Moa Jamir
In the continuing effort towards tackling the ongoing COVID-19 pandemic, two formidable challenges are presently facing the State policymakers, particularly the health department – the possible onset of “second wave” and visibly high vaccine hesitancy.
The twin challenge is augmented by understandable pandemic fatigue, a verifiable phenomenon across the world. The COVID-19 lockdown measures imposed since the end of March last year have been physically, mentally and economically, exacting.
Accordingly, as the possibility of a second wave appears on the horizon as things were being normalised, adopting counter-strategies to tackle the situation would be an uphill task.
India is indeed seeing a second wave, though most cases so far are restricted to certain states and locations. On Monday, continuing the upward trend, India reported 1, 03,558 fresh cases, the highest single-day spike since the beginning of the pandemic. According to an analysis by the IANS news agency, the country is now averaging 78,489 COVID-19 cases per day, based on a 7-day moving average.
In Nagaland, as per the weekly roundup bulletin by the State Integrated Disease Surveillance Programme (IDSP), Health & Family Welfare (H&FW) issued on April 3, after reporting relatively low cases for some time, the weekly tally increased to 132 cases last week.
The surge was attributed to a “superspreader event” at a training institute in Kohima resulting in detection of 107 cases on March 31, however, the IDSP said that it “sends a clear message that such events can happen anywhere when necessary conditions (crowding) are met.”
Complicating the matter on the other end is the high vaccine hesitancy, described by the World Health Organization (WHO) as “delay in acceptance or refusal of vaccines despite availability of vaccine services.”
While the approval of various vaccines for coronavirus has given a ray of hope, high vaccine hesitancy is impacting the vaccination drive in the State.
As per the IDSP April 3 bulletin, only 89,349 doses of the COVID-19 vaccine have been administrated across Nagaland since the launching of the nationwide vaccination drive on January 16. Even among the healthcare workers (HCWs), the vaccination was quite low and “below expectation.”
A review meeting of Nagaland State Task Force held on February 11 informed that there were 21,549 and 51,718 registered HCWS and frontline workers (FLWs) respectively in the State. Based on the IDSP's data on April 3, only 12123 HCWs have received the 1st dose, denoting just only 56.25% of the total registered. The percentage among FLWs was much higher at 73.10 % (37806).
According to the WHO’s Strategic Advisory Group of Experts on Immunization (SAGE), while vaccine hesitancy is ‘complex and context specific varying across time, place and vaccines,’ it is chiefly influenced by “3 Cs" factors - complacency, convenience and confidence.
Complacency exists where ‘perceived risks of vaccine-preventable diseases are low and vaccination is not deemed a necessary preventive action’ while confidence involves trust in the vaccine’s effectiveness and safety, the system that delivers them, and the motivations of policy-makers. Convenience, among others, refers to ‘physical availability, affordability and willingness-to-pay.’
To tackle the first challenge, on April 4, the Nagaland’s H&FW Directorate has issued an advisory for all District Task Forces (DTFs) to conduct random sampling and testing for screening while a high-level review meeting chaired by Prime Minister, among others, called for a special campaign for Covid appropriate behaviour from April 6-14.
Concurrently, it is crucial for the State health authority to develop a new cogent strategy to tackle vaccine hesitancy, particularly among HCWs, perceived to be one of the most trusted “advisor and influencer of vaccination decisions.” It should begin by holistically addressing the 3 Cs.
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