After gifting and selling tens of millions of COVID-19 vaccine doses abroad, India suddenly finds itself short of shots as new infections surge in the world’s second-most populous country.
India breached 200,000 daily infections for the first time on Thursday, and is trying to inoculate more of its population using domestically produced shots.
Facing soaring cases and overflowing hospitals after lockdown restrictions were eased, it also abruptly changed the rules to allow it to fast-track vaccine imports, having earlier rebuffed foreign drugmakers like Pfizer (PFE.N).
It will import Russia’s Sputnik V vaccine starting this month to cover as many as 125 million people.
The reversal in fortunes could hamper not only India’s battle to contain the pandemic, but also vaccination campaigns in more than 60 poorer countries, mainly in Africa, for months.
The COVAX programme, backed by the World Health Organization and Gavi vaccine alliance, aims at equitable vaccine access around the world, and is relying heavily on supplies from India, Asia’s pharmaceutical powerhouse.
But so far this month India has only exported around 1.2 million vaccine doses. That compares with 64 million doses shipped abroad between late January and March, according to data from the foreign ministry.
An official with knowledge of India’s vaccine strategy said that available shots would be used domestically while the country faced an “emergency situation”.
“There is no commitment to other countries,” he said.
India’s foreign ministry, which oversees vaccine deals with other countries, said last week that Indian demand would dictate the level of exports.
Resulting shortages are already being felt in some countries in the COVAX scheme, and a U.N. health official involved in the vaccine rollout in Africa said: “To be so reliant on one manufacturer is a massive concern.”
The director of the Africa Centers for Disease Control and Prevention, John Nkengasong, said earlier this month delays in supplies from India could be “catastrophic”.
Four sources involved in discussions on vaccine supplies and procurement said factors including delays by India and COVAX in placing firm orders, a lack of investment in production, raw material shortages and underestimating the coronavirus surge at home had contributed to vaccine shortages.
The Serum Institute of India (SII), the world’s biggest vaccine manufacturer, had vowed to deliver at least 2 billion COVID-19 shots to low and middle-income countries, with nearly half of that by the end of 2021.
But it has also come under pressure to meet the needs of other governments, including Britain, Canada and Saudi Arabia, amid AstraZeneca’s global production problems.
The United States, meanwhile, ring-fenced the supply of key equipment and raw materials for its own vaccine makers, limiting SII’s operations and delaying by months its goal of raising monthly output to 100 million from up to 70 million now, said one of the sources.
A further initial hurdle to SII’s supply ambitions was India’s hesitation in placing firm orders, two sources said.
That could have allowed it to boost output of the AstraZeneca vaccine early, even though regulators had yet to approve it.
India spent months discussing the final price per dose, and inked an initial purchase order roughly two weeks after India’s drug regulator approved the AstraZeneca shot, according to the sources.
At one point, SII ran out of space to store produced doses.
“That is why I chose not to pack more than 50 million doses, because I knew if I packed more than that, I would have to store it in my house,” SII Chief Executive Adar Poonawalla told Reuters in January.
He said he had spent 20 billion rupees ($272 million) on the 50 million doses that the company started stockpiling since around October.
Even now, the government only makes ad-hoc purchases from SII instead of agreeing a longer-term supply schedule, said one of the sources.
SII has sought more than $400 million from the government to increase capacity, but no commitment has yet been made.
The health department and foreign ministry did not respond to requests for comment on issues of funding, purchasing delays and other aspects of India’s vaccination rollout.
COVAX also did not green-light shipments to participating countries from SII until after the shot received WHO clearance in mid-February, said a source involved in the COVAX initiative.
The source said those delays meant tens of millions of additional doses that the SII could have produced between October and February never materialised.
Gavi defended its decision to wait for proper approvals before going ahead with firm orders. And while it is looking for more suppliers, it conceded that much still depended on India’s vaccine makers who account for some 60% of global supplies.
COVAX has a deal to buy 1 billion-plus doses from the SII. But it has received less than a fifth of the 100 million or so doses of the SII-made AstraZeneca vaccine it had expected by May. SII is also supposed to make millions of doses of the Novavax (NVAX.O) shot for COVAX.
Gavi had hoped SII would fully resume vaccine deliveries to COVAX in May, but on Wednesday it said India’s COVID-19 crisis could affect that.
“We understand the ferocity of the virus in India at the current time, nevertheless we hope and expect deliveries to resume as soon as possible,” it said in an email to Reuters.
On Thursday India reported 200,739 infections over the past 24 hours, a seventh daily record in the last eight days, while 1,038 deaths took its toll to 173,123. Its tally of 14.1 million infections is second only to the United States.
Having originally aimed to cover 300 million of its highest-risk people by August, or just over a fifth of its 1.35 billion population, the government has now expanded that by another 100 million, with the promise to widen it further.
Pfizer, Moderna vaccines effective against Indian variants: study
The Pfizer and Moderna COVID-19 vaccines should remain highly effective against two coronavirus variants first identified in India, according to new research carried out by US scientists.
The lab-based study was carried out by the NYU Grossman School of Medicine and NYU Langone Center and is considered preliminary because it has not yet been published in a peer-reviewed journal.
“What we found is that the vaccine’s antibodies are a little bit weaker against the variants, but not enough that we think it would have much of an effect on the protective ability of the vaccines,” senior author Nathaniel “Ned” Landau told AFP on Monday.
The researchers first took blood from people who were vaccinated with either of the two shots, which are predominant in the United States and have been given to more than 150 million Americans.
They then exposed these samples in a lab to engineered pseudovirus particles that contained mutations in the “spike” region of the coronavirus, which were particular to either the B.1.617 or B.1.618 variants, first found in India.
Finally, that mixture was exposed to lab-grown cells, to see how many would become infected.
The engineered pseudovirus particles contained an enzyme called luciferase, which fireflies use to light up. Adding it to the pseudovirus makes it possible to tell how many cells are infected, based on light measurements.
Overall, for B.1.617 they found an almost four-fold reduction in the amount of neutralizing antibodies — Y-shaped proteins the immune system creates to stop pathogens from invading cells. For B.1.618, the reduction was around three-fold.
“In other words, some of the antibodies now don’t work anymore against the variants, but you still have a lot of antibodies that do work against the variants,” said Landau.
“There’s enough that do work that we believe that the vaccines will be highly protective,” he added, because the overall levels remain well above those found in samples taken from people who recovered from infection with earlier unmutated virus.
But this kind of lab investigation cannot predict what the real world efficacy might look like — that will have to be investigated through other studies.
The coronavirus is known to latch on to a particular receptor on human cells called ACE2, which it uses to force its entry.
Landau’s team showed the Indian variants were able to bind more tightly to this receptor, like other variants of concern. This might be linked to its increased transmissibility compared to the original strain.
“Our results lend confidence that current vaccines will provide protection against variants identified to date,” the team concluded.
However, they do not preclude the possibility that newer variants that are more resistant to vaccines will emerge — highlighting the importance of widespread vaccination at the global level.
Japan’s economy slumps back into decline as COVID-19 hits spending
Japan’s economy shrank more than expected in the first quarter as a slow vaccine rollout and new COVID-19 infections hit spending on items such as dining out and clothes, raising concerns the country will lag others emerging from the pandemic.
Capital expenditure also fell unexpectedly and export growth slowed sharply, a sign the world’s third-largest economy is struggling for drivers to pull it out of the doldrums.
The dismal reading and extended state of emergency curbs have heightened the risk Japan may shrink again in the current quarter and slide back to recession, defined as two straight quarters of recession, some analysts say.
“Global chip shortages caused a marked slowdown in exports, putting a drag on capital spending as well,” said Yoshimasa Maruyama, chief market economist at SMBC Nikko Securities.
“Consumption will probably remain stagnant, raising risks of an economic contraction in the current quarter.”
The economy shrank an annualised 5.1% in the first quarter, more than the forecast 4.6% contraction and following an 11.6% jump in the previous quarter, government data showed on Tuesday.
The decline was mainly due to a 1.4% drop in private consumption as state of emergency curbs to combat the pandemic hit spending for clothing and dining out.
But the bigger-than-expected contraction also reflected a surprise 1.4% drop in capital expenditure, which confounded market expectations for a 1.1% increase as companies scaled back spending on equipment for machinery and cars.
While exports grew 2.3% thanks to a rebound in global demand for cars and electronics, the pace of increase slowed sharply from the previous quarter’s 11.7% gain, a worrying sign for an economy still reeling from weak domestic demand.
Domestic demand knocked 1.1% point off gross domestic product (GDP), while net exports shaved off 0.2 point, the data showed.
“That domestic demand is weak shows the adverse effects from the coronavirus haven’t been shaken off at all,” said Takeshi Minami, chief economist at Norinchukin Research Institute.
Despite massive monetary and fiscal stimulus, Japan’s economy slumped a record 4.6% in the fiscal year that ended in March, the data showed.
“There will undoubtedly be fiscal money poured on this problem to soften the blow, though after so much already, it is difficult to see this having more than a fairly marginal effect,” analysts at ING wrote in a research note, adding they expect the economy to shrink again in the current quarter.
“And the Bank of Japan seems to be out of fresh policy stimulus ideas currently, so we don’t anticipate anything new from them apart from extending existing measures.”
Economy Minister Yasutoshi Nishimura blamed the weak GDP reading mainly on the curbs to combat the pandemic, adding the economy still had “potential” to recover.
“It’s true service spending will likely remain under pressure in April-June. But exports and output will benefit from a recovery in overseas growth,” he told reporters.
Japan’s economy expanded for two straight quarters after its worst postwar slump in April-June last year due to the initial hit from the pandemic.
The export-driven recovery came to a standstill as consumption took a hit from a spike in new virus strains that forced the government to re-impose curbs just 10 weeks before the Tokyo Olympic Games.
Monster cyclone makes landfall in COVID-stricken India
A deadly cyclone blasted ashore in western India late Monday with fierce winds and drenching rains that turned streets into rivers, disrupting the country’s response to its devastating COVID-19 outbreak.
Cyclone Tauktae, which local press reports called the biggest to hit the area in 30 years, has unleashed heavy weather since the weekend that killed at least 20 people in its approach to land.
It made landfall in Gujarat state just after 8:30 pm local time (1500 GMT) as an Extremely Severe Cyclonic Storm packing winds of 155-165 kilometres (95-100 miles) per hour, gusting up to 185 kph, the Indian Meteorological Department said.
One woman died after high winds knocked over an electricity poll in the city of Patan in northern Gujarat, officials said.
Sea levels swelled as high as three metres (10 feet) along the coast, said local weather officials in the coastal town of Diu, which reported wind speeds of 133 kph.
The colossal swirling system visible from space has exacerbated India’s embattled response to a coronavirus surge that is killing at least 4,000 people daily and pushing hospitals to their breaking point.
In waterlogged and windswept Mumbai, where authorities on Monday closed the airport and urged people to stay indoors, authorities shifted 580 COVID-19 patients “to safer locations” from three field hospitals.
Six people died and nine were injured as the storm lashed Maharashtra state, of which Mumbai is the capital, the chief minister’s office said.
|Heavy rains and strong winds lash Mumbai as a major cyclone packing ferocious winds and threatening a destructive storm surge bore down on India. Photo: AFP|
Two navy ships were deployed to assist in search and rescue operations for a barge carrying 273 people “adrift” off Mumbai’s coast, with 28 picked up so far, the defence ministry said late Monday.
Seven people died and nearly 1,500 houses were damaged in Kerala state, Chief Minister Pinarayi Vijayan tweeted late Monday.
COVID-19 patients evacuated
Around 200,000 people were evacuated in Gujarat, where all COVID-19 patients in hospitals within five kilometres of the coast were also moved.
Authorities there scrambled to ensure there would be no power cuts in the nearly 400 designated COVID-19 hospitals and 41 oxygen plants in 12 coastal districts.
Chief minister Vijay Rupani told reporters that over 1,000 COVID-19 hospitals in coastal towns have been provided with generators and power backups, with 744 health teams deployed along with 174 ICUs on wheels and 600 ambulances.
“Besides the daily requirement of 1,000 tonnes of oxygen in Gujarat per day, an additional stock of 1,700 tonnes has been secured and could be used in case of emergency,” Rupani said.
Virus safety protocols such as wearing masks, social distancing and the use of sanitisers would be observed in the shelters for evacuees, officials added.
The state also suspended vaccinations for two days. Mumbai did the same for one day.
|Commuters drive through a waterlogged road amidst heavy rains in Mumbai. Photo: AFP|
Thousands of disaster response personnel have been deployed, while units from the coast guard, navy, army and air force have been placed on standby.
Maharashtra evacuated around 12,500 people from coastal areas.
Four people died on Saturday as rain and winds battered Karnataka state, while two died in Goa as winds hit power supplies and uprooted trees.
‘Terrible double blow’
The vast nation of 1.3 billion people on Monday reported 4,100 deaths and 280,000 fresh COVID-19 cases in the past 24 hours, taking the total close to 25 million — a doubling since April 1.
“This cyclone is a terrible double blow for millions of people in India whose families have been struck down by record COVID-19 infections and deaths,” said Udaya Regmi from the International Federation of Red Cross and Red Crescent Societies.
The organisation said it was helping authorities to evacuate people most at risk in coastal areas, providing first aid, masks “and encouraging other critical COVID-19 prevention measures”.
|This handout satellite image shows Cyclone Tauktae over western India on May 17, 2021. Photo: AFP|
Last May, more than 110 people died after “super cyclone” Amphan ravaged eastern India and Bangladesh in the Bay of Bengal.
The Arabian Sea previously experienced fewer severe cyclones than the Bay of Bengal but rising water temperatures because of global warming was changing that, Roxy Mathew Koll from the Indian Institute of Tropical Meteorology told AFP.
“(The) Arabian Sea is one of the fastest-warming basins across the global oceans,” he said.
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