How India's second wave risks causing global scramble for vaccines

UK added India to travel ban red list over mutant virus fears

Cemetery workers wear protective gear in New Delhi. Getty Images

Vaccine supply issues caused by India's alarming second wave of Covid-19 could have "huge repercussions" because the world is so reliant on imports from the subcontinent, an expert said.

Dr Sarah Schiffling, a vaccine supply chain expert at Liverpool John Moores University, said the world faced a “scramble for some time to come” as the crisis limits production capacity and India reserves more shots for itself.

She told The National her biggest worry was the potential effect on the global Covax scheme which is distributing shots to developing countries.

Covax had expected to receive more than 100 million doses from the Serum Institute of India between February and May, but has so far received only about 18.2m.

Vaccine shipments to Britain were also delayed last month because of hold-ups in India and the virus situation has worsened significantly since then.

Britain on Monday added India to its travel-ban red list because of the rampant surge in cases and fears over a new variant of Covid-19 which has already been detected in the UK.

Scientists in Britain are now examining whether the new variant is more contagious than others and whether it is able to evade vaccines or antibodies.

Why is India on Britain's travel red list? 

India’s infection rate reached a new high on Tuesday with the seven-day average reaching 233,000 new cases per day.

The figure has risen by about 275 per cent since the start of April.

More than 1.6 million new cases were recorded in the past week alone, along with nearly 9,500 deaths.

When adjusted for population, India’s infection rate is still lower than in some European countries, such as France and Germany.

However, UK authorities said there was a heightened risk of importing the “Indian variant” of Covid-19.

UK Prime Minister Boris Johnson was forced to cancel a visit to India which had already been postponed and then truncated because of the pandemic.

The travel ban will take effect at 4am London time on Friday.

British and Irish citizens and people with residency rights in the UK will have to stay in quarantine hotels if they arrive in the UK from India.

Overseas visitors with no residency rights will not be allowed to enter Britain if they have been in India in the previous 10 days.

A woman takes care of her husband who has Covid-19 as they wait outside the casualty ward at Guru Teg Bahadur Hospital, in New Delhi, India. Reuters

Family members mourn after a man is declared dead amid a surge in coronavirus cases in India. Reuters

A patient with breathing problems is seen inside a car while waiting to enter a hospital for treatment, amid the spread of the coronavirus in Ahmedabad, India. Reuters

India’s second Covid-19 wave is devastating, with more than new 200,000 coronavirus cases recorded each day. Reuters

Dr Rajesh Bhagchandani, centre, a director at Apex hospital in Bhopal city, intubates a patient. He feels helpless that the hospital, which is now reserved for critically ill Covid-19 patients, cannot accommodate more people who require oxygen. Dr Rajesh Bhagchandani

Dr Himanshu Dewan, director of critical care at QRG hospital in Faridabad, a town near India’s capital New Delhi, says the number of deaths will climb because patients do not have access to treatment. Dr Himanshu Dewan

A health worker arranges oxygen cylinders that are being used for Covid-19 coronavirus patients at a private hospital in Allahabad. AFP

Dr Himanshu Dewan, director of critical care at QRG hospital in Faridabad, a town near India’s capital New Delhi, is acutely aware a patient could die on the road if turned by hospitals that cannot admit more Covid-19 cases . Courtesy: Dr Himanshu Dewan

A man carries an empty oxygen cylinder to get it refilled at a private refilling station, for his relative who is suffering from the coronavirus disease, in New Delhi. Reuters

Patients with breathing problems are seen inside an ambulance waiting to enter a Covid-19 hospital for treatment in Ahmedabad. Reuters

A health worker collects a nasal swab sample from a woman in Amritsar. AFP

An Indian police officer distributes face masks in Hyderabad. AP Photo

A health worker administers the Covidshield vaccine at a government hospital in Hyderabad. AP Photo

People wearing masks wait to test for Covid-19 at a hospital in Hyderabad. AP Photo

A health worker takes a mouth swab sample at a hospital in Hyderabad. AP Photo

Nuns wait to take a test for Covid-19 at a test center in Kolkata, Eastern India. EPA

What is the variant that is worrying the UK government?

Known as B.1.617, the variant was first detected in India and most of the cases picked up in Britain are linked to international travel.

There have been 77 confirmed cases in the UK, of which 73 were in England and four in Scotland.

It has also been detected in 19 other countries including the United States, with the earliest samples dating back to October.

We only have a tiny window into which variants are becoming the most common

Scientists were on Tuesday still assessing whether the strain is more transmissible than other variants or potentially resistant to vaccines.

This means it has the status of a “variant under investigation” rather than a “variant of concern”.

Dr Jeffrey Barrett, the director of the Covid-19 genomics initiative at the Wellcome Sanger Institute, said the variant had “a couple of potentially concerning mutations”.

He said they were probably not as serious as some of the mutations seen in the UK, Brazilian and South African variants of Covid-19.

“This could be because we have had less time to study them, so these mutations should be watched carefully,” he said.

It is not clear whether the new variant is driving the second wave of infections in India.

“It is certainly possible that there is a cause-and-effect relationship but there have only been about 1,000 sequences published from India out of about four million cases in this wave so far,” Dr Barrett said.

“So we only have a tiny window into which variants are becoming the most common and it’s not clear if they are fully representative.”

What does this mean for global vaccine supplies?

India is the world’s biggest vaccine manufacturer and is sometimes described as the “pharmacy to the world”.

However, the world’s reliance on India means that global supplies are vulnerable to being delayed, Dr Schiffling said.

“There’s been a lot of reliance, particularly in Western countries, to say that we’re just going to import from India, making use of those vast production capacities that other countries just do not have,” she said.

“If you are producing these vaccines and you’ve got an urgent need for them, then obviously it’s very difficult to communicate that we’re just exporting them to countries that are less affected at the moment.

“Basically it comes down to – we have mass demand, but we currently do not have the production capacity to fulfil that demand any time soon.

“So it’s going to be a scramble for some time to come.”

Dr Schiffling warned that manufacturing problems could affect not only vaccine makers but also the supply of essential items such as glass vials and biological compounds.

“It just comes down to pure capacity,” she said.

“There’s not enough to go around in the first place, so every little hiccup in the production and every change in terms of exporting – or not exporting, in the case of India now – has huge repercussions for worldwide vaccination programmes.”

Dr Schiffling said the UK’s travel restrictions should not have a major effect because the rules for individuals were different from those for exporters.

However, said her biggest concern was about supplies to the Covax scheme, which she said was largely reliant on exports from India.

Covax is holding talks with the Indian government for the Serum Institute to resume supplies of the Oxford/AstraZeneca vaccine.

"These are countries that already are being forecast, many of them, to not have a decent vaccination rate for years to come,” Dr Schiffling said.

“So delays to that will have much larger knock-on effects than delays to the UK, the EU or other countries like that.”

More on Covid-19 vaccinations

One in a million: The truth about blood clots and vaccines

All the countries that are open to vaccinated travellers

Denmark's AstraZeneca ban could lead to 'a lot of dead people'