now mean lower allocation of vaccine quota. So, there was a disgruntle to the research professors “rational” suggestion. Chief Minister of Uttar Pradesh suggested that the vaccine allocation should be population based.

The Election Commissioner built further on the suggestions. He proposed that we follow our voting system and distribute the vaccine to people through polling booths. He said that this is a tested and well-oiled system. He assured that  adequate security will be provided so that “rigging” of the booths does not happen. He hurriedly explained that by rigging he meant stealing of the vaccine shots.

He added that since the age-related statistics will be available, vaccine could be given through rounds such as first round to senior citizens and second round to children and the third round to youth and middle-aged people.  I whispered to the Professor that children don’t vote but Professor chided me saying that I  always find faults.

Member of the communist party pointed out that this classification is not acceptable as the priority should be given to those underprivileged and poor and last to the rich and wealthy senior citizens. This suggestion led to another uproar and heated discussions between those who “have” and those who don’t.

A member from a Socialist party suggested that we should provide vaccines on priority to the migrant works as they keep moving “in” and “out” of the metro cities. Many appreciated the idea, but implementation was considered rather challenging. Chairman of Indian Railways said that Railways can dedicate one compartment on the train, reserved just for vaccination. Others pointed out that Chairman is assuming that all those who travel on train today are migrant.

Railway Chairman added that we should give priority to the ticket checkers. He pointed out that Railways were suffering huge financial losses as ticket checkers were not checking tickets anymore due to risks of COVID-19 infection.

Taking this cue, Chairman of Air India suggested that providing vaccines to the air-line staff should be the priority, especially all the crew.

Chief of Prisons said that we should give priority to all the jail inmates in India’s hundreds of prisons that are woefully overcrowded. One of the celebrated lawyers argued that this strategy will incentivize people to commit crime and go to the prison for getting a vaccine. The crime rates in India will increase.

The Chairman of the Committee asked my Professor Friend for some novel ideas.

Professor suggested that we should give vaccines only to those who have paid income tax and provide without any charge. People who are tax compliant can walk with their families to the nearest vaccination booth on a priority with a print copy of their income tax returns.

No one liked this idea. But I understood that Professor was trying to use vaccination as a strategy to increase India’s tax net and payments. I saw that unfortunately Chairman CBDT was not present in the meeting.

Commissioner of Income Tax made Professor aware that less than 2% of India’s adult population pays income tax.

But Professor did not want to give up, so he turned to me and said “Dr Modak, would you like to chip in”

Well Professor, I said I only know a bit about the subject of environment.  I was hesitating to speak.

Go ahead Dr Modak, every stupid idea is important

I said I have a suggestion that is rather opposite to Professors thinking.

I suggest that we should offer vaccines to only to those who are currently non-compliant to any of the applicable laws of India e.g. those do not have consent to establish, operate from pollution control board or those who operating boilers without a valid license or those running businesses without environmental clearance as examples. Well, I am not limiting or restricting to environmental non-compliance here – but my idea is to cover types of non-compliances to all applicable laws e.g. shops and establishment act or  not holding valid drivers license etc.

“Aha” said the Professor. “Very clever Dr Modak”

“So, people who want vaccine on priority will have to reach the vaccination booth with a proof of non-compliance giving a declaration. This “confession” could be then used by the regulatory agencies to go after (like the Enforcement Directorate is doing today) and ensure compliance.

A new design of the vaccination booth

“Wow”, the Commissioner of Income Tax exclaimed.

“This idea is simply fabulous. Through distribution of COVID-19 vaccine, we will be able to make India fully compliant – a dream we have been longing to achieve!. However, I am worried a bit as this would mean a huge workload to the enforcement agencies. 98% of India’s adult population must be non-compliant – one way or other.”

Professor smiled and said

“No worries Commissioner, don’t you know that India ranks the highest when it comes to the level of corruption. So, while becoming compliant, all involved will get benefited”

I couldn’t disagree.

 


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2 comments

  1. I think after PM visit yday on vaccine survey, something of this type would happen, so it would be better if you and Prof. friend speak to PMO and get yourself included in this very daring exercise of the decade!

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