Indian health minister Harsh Vardhan holds a vial of Covaxin at AIIMS Delhi. Photo: Reuters/Adnan Abidi
India aims to vaccinate 300 million people by the end of July to put the brakes on the COVID-19 pandemic. While this is an ambitious target, the state is slowly ramping up capacity and is currently administering 2 million shots a day. However, the real boost to both the vaccination drive and to resolving this public health crisis can come from plugging the major data gaps (right from collection to dissemination) within the government. COVID-19 has highlighted the cracks in the system for many countries, all of whom are slowly catching up to the importance of plugging data gaps. Improvement in the collection, analysis and sharing of health data could pave the way for a faster recovery from this pandemic and become a part of the playbook for navigating all future public health crises.
From the start of the pandemic, the paucity of data has been a major hurdle. Governments struggled to put together a number of crucial data points – from quantitative metrics such as number of doctors, bed capacity, and ventilators available to qualitative data on period of admission in the hospital, instances of readmission etc. Data on deaths and cluster outbreaks was sketchy. Disease surveillance systems across states had poor reporting and were not integrated. Such data gaps impeded effective policy decisions during the lockdown.
The government, to its credit, has improved during the current vaccination drive. The Union health ministry’s Co-win statistics dashboard has done a great job of sharing broad details on vaccine coverage of the population. However, the government should publish further data such as demographic and socio-economic profiles of vaccinated citizens, report at sub-districts levels for major urban hotspots and provide information on any side-effects reported post vaccination. Such dissemination can take place while still adhering to principles of data minimisation to protect privacy in addition to furthering long term research on the pandemic.
Collecting detailed vaccination data at the individual level is crucial in assessing vaccine coverage, evaluating immunisation programmes and facilitating future research on disease surveillance. For instance, in response to the SARS outbreak, Canada began developing a network of immunisation registries. However, data collection is the starting point, not the endgame. Any relevant information (with the necessary privacy safeguards) needs to be shared openly with the public in an open access format. Doing so would not only improve transparency and accountability but also assist in knowledge building by researchers and inform private sector innovation.
This can be seen in the case of Israel during the current pandemic. By running the world’s fastest vaccine campaign, it has provided researchers valuable data points for modelling how mass inoculation would be able to bend the trajectory of the pandemic in other countries. On the other hand, India is lagging behind with various issues with data sharing from the Co-win application. For instance, data formats of developed APIs are known to change regularly, making them difficult for third parties to collaborate and build upon the existing information. Moreover, the information regarding COVID-19 cases as well as on the vaccination drive is currently on two different portals, which makes it hard to ascertain a complete picture.
Apart from direct vaccination datasets, updated data on demographics, environmental factors and societal health profiles need to be collected and provided to vaccine distributors to improve the rollout of the COVID-19 vaccine. Such information would aid in the determination of health risks and societal vulnerability indices. To this end, data collection efforts such as the National Health and Family Survey should be conducted more frequently. Ultimately, sharing such datasets would help in the allocation of scarce resources effectively by ensuring that the distribution of the vaccine is sequenced in such a way that the most vulnerable have immediate access.
Major data points are also crucial pieces for effective communication strategies surrounding vaccines, especially given people’s hesitancy around its safety. In Europe, the inability to juxtapose the data on vaccinations and the number of lives that are being saved against the few who are affected, is precisely the reason the rollout is going haywire. In India, the government currently does not track and update information on individuals who have received the vaccination and whether they have faced any severe adverse effects. This information will be crucial to show that adverse effects of the vaccination are few and far in between as opposed to sensational news coverage around a few cases.
Ultimately, governments need to think long term here. This is a policy window to build effective, integrated and streamlined processes for data collection, analysis, storage and sharing within government and beyond. Accurate and updated health surveillance systems, a major bottleneck during this pandemic, need to be integrated going forward. Making use of alternative data sources to fill information gaps, a trend seen during the pandemic, should be continued and institutionalised within health systems. Going forward, health portals should also have a public facing arm, allowing any shareable information to be consumed by concerned citizens and researchers.
Given the sensitive nature of the health data that will be collected, the need to pass the data protection legislation becomes even more imperative and urgent. For instance, one of the reasons why Israel was able to obtain supply of vaccines from Pfizer ahead of other countries was due to its consent to share private medical data with the company to inform future research. India should be careful of such privacy breaches and assess the tradeoff of such transactions going forward. Data will be a crucial piece of bettering public health and fighting future pandemics. Hence, institutionalising its use by developing processes for its collection, analysis and dissemination while providing effective safeguards for individual privacy by fast tracking data protection laws should be the way forward.
Harsh Vardhan Pachisia and Sharmadha Srinivasan are senior associates and Anushka Bhansali is an intern – all at IDFC Institute.