Pan-India Covid-19 vaccinations dry run on 2nd January

By Raman Pandit

The Covid-19 vaccination dry run will be conducted across India on 2nd January.

The Union Government has asked all States and UTs to ensure effective preparedness for the vaccine roll out, said the press release issued by the Union Health Ministry. Union Health Secretary Sh. Rajesh Bhushan today chaired a high-level meeting to review the preparedness at session sites for COVID-19 vaccination with Pr. Secretaries (Health), NHM MDs and other health administrators of all States/UTs through video conference. The activity is proposed to be conducted in all State Capitals in at least 3 session sites; some States will also include districts that are situated in difficult terrain/have poor logistical support; Maharashtra and Kerala are likely to schedule the dry run in major cities other than their Capital.

The objective of the Dry Run for COVID-19 vaccine introduction is to assess operational feasibility in the use of Co-WIN application in field environment, to test the linkages between planning and implementation and to identify the challenges and guide way forward prior to actual implementation. This is also expected to give confidence to programme managers at various levels. The planning for the vaccine introduction will be as per the Operational Guidelines issued by the Ministry on 20th December 2020. For each of the three Session Sites, the concerned Medical Officer In-charge will identify 25 test beneficiaries (healthcare workers). The States/UTs have been asked to ensure that the data of these beneficiaries is uploaded in Co-WIN. These beneficiaries will also be available at the session site for the dry run. The States and UTs shall prepare the facilities and users to be created on CoWIN application including uploading the data of Health Care Worker (HCW) beneficiaries.

The States/UTs have been asked to ensure physical verification of all proposed sites for adequacy of space, logistical arrangements, internet connectivity, electricity, safety etc; prepare at least three model session sites in each State (at State capital) for demonstration; ensure that the Model Sites have separate entry and exit in a ‘three-room set-up’ with adequate space outside for awareness generation activities; display all IEC material at these sites; ensure that all SOPs and protocols are being practiced at the identified sites in an ideal environment along with vaccination teams to be identified and trained in all aspects. The dry run will also equip the State and UT administration in management of vaccine supply, storage and logistics including cold chain management.

As the vaccine administrators will play an important role in the vaccination process, training of trainers and those who shall administer the vaccine has been taken up across various States. Around 96,000 vaccinators have been trained for this purpose. 2,360 participants have been trained in National Training of Trainers and over 57,000 participants trained in District level training in 719 districts. States are augmenting the State helpline 104 (which shall be used in addition to 1075) for any vaccine/software related query. Orientation and capacity building of the Call Centre executives has taken place in the States/UTs. States were also encouraged to use the FAQs issued by the Health Ministry proactively to address any such query.

An important focus of the dry run will be on management of any possible adverse events following immunisation (AEFI). In addition, adherence and management of infection control practices at the session site, to prevent disease transmission. The mock drill will include concurrent monitoring and review at the block and district levels, and preparation of feedback. The State Task Force shall review the feedback and share with the Union Health Ministry.

States/UTs were also asked to address the communication challenges by taking in confidence all the concerned stakeholders and by augmenting the community engagement ‘Jan bhagidari’ through innovative strategies. Detailed checklist has been prepared by the Union Health Ministry and shared with the States/UTs to guide them in the dry run. The first round of the dry run was conducted in Andhra Pradesh, Assam, Gujarat, Punjab on 28-29th December 2020 in two districts each where five session sites with 25 beneficiaries each were identified. No major issues were observed in the operational aspects during this dry run. All States expressed confidence in the operational guidelines and IT platform for large scale programme implementation.

COVID mutant: 5 per cent +ve cases to be tested for whole genome sequencing

 

By Raman Pandit

 In the wake of a mutated variant of coronavirus detected in the UK, it is proposed to continue enhanced genomic surveillance for early detection and containment of the UK variant SARS-CoV-2 strains, said the Health Ministry of India. 

  In this regard, a genomic surveillance consortium has been formed for laboratory and epidemiological surveillance of circulating strains of the SARS-CoV-2 in India. The genomic surveillance consortium, INSACOG, has been formed under the leadership of the National Centre for Disease Control (NCDC), New Delhi.  Further, more than 50 samples of UK returnees are currently under sequencing at the designated laboratories.

“It is proposed to continue enhanced genomic surveillance for early detection and containment of the UK variant SARS-CoV-2 strains. However, it is important to understand that like all other RNA viruses, SARS-CoV-2 will continue to mutate,” the ministry said. Five percent of the positive cases of COVID-19 from all states and UTs will be tested for Whole Genome Sequencing (WGS) as part of the strategy that has been put in place to detect and contain the mutant variant, the Union Health Ministry said after a meeting of the National Task Force (NTF) on COVID-19 on the issue. The mutated virus can also be contained by measures like social distancing, hand hygiene, wearing masks and also by an effective vaccine, as and when available, the ministry said.

The meeting of the NTF was convened on Saturday by ICMR under co-chairpersonship of Dr Vinod Paul, Member NITI Aayog and Dr Balram Bhargava, Secretary, Director General ICMR. The main objective of the meeting was to discuss evidence-based modifications in testing, treatment and surveillance strategies for SARS-CoV-2 in view of the recent reports of the emergence of a new variant strain of the virus from the UK. It was emphasized that since the UK variant strain is implicated to cause increased transmissibility of the virus, it is critical to identify individuals infected with this strain and adequately contain them to prevent its transmission in India, the statement stated.

The NTF concluded that there is no need to change the existing Treatment Protocol in view of mutations emerging in the strain. Further, since ICMR has always advocated the use of two or more gene assays for testing SARS-CoV-2, it is unlikely to miss infected cases using the current testing strategy, the ministry said. The NTF recommended that in addition to the existing surveillance strategies, it is critical to conduct enhanced genomic surveillance for SARS-CoV-2 especially in incoming passengers from the UK.

The meeting was also attended by Prof. Randeep Guleria, Director, AIIMS; Director General Health Services (DGHS); Drug Controller General of India (DCGI); Director, National Center for Disease Control (NCDC); other representatives from Ministry of Health and ICMR as well as independent subject experts.

“The variant strain has14 non-synonymous (amino acid altering) mutations, 6 synonymous (non amino-acid altering), and 3 deletions. “Eight mutations are present in the Spike (S) gene which carries the binding site (Receptor Binding Domain) of the ACE2 receptors, which are the point of entry of the virus into the human respiratory cells,” the ministry said in its statement.

The NTF deliberated in detail on aspects related to the current National Treatment Protocol, testing strategy and surveillance of SARS-CoV-2 vis--vis the UK variant strain.

The NTF was of the view that it will also be critical to conduct genome sequencing in samples where there is a dropout of the S gene in lab diagnosis, proven cases of re-infections etc. Routine genomic surveillance of SARS-CoV-2 from representative samples all across the samples needs to be a continuous and well-planned activity, according to the statement.

The designated laboratories where samples of UK returnees are currently under sequencing include --NCDC, Delhi; CSIR-Institute of Genomics and Integrative Biology, Delhi; CSIR- Centre for Cellular and Molecular Biology, Hyderabad and DBT- Institute of Life Sciences, Bhubaneshwar. It is also being done at DBT-National Institute of Biomedical Genomics, Kalyani;DBT-InStem-National Centre for Biological Sciences, Bengaluru; National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru and National Institute of Virology, Pune.

The NCDC informed that the Centre has taken cognizance of the reports of mutant variant and the response of other countries to these reports. The situation is being monitored proactively. A strategy has been put under place under which all passengers who had arrived from the UK between December 21 and 23 have been tested at the airports and only after the-PCR test result are available, the negative passengers are permitted to exit the airports    All positively tested passengers are put under institutional isolation and their samples sent for Whole Genome Sequencing (WGS)       Only after the confirmation of the non-mutant variant upon WGS result, the positive cases are permitted to leave institutional isolation as per the existing management protocol.

Americas account for highest human rights violations against MPs: IPU

By Raman Pandit

The Inter-Parliamentary Union (IPU) has released its yearly figures on the human rights abuses experienced by parliamentarians around the world. The numbers confirm an upward trend of reported violations against parliamentarians. They also reveal an uptick in acts of intimidation and violence, with women MPs suffering more disproportionately, according to information received by the IPU Committee on the Human Rights of Parliamentarians.
In 2020 the IPU Committee examined the cases of 552 parliamentarians from 42 countries whose rights were allegedly violated. Eighty-three of them, from 13 countries, were new this year, with 43 reported from Venezuela alone. 
This compares with cases involving 533 MPs in 2019 and confirms an overall upward trend since the creation of the IPU Committee over 40 years ago. 
Opposition parliamentarians account for 85 per cent of the cases examined.

The most common human rights violations were:

1. Undue suspension and loss of parliamentary mandate

2. Lack of fair trial and other unfair proceedings

3. Threats, acts of intimidation

4. Violation of freedom of expression 

In 2020, threats and acts of intimidation moved up from fourth to third place of the most common human rights violations affecting MPs under IPU review.
The figures reveal that women MPs are significantly more exposed to torture, ill treatment and acts of violence, with 34 per cent of women parliamentarians considered by the IPU affected compared with 18 per cent of male colleagues.
In 2020, the IPU examined 98 cases concerning women parliamentarians, up from 85 in 2019. This represents 18 per cent of all cases before the Committee, almost three times higher than the figure from six years ago (34 women in 2014).

The Americas has the most cases

For the fifth year in a row, the Americas account for the greatest proportion of human rights violations against parliamentarians  - 32 per cent (178 cases out of 552) - driven by a large caseload from Venezuela. In Venezuela, the IPU continues to monitor closely allegations of human rights violations affecting 134 parliamentarians from the coalition of opposition parties, against the backdrop of parliamentary elections scheduled for 6 December. According to evidence available to the Committee, almost all the parliamentarians have been attacked, threatened, harassed or otherwise intimidated by pro-government supporters.

The Americas is the only region where the most frequent violation is: “Threats, acts of intimidation” which directly affects the physical integrity of MPs. The Middle East and North Africa (MENA) reported the second highest proportion of cases (25 per cent).

The IPU Committee is seeing more cases from the same countries than it has in recent years, suggesting that the situation in these countries (Brazil, Colombia, Democratic Republic of Congo, Venezuela and Yemen) is getting worse, particularly for opposition MPs.

Violations in a time of COVID-19

The coronavirus pandemic has provided an opportunity for some governments to act against opposition MPs using lockdown laws to detain or otherwise infringe upon the rights of opposition parliamentarians, notably in Venezuela, Uganda and Zimbabwe.      

As of December 2020, the IPU Committee was examining the cases of 30 MPs in detention from nine countries (Côte d'Ivoire, Eritrea, Gabon, Iraq, Mongolia, Niger, Palestine, Philippines, Turkey).

Some MPs released after IPU action

In some positive news, lobbying from the IPU and the global parliamentary community contributed to the release of some parliamentarians from detention. For example, four MPs in Côte d’Ivoire (Mr. Loukimane Camara, Mr. Kando Soumahoro, Mr. Yao Soumaïla and Mr. Soro Kanigui) were able to return home recently partly thanks to IPU follow-up actions with the national authorities.

The IPU Committee on the Human Rights of Parliamentarians is the only international complaints mechanism with the mandate to defend the human rights of persecuted parliamentarians. Its work includes mobilizing the international parliamentary community to support threatened MPs, lobbying national authorities, visiting MPs in danger and sending trial observers. The Committee is made up of 10 parliamentarians from the various regions of the world who are elected by their peers for a mandate of five years. 

India warns TV channels not to promote online Gaming without 'mandatory warning message"

Fantasy and Gaming app to find it tough to promote in India

India has issued a warning to private TV channels not to violate any guidelines while displaying advertisements on online gaming and fantasy sports. It told them to carry 'mandatory warning message' failing which government would take strict action against them.

The advertisements must carry the warning disclaimer: 'This game involves an element of financial risk and may be addictive. Please play responsibly and at your own risk”.

The move will discourage people from using gaming applications and not making people addictive of such games. The decision is taken to curb the use of Chinese gaming app among youngsters.

In its advisory, the Ministry of Information and Broadcasting asked all private television broadcasters to follow guidelines issued by the Advertising Standards Council of India (ASCI) for advertisements relating to online gaming, fantasy sports etc. It further told them not to promote any activity prohibited by statute or law.

“It has come to the notice of Ministry of I&B that a large number of advertisements on Online Gaming, Fantasy Sports, etc have been appearing on the television. Concerns were expressed that such advertisements appear to be misleading, do not correctly convey to the customers the financial and other risks associated thereof, are not in strict conformity with the Advertising Code laid down under Cable Television Networks (Regulation) Act, 1995 and the Consumer Protection Act, 2019” the advisory said.

The advisory has been issued after a consultation meeting held by the I&B Ministry with the officials and representatives of the Ministry of Consumer Affairs, ASCI, News Broadcasters Association, Indian Broadcasting Foundation, All India Gaming Federation, Federation of Indian Fantasy Sports, and the Online Rummy Federation.

ASCI guidelines require that every such gaming advertisement must carry the following disclaimer: 'This game involves an element of financial risk and may be addictive. Please play responsibly and at your own risk”. Such a disclaimer should occupy at least 20% of the advertisement space.

The guidelines also state that gaming advertisements cannot depict users under the age of 18 years as engaged in playing a game of “online gaming for real money winnings” or suggest that such users can play these games.

The advertisements should neither suggest that online gaming presents an income-generating opportunity as an alternative to employment nor depict a person playing such games is more successful than others.

The Advertising Standards Council of India, established in 1985, is a Mumbai based self-regulatory voluntary organization of the advertising industry in India. It seeks to ensure that advertisements conform to its Code for Self-Regulation.  Under the Cable Television Networks (Regulation) Act, 1995 it is mandatory for television networks to follow the advertising code laid down by ASCI.

Ends.

‘Vaccine warriors’ brave tough terrain to ensure routine immunization in remote areas

by Ishwar Nath Jha & Raman Pandit

Najeeta Begum, an ANM worker in Karnataka’s Lingsugur taluk, walked home to home post lockdown to ensure that children who were not vaccinate for preventable infections due to the COVID-19 lockdown, are covered under routine immunization services while  60-year-old Rameshwar Prasad, an alternate vaccine delivery person in Bihar’s Gaya District, had to wade across the river during monsoon to ensure that vaccines reach their destination on time.

 Both Begum and Prasad are among around two lakh vaccine warriors who travel several kilometres to deliver life saving vaccine doses to children and pregnant women at reach remote immunization sites. They brave tough terrain and hard-to-reach areas, often by cycling or motor bike and then walking, to prevent the vaccines from falling through the cracks.

 “We have been asked by villagers not to venture. I had to answer and convince them to vaccinate their children and pregnant women,” said Begum. Begum traveled to remote villages and visited the homes on foot to request families to not to miss their child vaccination schedule and visit the sub-centre to get vaccinated. 26-year-old Begum said that she managed to cover every child and mother who could have missed their vaccination schedule.

 Prasad on the other hand, cycled, walked and even waded through rivers to deliver vaccines to remote villages of his district. “When I have to go to Bentanawadhi village, I have to park my cycle in a neighbouring village. Then I had to walk two kilometres during the lockdown period to reach there as there is no proper road. During rainy season, I wade across the river to ensure that vaccines reach on time," he said. "If I don’t go, it will affect so many women and children. So, I have continued to do it with all precautions like wearing a face mask, washing my hands regularly and maintaining physical distance during collection and distribution of vaccine carrier,” he said.

 Since vaccines need to be stored and transported at a certain temperature (+2 to +8 degrees Celsius) to ensure their potency and efficacy, women and men spearheading the Alternate Vaccine Delivery system, are given specific training. The UNICEF supported training of 674 cold chain handlers, 36 cold chain technicians and almost 45,000 AVD personnel before the re-introduction of outreach immunization sessions as soon immunization was put under essential services during covid lockdown. .

A senior government official from the ministry of health said:  "There were some gaps in coverage because of  the pandemic due to restriction in movement of man and material to contain the spread. However, the government came up with  guidelines to ensure access to essential services in mid April that resulted in guiding the states on how to conduct vaccination sessions by taking due precautions. The states too worked on innovative ideas and the services have now been restored," 

 Elaborating on the process of alternate vaccine delivery systems, UNICEF said the states have different vaccine delivery mechanisms depending on the topography of the state ranging from motocycle, cycle, boats and by foot.

 "During and after the lockdown; when the regular road transport mechanism was affected, the AVD system was functional and it supported in vaccine delivery and resumption of Routine Immunization services. The AVDs are based on local need and depending upon local support and means for transport," the official said. The government along with partners ensured supportive supervision visits to the outreach sessions and hand holding of the ANM and ASHA workers for house to house surveys to identify children who may have missed routine immunization.

 Luigi d’Aquino, Chief of Health, UNICEF India, said vaccination is one of the most effective and cost-effective ways to protect children’s lives and futures, and for building healthier and safer communities.

 Till August 2020, over 12 million children were vaccinated, a coverage of 68.5% in eight months, according to data from the Union health ministry.