COVID’s First and Second Waves in India: Lessons and Policy Implications

Abstract

In this article, we argue that in a supply-deficient situation, a vaccination strategy that makes use of an analysis of the different stages of the COVID waves and the pattern of their geographical spread can prove to be far more effective than the current non-transparent mechanism of inter-state allocation of the vaccines. We divide the spread of the COVID waves into three stages: (a) seeding stage, (b) explosion stage and (c) subsiding and diffusion stages. In the seeding stage, two critical determinants of seeding the virus into the population are (a) the inter-state pattern of arrival of international passengers and (b) the inter-state pattern of the continuing active COVID-affected population from the previous wave. The explosion stage induces a policy response in the form of lockdowns which is followed by the wave starting to subside. But the lockdown also results in the migration of labour out of the state into the rural and less populated areas, leading to the diffusion stage. We advocate a vaccination strategy targeting universal coverage with strategic sequencing in which prioritisation is given to ‘saturation vaccination’ of high-density and high COVID-intensity urban areas. This would not only minimise the economic costs in terms of duration and spread of lockdowns but also the pressures on the inadequate health infrastructure in terms of availability of hospital beds, ambulances, oxygen and drugs. This strategy may be implemented in curbing the COVID’s subsequent waves which may hit India while its population is still only partially vaccinated.