Masks off?

Fresh cases of the coronavirus have begun to slowly increase as mobility restrictions relax, and masks come off. Certainly, the Pakistani government’s vaccination roll-out is ramping up with daily vaccine offtake falling somewhere between 300,000 to 400,000 doses with an upward looking trajectory indicating more people are lining up outside vaccination centres to get a jab. The challenge for vaccination response teams, however, is to inoculate a large share of the population really fast to avoid the more serious mutations of the virus being created and taking hold.

Experts have argued that unvaccinated people are potential “variant factories”. Unvaccinated people provide the host—the ideal opportunity—for the virus to evolve into potentially more dangerous and more contagious versions that is then passed onto people the carrier comes into contact with. It is very possible that the new mutation spreads more efficiently, has higher transmissibility or replication power and/or the capability of targeting those hosts that would have been otherwise safe from the original novel virus. This is dangerous territory and as has been witnessed in countries like India, can have devastating and rapidly worsening results.

The government’s target is to inoculate 100 million people by June-22 which requires a daily offtake of about >423,000 doses. This estimation assumes that about 20 million people will get the one-shot Cansino or PakVac vaccine. The country is on track to meet that target, granted the momentum is kept. That would require a steady supply of vaccine. Let’s review the progress.

The latest development in the vaccine front is the arrival of 2.5 million Moderna vaccine donated by the United States. Like Pfizer, Moderna will also be administered to individuals that are chronically immunocompromised, suffering from pre-existing comorbid conditions and those with mandatory requirement of vaccination for travel. Despite protests in Islamabad, the government should stick to its guns because while these vaccines are higher in efficacy, they are also short in supply.

Meanwhile, about 400,000 doses of the one-shot locally assembled Cansino called PakVac is also available as more Chinese vaccines under the procurement program are landing every month. The country is supposed to procure 90 more million doses from multiple vaccine suppliers by the end of this calendar year (see table).

Currently, about 80 percent of the vaccines that have landed on ground have been administered but there have been instances of certain vaccination centres facing shortages of the vaccine required. One very positive development is the local assembly of Cansino. The National Institute of Health has a facility with a capacity to churn out 3 million doses each month which can supplement existing stock or provide a ready substitute if imports dry out.

But all of these supply-side dynamics will come into play over the next 12 months, which means, the opportunity for the vaccine to mutate and multiply is aplenty. This is why even if mobility restrictions and SOPs lift, masks should not. On the demand side, consumer surveys indicate perceptions are changing as more people get the vaccine—and experience few or no symptoms—(read more: “Somewhere between luck and action”, May 31, 2021) which is an important shift from only a few months ago when vaccine hesitancy was at its peak.

The NCOC has, for the most part, done an incredible job at tackling the virus, though luck may also have played a nifty hand. But a new aggressive wave or a deadlier mutation of the virus can quickly derail the slow and steady progress the country is making to head back into a semblance of what we knew to be normal. We should stop that from happening—at all costs.