Anti-epidemic second half: India backs up, Biden takes advantage

In just two months, India has achieved an “average daily increase in the number of confirmed cases per week” from 20,000 to nearly 400,000 terrorist outbreaks. Although as of May 12, the cumulative number of confirmed diagnoses in India is only 70% of that of the United States, and the per capita number is only 1/6 of that of the United States, but media sensational reports seem to have described India as an adult purgatory.

The widespread medical collapse in India has made many people suddenly pessimistic about the global anti-epidemic situation.

In fact, when India unfortunately “contracted” more than half of the world’s new confirmed cases, the new crown vaccine is rapidly being rolled out globally, especially in major economies. If we advance at the current rate of 130 million doses per week, nearly 7 billion doses can be inoculated in a year. Assuming that the updated vaccine can better deal with the mutant virus, then the global fight against the epidemic has entered the second half of “from a strategic stalemate to a strategic counterattack”, I am afraid there will be no objections.

What is controversial is that the “India factor” is currently being used to explain the surge in epidemics in many Asian countries, although the chain of transmission is not always clear and identifiable; and the exempt vaccine patent proposed by the Biden administration has limited practical effects and is quite useful. Suspected of being a show. As for the U.S. side to supply India with raw materials for vaccine production, and Indian vaccines giving priority to domestic vaccination and thus affecting international delivery, they have not yet been fully discussed.

“Industry” in India
In Japan, where nearly 60% of the people oppose the Tokyo Olympics in July, the nearly 700,000 new crown cases accumulated in 470 days can now be reached in two days in India.

India’s status as the “global epicenter of the epidemic” is not constant. In March last year, Italy, which suffered a medical collapse, won this position first and transferred it to the United States within a month. After the small peak of the summer epidemic in the United States, a second wave of unprecedented scale broke out in the winter, with the daily increase in the number of confirmed cases as high as 300,000.

In the high-risk zone with an increase of more than 100,000 cases per day, the United States spent more than three months before returning to the status of “tens of thousands” after Biden took office. During this period, a variant virus epidemic broke out in the United Kingdom at the end of the year. Thanks to effective measures such as lockdown and vaccination, the epidemic was contained almost at the same time as the United States.

At this time, the European continent, which has been behind in vaccine administration, ushered in the third wave of epidemics. Originally, before the epidemic in India soared into the sky in April, the “global epicenter of the epidemic” had returned to the European continent, and this time it was “led by France”. However, when India exerted its strength, it was like Cheng Yaojin, who was halfway through, firmly grasping this position, and it also caused Asia to catch up with North America and Europe in the overall epidemic list, and rush to the continent with the largest number of confirmed diagnoses.

What is India? In summary, there are three.

Fortunately, underestimating the enemy is one of them. Relying on being a tropical country and a young population, India has been paralyzed almost half a year after containing the first wave of the epidemic. The country is slow in vaccination, and it is also thinking of saving the world and using the oxygen and vaccines it produces in large quantities for export. As a result, last year’s inconspicuous new variant of the virus became prosperous, killing men, women, and children, not to mention the high temperature of 30 or 40 degrees.

Gathering for carnival is the second. On Holi Festival on March 29th, people from all over India, regardless of the epidemic prevention ban, took to the streets to sing and dance to celebrate the arrival of spring. From April 11, the 6-week Dahu Festival (Holy Water Bathing Festival, held by 4 cities in the Ganges River Basin in turn, this year it is the turn of Khalidwar under the Himalayas), which attracted about 7 million people from afar. Come. The Indian government refused to cancel the gathering of this ancient Hindu festival that dates back to the Vedic era.

Passive anti-epidemic is the third. India imposed a nationwide blockade last spring, but it did not flatten the curve of the epidemic, but hit the economy and people’s livelihoods severely. Therefore, when the epidemic rebounded in March this year, the authorities did not dare to strictly block traffic. Instead, they boasted of a strong economic recovery and embraced “passive groups.” “Immunity” fantasy, so that the best time window for intervention is missed. In the private sector, Indian households are accustomed to go out to purchase food ingredients every day due to the low refrigerator retention rate (only about 30%), which also greatly reduces the epidemic prevention policy.

Even if India missed Jingzhou carelessly, it was quickly remedying it afterwards, such as appealing for foreign aid, speeding up vaccination, and mobilizing the army. The number of new diagnoses per day has now fallen. As for the scenes of open-air cremation pictures and corpse burning day and night, which have been circulated by foreign media, they are quite common in the Hindu tradition.

Even if India missed Jingzhou carelessly, it was quickly remedying it afterwards, such as appealing for foreign aid, speeding up vaccination, and mobilizing the army. The number of new diagnoses per day has now fallen. As for the scenes of open-air cremation pictures and corpse burning day and night, which have been circulated by foreign media, they are quite common in the Hindu tradition.
In a normal year, about 10 million people die and 25 million people are born in India every year. As of May 12 this year, the number of confirmed cases of death due to the new crown in India has just exceeded 250,000, which is far lower than the actual number of deaths from the new crown. However, in a country where almost all people believe in religion and bear little fate, the decline in the number of confirmed deaths of new crowns is more due to technical factors (for example, the poor are reluctant to go to the hospital for examinations, and the coverage of early new crowns is low). And this kind of shrinkage is not uncommon in European and American countries, even in the calculation of the actual infection ratio.

India is most criticized by its own people for its long-term insufficient medical investment, insufficient capacity of the emergency system to deploy medical resources, and the lack of production capacity of medical oxygen. However, under the national conditions of extremely low number of doctors and intensive care beds per capita, it is not easy for India to achieve that the cumulative number of confirmed deaths per capita is only 1/10 of that of the United States.

As for the recent surge in cases in many Asian countries, there is some connection with the epidemic tsunami in India. However, apart from Nepal, where the border between the two sides is ineffective, and the Maldives, which is frequented by the rich in India, the new crown rush can be attributed to India. However, at best, India has kept the AstraZeneca vaccine originally planned to be exported since late March for its own use, which has slowed down the vaccination progress of relevant countries.

In fact, the Philippines, Indonesia, Malaysia, Thailand, Mongolia, Cambodia, and many countries in West Asia, where the epidemic has a high fever, are not in the “close contact” circle of India. Even in Pakistan, Bangladesh, and Sri Lanka, which surround India, it cannot be said that most of the viruses are transmitted from India.

Sri Lanka’s rapid increase in cases is mainly attributed to the New Year’s gathering in mid-April; the country’s current epidemic is the British variant virus, not the Indian double variant virus. The growth rate of the epidemic in Pakistan since March has not been alarming, and the peak of the epidemic in Bangladesh has also been leveled out quickly. They do not need to pull India to help themselves.

Biden’s “show field”
The recent global epidemic is serious, but it is not the end of the world. On April 26, the “average daily increase in the number of confirmed cases per week” peaked, with an average daily increase of 863,000 cases. Compared with the previous peak, the average of 766,000 cases recorded on January 9, this is only a small increase of 1/8. Moreover, the worst seems to have passed-within two weeks after the “peak” on April 26, the above-mentioned average infection value has dropped by nearly 30%.

Looking at the “average daily increase in the number of confirmed deaths per week”, the global situation throughout April was not worse than in January this year. This is largely due to the spread of vaccination.

Except for the small places such as Gibraltar and Seychelles, the common countries with high COVID-19 vaccination rates are Israel, the United Arab Emirates, Chile, the United Kingdom, the United States, and Hungary in order. After Israel took the lead in realizing “mask freedom”, it was full of joy and sorrow: In the early morning of April 30, a stampede accident occurred at a religious gathering in Mount Meron in the north, killing 45 people.

China, the United States, and India are the three countries that have administered the most new crown vaccine doses, but China and India are not leading the way per capita.

As of May 14th, 1.4 billion doses have been vaccinated globally, which is equivalent to 17.94 doses per 100 people in the world, which is far from forming an immune barrier. However, the United States moved quickly, with more than 110 million people who completed two doses of the vaccine, accounting for more than one-third of the country’s population. In addition, the number of new crown vaccines ordered by the United States (more than 1 billion doses) is sufficient for future use, and the Biden administration began vaccine diplomacy.

On May 4, Biden announced that the United States will become the world’s “arms arsenal against the new crown epidemic.” He announced that he would ship 60 million doses of AstraZeneca vaccines abroad and “produce as many Modena and Pfizer vaccines as possible and export them to the world.”

The White House’s decision to provide millions of vaccines to India is easy because thousands of people die from the new crown every day in India, but for countries such as Ukraine where new infections are on the decline, the decision is relatively tricky. When countries are scrambling to seek international new crown assistance, if the United States uses the Ukrainian-Russian military struggle as a reason to give priority to supplying vaccines to Ukraine, then South American countries with high epidemics may criticize the fairness of such distribution of vaccines.

One of the most controversial anti-epidemic decisions of the Biden administration is the plan to terminate the company’s enforcement power on the new crown vaccine patent. This means that once the U.S. Congress passes such legislation, original vaccine companies will not be able to sue in the United States for infringement of companies that imitate the new crown vaccine during the patent period.

The plan not only met with opposition from the Republican Party and Pfizer and other American pharmaceutical companies, but also aroused opposition from powerful pharmaceutical companies such as Germany and the United Kingdom. The 27 EU countries also collectively expressed their opposition at the May 8 summit.

Why did Biden, who pays attention to negotiating with allies, suddenly make such a move?

In fact, this was Biden’s campaign promise, but few people believed that he would implement it, because many of Biden’s funders were large pharmaceutical companies. But Biden’s consideration is that for the top US vaccine companies, giving up patents is only symbolic, but it can alleviate the international criticism of the US’s insufficient supply of vaccines to developing countries.

The patent is usually public, but the details of the process are unclear. Inactivated vaccine technology is mature, and basic patents have expired; there are not many effective patents for adenovirus vector vaccines (AstraZeneca, Johnson & Johnson), and abandonment has little effect; as for imitation mRNA vaccines (Pfizer/BioNTech, Modena) and recombinant protein vaccines (Novavax), it’s not that easy technically. What’s more, the United States actually controls most of the raw materials for vaccine production. Even if Indian companies copy them, it will take a long time to pass the high-standard Phase III clinical trials and the approval procedures of various countries.

Many of Biden’s financial owners are major pharmaceutical companies. But Biden’s consideration is that for the top US vaccine companies, giving up patents is only symbolic, but it can alleviate the international criticism of the US’s insufficient supply of vaccines to developing countries.
As early as last October, India and South Africa proposed to the WTO for the first time to suspend the intellectual property rights of drugs and technologies related to the new crown. The proposal was quickly rejected by Europe and the United States. At that time, the American vaccine company Modena voluntarily announced the abandonment of its vaccine patent rights. But the company recently pointed out that there is a lack of generic companies that can quickly produce similar vaccines and obtain approvals. According to Indian media reports on April 20, if the United States does not provide India with 37 key raw materials, India’s new crown vaccine production line will be shut down within a few weeks.

Compulsory withdrawal of patent protection for vaccines, even if it does little harm to the original research drug companies in practice, in theory will intensify the current competition for scarce vaccine raw materials and discourage drug companies from investing in the next epidemic. It is understandable that a large generic drug country such as India issued a “patent compulsory license” in the early years, and the United States, a large original drug country, has also followed suit, and it seems that it has nothing to do with it or even a political show.

Africa Epidemic Suspense
Because the outside world is not optimistic about the above-mentioned one-size-fits-all vaccine patent exemption plan, the White House’s position has changed to support the “temporary withdrawal” of patent protection for the new crown vaccine. But French President Macron still clings to the existing “vaccine and raw material export restrictions” in the United States, criticizing the Anglo-Saxon countries for reluctance to share vaccines with poorer countries.

In poorer countries, unlike India, the “World Pharmacy”, the overall new crown vaccination rate in African countries is very lagging, and only Morocco is keeping up with the rhythm. From the perspective of vaccination volume, Africa currently accounts for only about 1.5% of the world’s total. Fortunately, the epidemic in Africa is not too serious. The cumulative number of confirmed diagnoses is less than 5 million (only 1/5 of India), while Asia and Europe are moving towards the 50 million milestone, and South America has exceeded 26 million.

Although South Africa has returned the Indian-made AstraZeneca vaccine, which is said to be basically ineffective against its variant virus, other countries in Africa still need this relatively easily available and highly-scoring vaccine. Obviously, the Indian epidemic tsunami will affect the supply of vaccines in a large number of developing countries, including African countries. Previously, 80% of the vaccines in the WHO COVAX global distribution plan were produced in India.

The new crown vaccine developed by China is becoming a substitute for the AstraZeneca vaccine produced by India. Although most of the more than 50 countries that have introduced Chinese vaccines only use it as a combination of vaccines, there are also 7 African countries (Zimbabwe, Senegal, Equatorial Guinea, Gabon, Niger, Mauritania, Cameroon) and Kyrgyzstan. Use Chinese vaccines.

In the second half of the fight against the epidemic in India’s “cause” and Biden’s “show”, if Africans can get more alternative vaccines, including Sino-Russian vaccines, they may be able to avoid the vast ocean of viruses like India.

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