Two bits of reading for you today, since I overlooked out sending out last week's column.
A couple of weeks ago, we heard a government claim that by the end of this year, India would have 2 billion doses available to vaccinate its citizens against Covid. This is a huge number. It's what our huge population needs, of course, but it also is a huge leap upward from the kinds of numbers we're seeing today. My inclination when I see huge numbers - huge claims, actually - is to pull on my sceptic's hat. And what resulted is my math column for Friday May 21. There's really not much mathematical about it - just a perusal of numbers. Still, take a look: When the whistle blows two billion doses, https://www.livemint.com/opinion/columns/when-the-whistle-blows-two-billion-doses-11621541157395.html yours, dilip PS: Two (possibly obscure) musical references. Let me know if you find them. --- The whistle blows two billion doses Two billion vaccines by the end of the year, we hear? That's an encouraging number. We have about 950 million people in this country - essentially, the adult population - who must be vaccinated. Two billion vaccines would mean everyone who should be vaccinated will get vaccinated, with both shots. Seen from the wreckage of this second surge that's overwhelmed us, that prospect is a light at the end of a long tunnel. So it's worth looking more closely at this number, purely in the light of other numbers. Several different vaccines make up the two billion. This is the published breakdown: * Covishield 750 million * Covaxin 550m * Sputnik V 156m * Covovax 200m * Zycov-D 50m * Nasal Vaccine 100m * Biological EVaccine 300m * Gennov mRNA 60m. Those figures total to 2.166 billion doses. Call it a neat two billion. So here's the question: how much can we rely on these numbers? Start with Covishield. In November last year, for example, the Serum Institute of India was reported to be "ramping up production" of Covishield so as "to have 100 million doses ready by December", all of which were to be administered in India. Which was good news. The only concern was that in the two months before that report, SII had produced 40m doses of Covishield. So another 60m doses in a month would certainly qualify as "ramping up production." Would they manage what was in effect a tripling of their rate of production? Well, those 100 million doses were not ready by December. At the beginning of April, another report told us that SII had supplied about 80m of the 90m vaccine shots that had till then been administered in India. It had also exported about 40m more doses. Add those two to get 120m: so we can safely conclude that the 100m December target was reached at least two months later than expected. Still, SII had indeed ramped up its Covishield production capacity, by then to about 70m doses a month - better than tripling. That was about when SII, conscious of the enormous demand for vaccines in India alone and aware that it was bumping up against its own limits in producing them, asked the Government of India for a grant of over $400 million. The reason was to add facilities so that they could, you guessed it, ramp up production again. This time, the goal was to reach a level of 100m doses every month by July. If SII achieves that, they will produce 500m doses of Covishield between August and December 2021. Yet that breakdown above lists 750m Covishield doses. How is SII going to produce 50% more than is allowed by the capacity they hope to reach in July? But that's not the only question SII must answer. It is also supposed to produce 200m doses of the Covovax vaccine between August and December. This is another number that looks extraordinarily ambitious. Consider that SII's Adar Poonawalla announced at the end of March that they would launch Covovax only by September. One reason is that the raw materials for Covovax production must be imported from the US. In addition, Covovax has not yet been through its phase-3 clinical trial. After the trial is gone, the American firm Novavax, which developed Covovax, has a contract with SII under which SII will produce a billion Covovax doses for use in India and abroad. But how quickly can SII deliver? And of that billion, can they deliver 200m doses by December, as part of the two billion doses? One "conservative estimate" suggested that once production starts in September, SII will produce 25-30m Covovax doses a month, which means 100-120m doses by December. Let's call it 150m - that's still well short of the 200m target. None of this is meant as a criticism of SII itself. From all we've heard, the firm has been operating at full capacity to produce doses of Covishield. Some 90% of the 185m vaccinations administered so far in India are Covishield. That's 165m doses, no small achievement. But then think of increasing that nearly five-fold, to 750m - or even three-fold, to 500m - over the next several months. Then think of going from 0 to 200m Covovax doses over the same several months. The remaining 10% of vaccinations administered in India - about 16.5m - are Bharat Biotech's Covaxin. This number suggests that the ramp expected of BB is, if anything, even steeper than SII's. In April, they were producing about 10m Covaxin doses a month. In this announced plan for the end of the year, BB's target is 100m doses a month by September. That's a ten-fold increase in just five months. How is this going to happen? And like with SII, that's not the only question BB must answer. It also has plans to make a nasal vaccine, and so it is the designated supplier of the 100m of those mentioned in the list above. To begin with, there are health professionals who have serious doubts about how effective nasal vaccines are against respiratory infections like Covid. But even if those doubts can be addressed, BB's nasal vaccine, BBV154, is very far from being ready for production and use. In early May, BB announced that the results of BBV154's phase-1 trial - conducted on 175 people in 4 Indian cities - were promising. They expected to complete phase-2 and phase-3 trials within the next three or four months and then launch the vaccine within another couple of months. That is, if the trials are a success, it will be early November before BB even begins producing BBV154. How will the firm finish the trials and then turn out 100m doses of its nasal vaccine - all in just a few months? How will they do it in addition to the 100m Covaxin doses they are also expected to produce per month? Again like with SII, and for the same reasons, this is not a criticism of BB itself. Other numbers also leap out of that two billion claim. I'm looking, in particular, at the Sputnik count of 156m. The Russian Sputnik V vaccine is now being imported by Dr Reddy's. They expect to import a total of 36m doses by July. A pilot vaccination programme, using the first batch of 150,000 vaccines that arrived from Russia, kicked off this week. Starting in July, six Indian companies, including Dr Reddy's, are expected to start producing Sputnik V. What kind of numbers can we expect from them? In an affidavit submitted to the Supreme Court, the Government of India asserted that "locally manufactured Sputnik V vaccine will be available to the extent of 8m and 16m doses ... for the months of July and August 2021, respectively." If those six companies can keep that 16m/month level going after August, by December they will have produced 88m doses of Sputnik V. Add the 36m Russian imports and we have 124m. Still well short of the projected 156m. In sum: This hardly qualifies as a detailed analysis of the claim of two billion vaccines by the end of 2021. Instead, it's merely a layman's attempt to gather publicly reported numbers to see if the claim of two billion doses by December is realistic. If it makes any sense. Considered that way, the issue is less about the capabilities of various firms producing vaccines in India, and more about the numbers that make up the two billion. Let's just say, while I dearly want to be wrong, there's much room for scepticism. -- My book with Joy Ma: "The Deoliwallahs" Twitter: @DeathEndsFun Death Ends Fun: http://dcubed.blogspot.com -- You received this message because you are subscribed to the Google Groups "Dilip's essays" group. To unsubscribe from this group and stop receiving emails from it, send an email to dilips-essays+unsubscr...@googlegroups.com. To view this discussion on the web, visit https://groups.google.com/d/msgid/dilips-essays/CAEiMe8pPyvfMpkNnxcp6Jd_5qW-ZfNgpmc3yWPLXxUMtRXQmJg%40mail.gmail.com.