People wait to receive a dose of Covishield at a hospital in Noida, August 30, 2021. Photo: Reuters/Adnan Abidi
In a wide-ranging interview where he discusses the present sharp rise in COVID-19 cases in Europe and East Asia, the BA.2 lineage of Omicron that is responsible for them and the likelihood of a similar surge or wave in India, Shahid Jameel, one of the country’s foremost virologists, has said in the present circumstances it is “unscientific” for the Indian government not to give boosters to every adult.
Jameel, who is professor of virology at Ashoka University and a senior research fellow at Green Templeton College at Oxford University, also said that the Indian system’s lack of attention to and, often, unwillingness to follow science is “perplexing”. He made this point specifically with reference to two facts: that science shows boosters are necessary but they are not being given and the fact that science has established there are better vaccines, which are available in India, to give as boosters, rather than those that are being given, but this is not being done.
In a 42-minute interview with Karan Thapar for The Wire, Jameel suggested that one reason why the Indian government does not have a clear and scientific policy on the need for boosters is that it has not decided what precisely is the aim and intention of its vaccine policy. “As a country, we haven’t really decided what we mean by protection. Is it protection from infection? Or protection from moderate to severe disease and mortality?” he said.
He pointed out that science has established, without any doubt or confusion, that antibodies after six months of the second vaccination can dip very sharply. Science has also established that protection from serious disease, whilst not getting eliminated, can also dip and, again, in some cases substantially. This is why boosters are necessary.
Jameel said that even if infection from Omicron is mild and people recover after 3-4 days, 30% of those with mild infection tend to get long-COVID. He said we do not fully understand long-COVID and, in addition, it can cause stress for the health system. This is another reason for boosters.
Speaking bluntly, Jameel said, in these circumstances, it would be unscientific not to give boosters and he cannot understand why they are not being given in India. “My thinking on this is very clear and I have said it several times. If India has no shortage of vaccines, it must allow boosters to all adults who wish to take them. Every vaccine has proven effective against disease. Keeping up the protection is a good strategy. It also makes economic sense when viewed against treatment and lockdowns.”
Speaking to The Wire, he said it is perplexing that the Indian government is not following international science which clearly suggests a heterologous vaccine is far better than a homologous vaccine as a booster. So, given that Covovax (the Indian name for the Novavax vaccine) is available in India, this should have been given to people who have had two jabs of Covishield rather than a third Covishield. This is yet another aspect of science that the Indian government seems to have ignored or disregarded.
Jameel made one further point. He said COVID-19 is a complex issue but our response needs to be simple. Instead, the Indian government’s policy seems to have added complications and complexity. “It is also important to keep the vaccine policy simple and not complicate it with too many conditions. We are facing a very complex situation. The solutions should be simple, not equally complex,” the professor said.
In the interview, Jameel also discusses in detail the nature of the present infections in Europe and points out that although cases are rising sharply, the mortality rate is around 0.1% or less which, he says, is the mortality rate for seasonal flu. The mortality rate is the same for South Korea where daily cases crossed 6 lakhs a day a few days ago.
He also says that both in Europe and East Asia, where cases have risen sharply (but are now dipping in the last few days), the impact on hospitals has been minimal or negligible.
Jameel also discusses the characteristics of the BA.2 variant of Omicron, which is considerably more infectious than BA.1 but all the reliable evidence suggests the disease it causes is not more virulent.
Finally, the virologist explains at length why he doesn’t think the present surge of infections in Europe and East Asia could also occur in India. This has to do with both high levels of vaccination as well as high levels of seropositivity.
These are some main points indicating the range of areas on which Jameel has spoken in detail. He also refers frequently to recent, up-to-date, scientific papers, including several published in the last few days, providing the most up-to-date information and analysis.