Covid's First and Second Waves in India: Lessons and Policy Implications

In this paper, 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 interstate 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 (i) the interstate pattern of arrival of international passengers and (ii) the interstate 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 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 prioritization is given to ‘saturation vaccination’ of high density and high Covid-intensity urban areas. This would not only minimize 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.