Context

Questions are being asked about India’s preparedness as the cases with the Omicron variant of the Coronavirus has been on the rise in the country.

Where does India stand?

[1] The Positives

• Addressing oxygen shortage: The extreme shortages of oxygen that we saw barely six months ago will hopefully not be a feature of a third wave.
• Vaccinated population: We have now vaccinated more than 50% of the adult population with both doses of vaccine, and approximately 85% have received one or two doses.
• Ramping up testing to deal with a spike should not require an increase in capacity.
• More vaccine doses: We have more vaccine doses than in May 2021 and the potential for oral antiviral therapy in the near future.

[2] The negatives

• Lack of data: An urgent and important one is the lack of publicly available data on the pandemic from Government sources, particularly in regard to testing, but also in terms of being able to correlate disease severity with age, prior medical conditions, locations and other variables.
• Data from the Indian Council of Medical Research (ICMR), India’s premier medical research agency, remains inaccessible.
• The National Centre for Disease Control (NCDC) has not responded.
• The CoWIN data contains valuable information but it is of little value for future planning and prediction unless it can be tied to testing data and clinical information at the level of individuals.
• ICMR data not correlated to CoWIN platform data: The Indian Council of Medical Research holds data on every COVID-19 test conducted in India.
• However, these data are not correlated to the vaccine data in the CoWIN platform.
• Data with States is inaccessible: Data on hospitalisations, etc. are apparently available at the State level, but seem inaccessible.

What we can know from the data about pandemic

• Infer the probability of reinfection: If we knew that a person had tested positive on successive tests separated by, say four months or more, with a negative test in-between, that would suggest a reinfection.
• We could then infer the probability of such a reinfection.
• Probability of vaccine breakthrough infection: With information about testing and vaccination status, we could compute the probability of a vaccine breakthrough event.
• To know the efficacy of single vaccine dose: By checking to see whether the positive test happened after the first but before the second dose of vaccine, or after the second dose, the relative efficacy of such single vaccine doses at preventing disease could be derived.
• Effect of the vaccine on disease severity: By examining symptoms reported after a vaccine breakthrough event, we could understand the extent to which vaccines reduce disease severity.
• Impact of new variant: Add to this a layer of sequence information, and we could study the impact of new variants.

Role of the volunteer organisation

• The most trustworthy and granular data on cases in India have resulted from the remarkable and public-spirited work of a volunteer organisation, Covid19India.org.
• Their work has now been taken over by several other voluntary groups, all operating on the same broad principles of data accessibility: covid19bharat.org, incovid19.org and covid19tracker.in.

Way forward

• Commitment towards data accessibility: We need to stress on data availability because this is the one area where a swift realignment is possible.
• The more widely data are shared, the greater the likelihood of integration of the rapidly shifting scientific frontier with clinical practice.
• Learning from the experience of South Africa: With the advantages of a relatively high-quality surveillance system among low- and middle-income countries (LMIC) countries, bolstered by a commitment towards transparency and data accessibility, South Africa’s rapid sharing allowed the world to prepare swiftly for the appearance of the highly mutated Omicron variant.
• It is clear that pre-emptive decisions on vaccination and other measures could be made faster and better if more integrated data were available.

Consider the question “Why availability and accessibility of data is important in dealing with the Covid-19 pandemic? What are the challenges facing health data accessibility in India?”

Conclusion

Now, more than ever before is the time for us to urgently reassess our attitude towards data for public health purposes and the role of national health agencies in sharing data, generated with public funds, with scientists in India and across the world.

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